Smoking at time of CIS increases the risk of clinically definite multiple sclerosis
Background: Cigarette smoking is a modifiable risk factor that influences the disease course of patients with multiple sclerosis (MS). However, in patients with a clinically isolated syndrome (CIS), there are conflicting results about the association between smoking and the risk of a subsequent MS diagnosis. The aim of this study was to determine the risk of clinically definite MS (CDMS) in smoking and non-smoking patients at time of a first demyelinating event. Methods: Two hundred and fifty patients, aged 18–50 years, were included in our prospective CIS cohort. At time of the first neurological symptoms, patients completed a questionnaire about smoking habits. Cox regression analyses were performed to calculate univariate and multivariate hazard ratios for CDMS diagnosis in smoking and non-smoking CIS patients. Results: One hundred and fourteen (46%) CIS patients were diagnosed with CDMS during a mean follow-up of 58 months. In total, 79 (32%) patients smoked at time of CIS. Sixty-seven % of the smoking CIS patients were diagnosed with CDMS during follow-up compared to 36% of the non-smoking CIS patients (p < 0.001). Smoking at time of CIS was an independent predictor for CDMS diagnosis (HR 2.3; p = 0.002). Non-smoking CIS patients who had a history of smoking did not have a higher risk for CDMS than those who had never smoked. Conclusions: Smoking at time of CIS was an independent risk factor for a future CDMS diagnosis. This is an additional argument to quit smoking at time of the first attack of suspected MS.
|Keywords||Clinically isolated syndrome, Multiple sclerosis, Smoking|
|Persistent URL||dx.doi.org/10.1007/s00415-018-8780-4, hdl.handle.net/1765/104772|
|Journal||Journal of Neurology: official journal of the European Neurological Society|
van der Vuurst de Vries, R.M, Mescheriakova, J.Y, Runia, T.F, Siepman, T.A.M, Wokke, B.H.A. (Beatrijs H. A.), Samijn, J, & Hintzen, R.Q. (2018). Smoking at time of CIS increases the risk of clinically definite multiple sclerosis. Journal of Neurology: official journal of the European Neurological Society, 1–6. doi:10.1007/s00415-018-8780-4