Abstract| Volume 37, 101604, January 2020

Osteoporosis in Multiple Sclerosis: The Bystander Effect

      Osteoporosis is a frequently encountered medical issue in practice. Several studies in patients with multiple sclerosis (MS) have shown a lower Bone Mineral Density (BMD) when compared to their age matched healthy controls; nonetheless, it has been found to be prevalent in patients with MS and contributes to both morbidity and mortality in this population. We aimed to determine if MS patients are screened and managed for osteoporosis at our facility.
      A retrospective chart review of 28 patients between the ages of 45-70 years was conducted. Data collected included gender, MS type, mobility status, falls risk, history of glucocorticoid, smoking and alcohol use and lastly supporting radio graphic evidence; such as x-rays or BMD scan. Other data gathered included Vitamin D level, calcium supplementation and agents used for osteoporosis treatment.
      Our cohort was comprised of 26 patients with either primary or secondary progressive MS; 24 of which were Emiratis and the remaining 2 were Arab non-nationals. Falls risk was significant in 19 patients. Wheel chair dependency was found in 10 patients and 7 had limited overall mobility.
      All patients were supplemented with Vitamin D. However, only 8 had at least one course of IV Glucocorticoids. BMD scan was performed on 8 patients. Eight patients were diagnosed with Osteopenia/Osteoporosis, out of which 3 were treated with bisphosphonates. Two patients had X-Ray evidence of fractures.
      Our findings show limited active participation by neurologists and physicians in general regarding the bone health of this cohort of MS patients. One major limitation of our study is that many of our patients are seen at multiple facilities, which may skew our findings towards the null. In conclusion, we propose that all MS patients should undergo a yearly structured and thorough bone health risk factor evaluation and be treated accordingly.