What question did this study set out to answer?

This study aims to explore prescription patterns before a multiple sclerosis diagnosis to identify early detection opportunities.

April 22, 2026British Journal of General Practice1 citationsOpen Access

Prediagnostic prescription patterns in multiple sclerosis: a UK-based longitudinal linked data study

BZBaoyue ZhangQueen Mary University of London OBOleg BlyussQueen Mary University of London KAKirsten D. ArendseQueen Mary University of London

Puntos clave

This study aims to explore prescription patterns before a multiple sclerosis diagnosis to identify early detection opportunities.
Conducted a case-control study using primary care data from 2001 to 2022
Applied multivariable conditional logistic regression to analyze prescription associations with MS
Used Poisson regression to identify inflection points in prescription rates over time prediagnosis.
Found positive associations between seven prescription types and MS diagnosis, with heightened odds in the 2 years before diagnosis.
Inflection points in prescription rates were identified for various symptoms like gastrointestinal issues and anxiety/depression, suggesting changes years before diagnosis.
Overall, prescription rates for certain symptoms were significantly higher in those later diagnosed with MS than in matched controls.

Resumen

Background Early detection of multiple sclerosis (MS) could improve patient outcomes. Changes in clinical activity before MS diagnosis may represent ‘diagnostic windows’ for earlier detection. Aim To determine whether certain prescriptions are more common in patients with MS and examine prescription patterns prediagnosis in the UK. Design and setting Case–control study using routinely collected primary care data. Patients in the case group had an MS diagnosis (2001–2022) and patients in the control group were matched by birth year. Method Multivariable conditional logistic regression adjusting for sex and socioeconomic status (SES) examined associations between MS diagnosis and prescriptions for anxiety/depression, migraine, lower urinary tract symptoms (LUTS), urinary tract infection (UTI) treatments, sleep disorder, gastrointestinal (GI) symptoms, and erectile dysfunction (ED) in the 0–2, 2–5, 5–10 years prediagnosis/match date. Poisson regression adjusting for age, sex, and SES estimated the inflection points in the case group at which the rate of prescriptions changed from baseline, identifying the start of diagnostic windows. Results In total, there were 9662 patients in the case group and 56 455 in the control group. Positive associations were found between seven prescriptions and MS diagnosis, with highest odds ratios (3–7 times) in the 2 years prediagnosis. In the all-prescription analysis, inflection points were identified for: GI (69–72 months, 95% confidence interval CI = 51 to 90), LUTS (69–72 months, 95% CI = 30 to 111), UTI (66–69 months, 95% CI = 45 to 90), migraine (63–66 months, 95% CI = 27 to 102), ED (60–63 months, 95% CI = 30 to 93), and anxiety/depression (9–12 months, 95% CI = 3 to 18). Conclusion Prescriptions for symptoms of possible MS were more common in the case group than the control group up to 10 years prediagnosis. Prescription rates changed years prediagnosis, indicating potential opportunities for earlier detection, but broad CIs demonstrated uncertainty regarding diagnostic window duration.

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