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Bergeron-Vitez, Himali

University of British Columbia

Introduction: There is evidence of a prodromal phase in multiple sclerosis (MS), which may involve increased health care visits for pain-related issues in the years preceding MS onset. Over 50% of MS patients experience neuropathic pain, with gabapentinoids and/or other anticonvulsants among the first-line treatments for neuropathic pain. This study’s objective was to estimate the number of MS cases vs matched controls who filled at prescriptions gabapentinoids with and without other anticonvulsants (as use of both may suggest epilepsy treatment). Methods: This population-based matched cohort study used health administrative data from British Columbia, from 1996 to 2013. MS cases were defined based on a previously validated criteria and their first demyelinating-disease claim was defined as the index date. Up to 5 controls were matched to cases by sex, age, calendar-year, and geographical location at index date. In the five years before the index date, we compared cases and controls regarding use of anticonvulsants and gabapentinoids not combined with anticonvulsants Age-and-sex adjusted odds ratios (aOR) and 95% confidence intervals (CIs) were estimated using logistic regression. Results: The cohort comprised 4,862 MS cases and 22,669 controls; 72% were female. In the 5 years before the index date, 992 (20%) cases and 1,600 (7.1%) controls filled at least one prescription for any anticonvulsant, while 371 (7.6%) cases and 473 (2.1%) controls filled at least one prescription for gabapentinoids not combined with any other anticonvulsants. The odds of a filled prescription were higher for cases than controls for any anticonvulsants (aOR = 3.40, 95% CI: 3.12, 3.71), and for gabapentinoids without other anticonvulsants (aOR = 4.05, 95% CI: 3.52, 4.66). Conclusion: Neuropathic pain-related medication use was more common for MS patients in the five years before MS onset versus matched controls, suggesting that neuropathic pain may be part of the MS prodrome.

Text

2024-09-30

Attribution-NonCommercial-NoDerivatives 4.0 International

http://hdl.handle.net/2429/85529

Pharmacology

University of British Columbia

UBCV

http://creativecommons.org/licenses/by-nc-nd/4.0/