Publication: The influence of smoking on the pattern of disability and relapse risk in AQP4-positive Neuromyelitis Optica Spectrum Disorder, MOG-Ab Disease and Multiple Sclerosis
Issued Date
2021-04-01
Resource Type
ISSN
22110356
22110348
22110348
Other identifier(s)
2-s2.0-85100150729
Rights
Mahidol University
Rights Holder(s)
SCOPUS
Bibliographic Citation
Multiple Sclerosis and Related Disorders. Vol.49, (2021)
Suggested Citation
Silvia Messina, Romina Mariano, Ruth Geraldes, Su Hyun Kim, Chanjira Satukijcha, Domizia Vecchio, Yi Yi Chua, James Taylor, Naveen George, Ana Cavey, Alejandro Rubio Diaz, Sandra Reeve, Rosie Everett, Gabriele De Luca, Maria Isabel Leite, Ho Jin Kim, Jacqueline Palace The influence of smoking on the pattern of disability and relapse risk in AQP4-positive Neuromyelitis Optica Spectrum Disorder, MOG-Ab Disease and Multiple Sclerosis. Multiple Sclerosis and Related Disorders. Vol.49, (2021). doi:10.1016/j.msard.2021.102773 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/78329
Research Projects
Organizational Units
Authors
Journal Issue
Thesis
Title
The influence of smoking on the pattern of disability and relapse risk in AQP4-positive Neuromyelitis Optica Spectrum Disorder, MOG-Ab Disease and Multiple Sclerosis
Abstract
Background: the role of smoking on clinical outcomes of central nervous system (CNS) inflammatory disorders is unclear. To assess the effect of smoking on relapses and disability in neuromyelitis optica with aquaporin-4-antibodies (NMOSD-AQP4-Ab), Myelin Oligodendrocyte Glycoprotein-antibodies associated disease (MOGAD) and relapsing remitting Multiple Sclerosis (MS) patients. Methods: in a UK cohort of 101 NMOSD-AQP4-Ab, 70 MOGAD and 159 MS, and a Korean cohort of 97 NMOSD-AQ4-Ab, time to first relapse, annualised relapse rate, onset relapse severity and recovery, time to Expanded Disability Status Score(EDSS)/secondary progressive MS (SPMS) were compared between never-smokers and ever-smokers. All clinical data were collected under the local ethics between January 2017 and January 2019. Results: Smoking did not affect the risk of relapse in any of the diseases. The risk of reaching EDSS 6.0 in the UK NMOSD-AQP4-Ab cohort was higher in ever smokers but this did not achieve significance (HR 2.12, p=0.068). When combining the UK and Korea NMOSD-AQP4-Ab cohorts, poorer recovery from the onset attack was significantly more frequent in the ever-smokers versus the never smokers (55% vs 38%, p=0.04). In the MS cohort the risk of reaching EDSS 6 and SPMS was significantly higher in the ever-smokers (HR=2.67, p=0.01 and HR=3.18, p=0.001). In MOGAD similar patterns were seen without reaching significance. Conclusions: In NMOSD-AQP4-Ab smoking associates with worse disability not through an increased risk of relapses but through poor relapse recovery. As in MS, smoking cessation should be encouraged in NMOSD-AQP4-Ab.