Osteoporosis and multiple sclerosis: Exploring the complex intersection between bone and brain, a clarion call for change

Abstract

Osteoporosis is a common but often underrecognized condition in people with multiple sclerosis (PwMS), occurring more frequently and at an earlier age compared to the general population. It leads to an increased risk of fractures due to reduced bone mineral density (BMD). This review identifies key risk factors contributing to osteoporosis in PwMS, including age, vitamin D deficiency, reduced mobility, and long-term corticosteroid use. In addition to these factors, shared inflammatory mechanisms between MS and osteoporosis, such as elevated pro-inflammatory cytokines, further exacerbate bone loss. Strategies for early identification and proactive management are also discussed, highlighting their importance in reducing fracture risk and improving outcomes. The ultimate aim is to promote tailored pharmacological treatments, effective interventions, and comprehensive management of osteoporosis in PwMS.

Keywords: Bone mineral density; Corticosteroids; Fracture risk; Multiple sclerosis; Osteoporosis.