Medication Use in RRMS Patients Highlights Importance of Better Treatment Management, Study Says

Patients with relapsing-remitting multiple sclerosis, particularly those with multiple conditions who are more severely disabled, are more likely to be using several medications at the same time, a study shows.

These findings highlight the need for physicians to be aware of what medications their patients are taking to avoid unnecessary prescriptions and potentially harmful interactions.

The simultaneous use of five or more medications, a practice known as polypharmacy, has been increasing among the general population. Older people are often particularly affected, because they are more likely to have comorbidities — multiple medical conditions present at the same time — leading to an increase in the number of medications taken.

Ignoring polypharmacy in treatment plans can lead to serious interactions between therapies and unnecessary costs to the patients. 

Given the chronic nature of MS, “treatment with various therapies is a frequent scenario in clinical practice,” the researchers wrote in this study. But there are only a few studies on partial aspects of polypharmacy in these patients.

To take a closer look at this phenomenon, the researchers at the University of Rostock in Germany investigated polypharmacy in RRMS patients. They investigated possible links between sociodemographic and clinical factors with polypharmacy as well as links between the occurrence of comorbidities and all medications taken by the participants.

A total of 145 RRMS patients were examined, with about one-third (30.3%) reporting polypharmacy. Disease-modifying therapies were the most often-used medications, followed by dietary supplements.

This is consistent with other studies showing that taking supplements, dietary or herbal, is common among MS patients, making up a large part of their self-medication. The researchers pointed out that neglecting such prescription-free supplements by physicians carries a certain risk of possible medication interactions and side effects. 

Results showed that those with polypharmacy were older — 45.9 years compared with 41.7 years in patients without polypharmacy; and twice as likely to be retired — 59.1% vs. 30.7%, respectively.

Non-polypharmacy patients had significantly more years in school than polypharmacy patients, suggesting an association between the level of education and polypharmacy.

Non-polypharmacy patients also had lower disability scores, assessed by the Expanded Disability Status Scale (EDSS), compared with polypharmacy patients — 2 versus 3.

Researchers observed that roughly half of the participants had comorbidities, the most prevalent of which were thyroid diseases, gastrointestinal diseases, spasticity, and deficiency symptoms.

Interestingly, the rate of polypharmacy in the patient group with comorbidities was much higher than in the group without — 46.8% versus 11.8%.

These findings point to the importance of well-thought-out medication management, particularly in RRMS patients with comorbidities.

“Our study showed that polypharmacy plays an important role for MS patients and that it is associated with a higher EDSS score. RRMS patients with secondary illnesses are particularly affected by polypharmacy,” the researchers wrote.

Nonetheless, according to the team, “further evidence is needed on how polypharmacy poses an issue in the management of MS and this demands a prospective study of side effects, drug interactions, and adherence problems.”