Contributions
Abstract: P874
Type: Poster
Abstract Category: Clinical aspects of MS - 5 Epidemiology
Background: Several environmental and lifestyle factors have been associated with multiple sclerosis (MS) risk, including some pharmacological treatments. We systematically reviewed the literature on prescription drug exposure and MS risk.
Methods: Six databases were searched for original observational studies reporting drug exposure and MS risk published before 2017.
Results: Thirteen articles fulfilled inclusion criteria. Exposure to neither amiloride nor valproic acid was associated with MS (adjusted hazard ratio (adj.HR=1.34;95% CI:0.81-2.20; adj.HR=1.30;95%CI:0.44-3.80, respectively). Four studies explored oral contraceptive (OC) exposure and reported no association with MS; while a single study found an increased risk (odds ratio (adj.OR)=1.52;95%CI:1.21-1.91). While penicillin exposure was associated with reduced risk of developing MS (adj.OR=0.5;95%CI:0.3-0.9), a later study observed an elevated risk for penicillin (adj.OR=1.21;95%CI:1.10-1.27) and all antibiotics (adj.OR=1.41;95%CI:1.29-1.53), which was potentially attributed to underlying infection. Anti-TNFα was not associated with MS risk in persons with inflammatory bowel disease (Standard Morbidity Ratio=4.2;95%CI:0.1-23.0) and arthritis (Standardized Incidence Ratio (SIR)=1.38;95%CI:0.69-2.77); however, men exposed to anti-TNFα who also had arthritis and individuals with ankylosing spondylitis were at an increased risk (SIRs= 3.91;95%CI:1.47-10.42 and 3.48;95%CI:1.45-8.37, respectively). A reduced risk of MS was observed with exposure to the beta2-adrenergic agonist fenoterol (adj.OR=0.58;95%CI:0.45-0.76); and the sedating histamine 1-receptor antagonists (adj.OR=0.2;95%CI:0.1-0.8), but not the non-sedating equivalent (adj.OR=0.8;95%CI:0.4-1.6).
Conclusions: The suggestion that some drugs may prevent MS is intriguing and warrants further study. In addition, further pharmacovigilance is needed to assess the safety of anti-TNFα drugs in specific populations in the context of MS risk.
Disclosure:
Helen Tremlett is funded by the Canada Research Chair program and in the last year has received research support from the National Multiple Sclerosis Society, the Canadian Institutes of Health Research, the Multiple Sclerosis Society of Canada and the Multiple Sclerosis Scientific Research Foundation.
Kyla McKay receives research funding from the Canadian Institution of Health Research.
Heather Yong and Cole Daley have no conflict of interests to declare.
Abstract: P874
Type: Poster
Abstract Category: Clinical aspects of MS - 5 Epidemiology
Background: Several environmental and lifestyle factors have been associated with multiple sclerosis (MS) risk, including some pharmacological treatments. We systematically reviewed the literature on prescription drug exposure and MS risk.
Methods: Six databases were searched for original observational studies reporting drug exposure and MS risk published before 2017.
Results: Thirteen articles fulfilled inclusion criteria. Exposure to neither amiloride nor valproic acid was associated with MS (adjusted hazard ratio (adj.HR=1.34;95% CI:0.81-2.20; adj.HR=1.30;95%CI:0.44-3.80, respectively). Four studies explored oral contraceptive (OC) exposure and reported no association with MS; while a single study found an increased risk (odds ratio (adj.OR)=1.52;95%CI:1.21-1.91). While penicillin exposure was associated with reduced risk of developing MS (adj.OR=0.5;95%CI:0.3-0.9), a later study observed an elevated risk for penicillin (adj.OR=1.21;95%CI:1.10-1.27) and all antibiotics (adj.OR=1.41;95%CI:1.29-1.53), which was potentially attributed to underlying infection. Anti-TNFα was not associated with MS risk in persons with inflammatory bowel disease (Standard Morbidity Ratio=4.2;95%CI:0.1-23.0) and arthritis (Standardized Incidence Ratio (SIR)=1.38;95%CI:0.69-2.77); however, men exposed to anti-TNFα who also had arthritis and individuals with ankylosing spondylitis were at an increased risk (SIRs= 3.91;95%CI:1.47-10.42 and 3.48;95%CI:1.45-8.37, respectively). A reduced risk of MS was observed with exposure to the beta2-adrenergic agonist fenoterol (adj.OR=0.58;95%CI:0.45-0.76); and the sedating histamine 1-receptor antagonists (adj.OR=0.2;95%CI:0.1-0.8), but not the non-sedating equivalent (adj.OR=0.8;95%CI:0.4-1.6).
Conclusions: The suggestion that some drugs may prevent MS is intriguing and warrants further study. In addition, further pharmacovigilance is needed to assess the safety of anti-TNFα drugs in specific populations in the context of MS risk.
Disclosure:
Helen Tremlett is funded by the Canada Research Chair program and in the last year has received research support from the National Multiple Sclerosis Society, the Canadian Institutes of Health Research, the Multiple Sclerosis Society of Canada and the Multiple Sclerosis Scientific Research Foundation.
Kyla McKay receives research funding from the Canadian Institution of Health Research.
Heather Yong and Cole Daley have no conflict of interests to declare.