Contributions
Abstract: P499
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - 17 Environmental factors
Introduction: Smoking is a risk factor for developing Relapsing Remitting Multiple Sclerosis (RRMS) and has shown to accelerate conversion to Secondary Progressive MS (SPMS) through unclear mechanisms. The effect of smoking on Neuromyelitis Optica Spectrum Disorder (NMOSD) accumulation of clinical disability is unknown. We aim to compare the effect of smoking on relapse rates and accumulation of disability in these two diseases.
Methods: We collected the following data from the MS and NMOSD databases: smoking status (ever/never), age at onset, gender, disease duration, time to first relapse, the number of relapses within the first 2 years from disease onset, the time from disease onset to reaching EDSS 6 and time taken until conversion from RRMS to secondary progressive (SP) MS. Smokers and non-smoker were age and gender matched.
Results: We have included 101 NMOSD AQP4 positive cases (31 ever smokers, 70 never smokers) and 159 MS cases (53 ever smokers, 106 never smokers). Annualised relapse rate in the first two years did not differ when NMOSD smokers (0.41) were compared to NMOSD non-smokers (0.43) nor when MS smokers (0.53) were compared to MS non-smokers (0.51). Smoking increased the risk to reach EDSS 6 in NMOSD patients (univariate, HR=2.25, p=0.049, 95% CI 1.0-5.0). In MS, when controlling for age and sex, smoking did not influence the time to reach EDSS 6 (univariate, HR=1.4, p=0.317, 95% CI 0.7-2.6; multivariate, HR=1.6. p=0.171, 95% CI 0.8-3) but affected the risk of converting to SPMS (multivariate, HR=2.32, p=0.013, 95% CI 1.2-4.5).
Conclusions: our study suggests that smoking impacts accumulation of disability in NMOSD and the risk of converting to secondary progressive MS but does not influence relapse rate in these two disorders.
Disclosure:
S. Messina: has received travel payment from Merck Serono and Almirall.
R. Geraldes: nothing to disclose.
Y. Chua: nothing to disclose.
J. Taylor: nothing to disclose.
A. Cavey: nothing to disclose.
A. Rubio Diaz: nothing to disclose.
D. Vecchio: nothing to disclose.
R. Everett: nothing to disclose.
S. Reeve: nothing to disclose.
R. Mariano: nothing to disclose.
G.C. DeLuca is supported by the NIHR Biomedical Research Centre (BRC), Oxford and has research funding from the Oxford BRC, MRC(UK), and Merck-Serono. G.C. DeLuca has received travel expenses from Bay Schering, Biogen Idec, Genzyme, Merck Serono, and Novartis, and honoraria as an invited speaker for Bayer Schering and Novartis.
M. I. Leite: nothing to disclose.
J. Palace: received support for scientific meetings and honorariums for advisory work from Merck Serono, ABIDE, Biogen Idec, Roche, Novartis, Alexion, Medimmune, Teva, Chugai Pharma and Bayer Schering, and unrestricted grants from Merck Serono, Novartis, Biogen Idec and Bayer Schering. Grants from the MS society. GMSI, NIHR and Guthy- Jackson Foundation for research studies. Run Nationally commissioned services for CMS and NMO.
Abstract: P499
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - 17 Environmental factors
Introduction: Smoking is a risk factor for developing Relapsing Remitting Multiple Sclerosis (RRMS) and has shown to accelerate conversion to Secondary Progressive MS (SPMS) through unclear mechanisms. The effect of smoking on Neuromyelitis Optica Spectrum Disorder (NMOSD) accumulation of clinical disability is unknown. We aim to compare the effect of smoking on relapse rates and accumulation of disability in these two diseases.
Methods: We collected the following data from the MS and NMOSD databases: smoking status (ever/never), age at onset, gender, disease duration, time to first relapse, the number of relapses within the first 2 years from disease onset, the time from disease onset to reaching EDSS 6 and time taken until conversion from RRMS to secondary progressive (SP) MS. Smokers and non-smoker were age and gender matched.
Results: We have included 101 NMOSD AQP4 positive cases (31 ever smokers, 70 never smokers) and 159 MS cases (53 ever smokers, 106 never smokers). Annualised relapse rate in the first two years did not differ when NMOSD smokers (0.41) were compared to NMOSD non-smokers (0.43) nor when MS smokers (0.53) were compared to MS non-smokers (0.51). Smoking increased the risk to reach EDSS 6 in NMOSD patients (univariate, HR=2.25, p=0.049, 95% CI 1.0-5.0). In MS, when controlling for age and sex, smoking did not influence the time to reach EDSS 6 (univariate, HR=1.4, p=0.317, 95% CI 0.7-2.6; multivariate, HR=1.6. p=0.171, 95% CI 0.8-3) but affected the risk of converting to SPMS (multivariate, HR=2.32, p=0.013, 95% CI 1.2-4.5).
Conclusions: our study suggests that smoking impacts accumulation of disability in NMOSD and the risk of converting to secondary progressive MS but does not influence relapse rate in these two disorders.
Disclosure:
S. Messina: has received travel payment from Merck Serono and Almirall.
R. Geraldes: nothing to disclose.
Y. Chua: nothing to disclose.
J. Taylor: nothing to disclose.
A. Cavey: nothing to disclose.
A. Rubio Diaz: nothing to disclose.
D. Vecchio: nothing to disclose.
R. Everett: nothing to disclose.
S. Reeve: nothing to disclose.
R. Mariano: nothing to disclose.
G.C. DeLuca is supported by the NIHR Biomedical Research Centre (BRC), Oxford and has research funding from the Oxford BRC, MRC(UK), and Merck-Serono. G.C. DeLuca has received travel expenses from Bay Schering, Biogen Idec, Genzyme, Merck Serono, and Novartis, and honoraria as an invited speaker for Bayer Schering and Novartis.
M. I. Leite: nothing to disclose.
J. Palace: received support for scientific meetings and honorariums for advisory work from Merck Serono, ABIDE, Biogen Idec, Roche, Novartis, Alexion, Medimmune, Teva, Chugai Pharma and Bayer Schering, and unrestricted grants from Merck Serono, Novartis, Biogen Idec and Bayer Schering. Grants from the MS society. GMSI, NIHR and Guthy- Jackson Foundation for research studies. Run Nationally commissioned services for CMS and NMO.