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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.

PDF of Module

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.