Medication Use in Multiple Sclerosis: A Population-Based Comparison With the General Danish Population

OBJECTIVE: To investigate the overall use of prescription medications among individuals with multiple sclerosis compared to the general population, with a focus on treatments beyond disease-modifying therapies.

METHODS: We conducted a nationwide, registry-based study in Denmark. All residents with a diagnosis of multiple sclerosis aged 20-80 years and alive on January 1, 2023, were included and followed for 1 year. Each patient was matched with 10 individuals from the general population based on age, sex, and residence. Prescription data were obtained from the Danish National Prescription Registry and categorized using the Anatomical Therapeutic Chemical classification. Relative risks of medication use were calculated.

RESULTS: A total of 14,491 individuals with multiple sclerosis and 144,910 matched controls were included. Patients with multiple sclerosis had significantly higher use of several therapeutic drug classes, including analgesics (51% vs. 33%; RR: 1.56, 95% CI: 1.52-1.60), agents for constipation (12% vs. 3%; RR: 4.61, 95% CI: 4.36-4.88), spasmolytics, and urological medications. Among specific drugs, the most pronounced differences were observed for modafinil (RR: 323.33, 95% CI: 228.67-457.19), baclofen (RR: 36.51, 95% CI: 33.33-39.99), and fesoterodine (RR: 36.36, 95% CI: 18.66-70.87). In contrast, individuals with multiple sclerosis had lower usage of antidiabetic medications and treatments for chronic obstructive pulmonary disease.

INTERPRETATION: This large, population-based study reveals extensive use of medications targeting symptoms and comorbidities in individuals with multiple sclerosis. These insights can guide healthcare providers in optimizing patient management, addressing overlooked treatment needs, and improving overall care.