Psychotropic medication use and bone fracture risk among patients with multiple sclerosis: a real-world study
Main finding · All fracturesResult — go to the resultHazard ratio 2.41 95% CI 2.22–2.63Authors' conclusion
Psychotropic medication use was associated with increased fracture and relapse risk in multiple sclerosis, driven primarily by opioid analgesics, without an effect on mortality.
Study context
- Population
- Adult patients with multiple sclerosis, TriNetX Research Networkafter matching
- Participants
- 117,534 patients
- Exposure
- Psychotropic medication use vs no psychotropic use in multiple sclerosis (MS)
- Outcome
- Primary outcomes: all fractures (hip, vertebral, extremity), MS relapse and mortality
- Follow-up
- 5 years
Methodological detailsglobal, propensity-score matched (1:1), TriNetX Research Network
- Global
- Propensity-score matched (1:1)
- TriNetX Research Network
Main finding
All fractures
Hazard ratio
2.41
95% CI 2.22–2.63
P < 0.001
Psychotropicsvs Control
HR 2.41 (95% CI 2.22–2.63); P < 0.001
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Primary outcome: MS relapse · 5 yearsNNH, 6 | 3.63 (3.51–3.75) | P < 0.001 | |
| 0.20.5125Hazard ratio (log scale) |
Fractures, opioid users (subgroup) · 5 years
| HR (95% CI) | P value | ||
|---|---|---|---|
| OpioidsNNH, 24 | 3.83 (3.45–4.25) | P < 0.001 | |
| 0.20.5125Hazard ratio (log scale) |
Primary outcome: mortality · 5 years
- No significant difference in mortality
Fractures, opioid users (subgroup) · 5 years
- Analgesic use was the primary contributor to fracture risk (interaction testing)
- Non-opioid analgesics: no significant association with overall fracture risk
Original publication
Psychotropic medication use and bone fracture risk among patients with multiple sclerosis: a real-world study. Osteoporos Int. Published 16 February 2026. doi:10.
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