Polypharmacy in patients with multiple sclerosis: a gender-specific analysis

Biol Sex Differ. 2019 May 27;10(1):27. doi: 10.1186/s13293-019-0243-9.

Abstract

Background: Multiple sclerosis (MS) affects about three times more women than men. Due to variable MS courses, multiple therapies are necessary in clinical practice.

Objective: We aimed at conducting sex-specific analyses of MS patients regarding polypharmacy (≥ 5 drugs) and at identifying differences in the medication spectrum.

Methods: Clinico-demographic data were gathered from 306 patients using clinical examinations, structured patient interviews, and patient records. Statistical data analyses were performed to evaluate whether the same or different factors are associated with polypharmacy in both genders.

Results: Women (N = 218) and men (N = 88) showed similar polypharmacy rates (56.0% vs. 58.0%; p = 0.799). For both genders, higher age, severe disability degrees, comorbidities, and inpatient treatment were significantly associated with a higher polypharmacy risk. Low educational levels were predictors of polypharmacy only in women. Fampridine (p < 0.021) and antispasmodics (p < 0.010) were used more often by men, while women took more frequently thyroid medications (p < 0.001) and contraceptives (p < 0.001). The age-related increase in medication use was much stronger in women (p < 0.001).

Conclusion: Male and female MS patients with older age, comorbidities, higher disability degree, and inpatient treatment are at greater risk of polypharmacy. Future studies should examine the occurrence of clinically relevant drug interactions in MS patients stratified by sex.

Keywords: Comorbidity; Concomitant drugs; Gender; Medication management; Multiple sclerosis; Patient care; Polypharmacy.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Comorbidity
  • Disability Evaluation
  • Drug Utilization
  • Educational Status
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multiple Sclerosis / drug therapy*
  • Polypharmacy*
  • Sex Characteristics*
  • Young Adult