Anticonvulsant and gabapentinoids pharmacotherapy in the multiple sclerosis prodrome: A population-based matched cohort study

Himali Bergeron-Vitez; Fardowsa LA Yusuf; Feng Zhu; Yinshan Zhao; Charity Evans; John D Fisk; Ruth Ann Marrie; John Lk Kramer; Helen Tremlett

doi:10.1016/j.msard.2024.106167

Anticonvulsant and gabapentinoids pharmacotherapy in the multiple sclerosis prodrome: A population-based matched cohort study

Mult Scler Relat Disord. 2024 Nov 16:93:106167. doi: 10.1016/j.msard.2024.106167. Online ahead of print.

Authors

Himali Bergeron-Vitez¹, Fardowsa LA Yusuf², Feng Zhu³, Yinshan Zhao³, Charity Evans⁴, John D Fisk⁵, Ruth Ann Marrie⁶, John Lk Kramer⁷, Helen Tremlett⁸

Affiliations

¹ International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, Canada; Department of Anesthesiology, Pharmacology and Therapeutics, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
² School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada; Djavad Mowafaghian Centre for Brain Health and Faculty of Medicine (Neurology), University of British Columbia, Canada.
³ Djavad Mowafaghian Centre for Brain Health and Faculty of Medicine (Neurology), University of British Columbia, Canada.
⁴ College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada.
⁵ Nova Scotia Health and the Departments of Psychiatry, Psychology & Neuroscience, and Medicine, Dalhousie University, Halifax, NS, Canada.
⁶ Departments of Internal Medicine and Community Health Sciences, Health Sciences Centre, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
⁷ International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, Canada; Department of Anesthesiology, Pharmacology and Therapeutics, Faculty of Medicine, University of British Columbia, Vancouver, Canada; Djavad Mowafaghian Centre for Brain Health and Faculty of Medicine (Neurology), University of British Columbia, Canada.
⁸ Djavad Mowafaghian Centre for Brain Health and Faculty of Medicine (Neurology), University of British Columbia, Canada. Electronic address: helen.tremlett@ubc.ca.

PMID: 39616772
DOI: 10.1016/j.msard.2024.106167

Abstract

Background: Before disease onset, multiple sclerosis (MS) persons fill more prescriptions than controls, including for pain. However, knowledge regarding neuropathic pain-related medications is lacking OBJECTIVE: Compare odds of anticonvulsant/gabapentinoid prescriptions for 4,862 MS-cases versus 22,669 controls, pre-MS onset (defined as first demyelinating disease-related event).

Methods: Matched-cohort study using administrative data (1996-2013), comparing the odds of anticonvulsant/gabapentinoid prescriptions pre-MS onset using multivariable logistic regression.

Results: Versus controls, MS-cases were more likely to fill prescriptions for anticonvulsants (aOR[adjusted odds ratios] = 3.1,95 % confidence interval[CI]:2.8,3.4), gabapentinoids (aOR = 4.1,95 %CI:3.6,4.6), and gabapentinoids without anticonvulsants (aOR = 3.9,95 %CI:3.4,4.5).

Conclusion: MS-cases filled anticonvulsant and gabapentinoid prescriptions more than matched controls pre-MS onset.

Keywords: Health administrative data; Multiple sclerosis; Neuropathic; Prodrome; pain.