Bone Health

Patsakos EM, Mirkowski M, Bruno T, Craven BC, on behalf of the MSBEST Team. (2019). Bone Health. Multiple Sclerosis Best Evidence-Based Strategies and Treatment/Therapies for Rehabilitation. Version 1.0: p. 1-16.

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This module provides a comprehensive overview of the available evidence for pharmacological and non-pharmacological interventions for the prevention and treatment of low bone mass and high fragility fracture risk in persons with multiple sclerosis.

Key Points

  • Fingolimod may prevent declines in bone mass in persons with MS.
  • It is unclear if interferon beta improves bone mineral density in persons with MS, but it may induce changes in proteins related to bone homeostasis.
  • A physical activity behavioural intervention may result in improved bone mineral density and bone mineral content in persons with MS.
  • Vitamin D deficiency or insufficiency are common in the MS population. Supplementation with vitamin D3 increases serum levels of vitamin D; however, the effects of vitamin D supplementation on fracture risk are not known.
  • Evidence for bone strengthening treatments specifically for the MS population is unavailable. Cautious extrapolation from other clinical populations is currently standard practice in most MS clinical care settings.

2017 literature search

Module to be updated