Sleep Disorders, Anemia, Pain May Be Part of Multiple Sclerosis Prodrome

The following article is part of conference coverage from the Americas Committee for Treatment and Research in Multiple Sclerosis 2020 Forum in West Palm Beach, Florida. Neurology Advisor‘s staff will be reporting breaking news associated with research conducted by leading experts in neurology. Check back for the latest news from the ACTRIMS 2020 Forum.

WEST PALM BEACH, FL — The multiple sclerosis (MS) prodrome is characterized by fatigue, sleep disorders, anemia, and pain, according to study results presented at the Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) 2020 Forum held from February 27 to 29, 2020, in West Palm Beach, Florida.

Increasing evidence exists that MS has a prodromal phase. The objective of the study researchers was to identify components of the prodrome phase in MS and to assess modifying effects of gender and age.

In this population-based study, researchers identified patients with MS from linked databases in British Columbia, Canada. Each patient was matched with up to 5 controls without multiple sclerosis by gender, age, and region. The odds of hospital admissions or physician visits for fatigue, sleep disorders, anemia, and pain within 5 years prior to the first demyelinating claim or onset of MS symptoms were compared with those of matched controls using logistic regression. Researchers also evaluated the modifying effects of age and sex on the association between MS and these conditions. 

Results revealed that during the 5 years before the first demyelinating event, fatigue (adjusted odds ratio [aOR], 3.37; 95% CI, 2.76-4.10), sleep disorders (aOR, 2.61; 95% CI, 2.34-2.91), anemia (aOR, 1.53; 95% CI, 1.32-1.78), and pain (aOR, 2.15; 95% CI, 2.03-2.27) were more frequent among patients with MS than among controls.

The association between anemia and MS was greater in men than in women (aOR, 2.40; 95% CI, 1.68-4.29 vs aOR 1.23; 95% CI, 1.04-1.45), and the association between pain and MS increased with age (aORs, <30 years=1.76; 95% CI, 1.49-2.06; 30 to <50 years=2.14; 95% CI, 1.98-2.30; ≥50 years=2.35; 95% CI, 2.13-2.60).

Sleep disorders and pain were also more prevalent among cases of MS (aOR 1.72; 95% CI, 1.12-2.56 vs aOR 1.53; 95% CI, 1.32-1.76) than among controls during the 5 years before the onset of MS symptoms.

The study researchers concluded that fatigue, anemia, pain, and sleep disorders form part of the prodrome in MS. Moreover, during this period, anemia is higher among men, and pain burden is higher among older adults.

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Reference

Yusuf F, Wijnands J, Kingwell E, et al. Fatigue, sleep disorders, anaemia and pain in the five years preceding the first demyelinating event or onset of multiple sclerosis. Abstract presented at: 5th Annual Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum; February 27-29, 2020; West Palm Beach, FL.

This article originally appeared on Neurology Advisor