Gastrointestinal conditions in the multiple sclerosis prodrome.
Ann Clin Transl Neurol
; 11(1): 185-193, 2024 01.
Article
em En
| MEDLINE
| ID: mdl-38115680
ABSTRACT
OBJECTIVE:
To investigate gastrointestinal (GI)-related physician visits and drug dispensations in the 5 years preceding a first recorded demyelinating event or multiple sclerosis (MS) onset.METHODS:
Using linked administrative and clinical data from British Columbia (1996-2013), Canada, we identified an administrative cohort via a validated algorithm (n = 6863), a clinical cohort diagnosed at a MS clinic (n = 966), and matched controls (administrative cohort n = 31,865; clinical cohort n = 4534). In each cohort, the 5 years before a first demyelinating event or MS symptom onset (i.e., index date) were examined. We compared rates of GI-related physician visits and risk of ≥1 GI-related dispensation between MS cases and controls using negative binomial and robust Poisson models. Sex differences were tested using interaction terms.RESULTS:
The administrative cohort MS cases had higher rates of physician visits related to gastritis and duodenitis (adjusted rate/risk ratio (aRR)1.42, 95% CI 1.10-1.83) and diseases of the esophagus (aRR 1.46, 95% CI 1.06-2.02) prior to the index date. MS cases also had greater risk of at least one dispensation for several drug classes, including constipation-related (aRR 1.82, 95% CI 1.50-2.22), antiemetics/antinauseants (aRR 1.64, 95% CI 1.43-1.89), and propulsives (promotility drugs; aRR 1.62, 95% CI 1.47-1.79). Men had a disproportionally higher relative risk for propulsives than women (aRR men = 2.32, 95% CI 1.79-3.00; women = 1.54, 95% CI 1.36-1.72). Several findings were similar in the smaller clinical cohort though none reached statistical significance.INTERPRETATION:
GI-related physician visits and drug dispensations were more common in the 5 years before the first demyelinating event versus matched controls. GI symptoms are a measurable feature of the prodromal or early phase of MS, with a sex difference evident.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Gastroenteropatias
/
Esclerose Múltipla
Limite:
Female
/
Humans
/
Male
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Ann Clin Transl Neurol
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Canadá