TY - JOUR
AU - B. Zhang
AU - O. Blyuss
AU - K. D. Arendse
AU - L. T. Mounce
AU - R. Dobson
AU - G. Funston
A1 - 
AB - 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.
AD - Centre for Cancer Screening, Prevention and Early Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, UK baoyue.zhang@qmul.ac.uk.; Centre for Cancer Screening, Prevention and Early Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, UK.; Department of Pediatrics and Pediatric Infectious Diseases, Sechenov University, Moscow, Russia.; Institute of Health Research, University of Exeter, Exeter, UK.; Department of Neurology, Royal London Hospital, Barts Health NHS Trust, London, UK.
AN - 42009602
BT - Br J Gen Pract
C5 - Opioids & Substance Use
CP - 766
DA - 05/2026
DO - 10.3399/bjgp.2025.0210
DP - NLM
ET - 20260430
IS - 766
JF - Br J Gen Pract
LA - eng
N2 - 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.
PY - 2026
SN - 0960-1643
SP - e398
EP - e407+
ST - Prediagnostic prescription patterns in multiple sclerosis: a UK-based longitudinal linked data study
T1 - Prediagnostic prescription patterns in multiple sclerosis: a UK-based longitudinal linked data study
T2 - Br J Gen Pract
TI - Prediagnostic prescription patterns in multiple sclerosis: a UK-based longitudinal linked data study
U1 - Opioids & Substance Use
U3 - 10.3399/bjgp.2025.0210
VL - 76
VO - 0960-1643
Y1 - 2026
ER -