Smoking and multiple sclerosis: an updated meta-analysis.

Multiple sclerosis (MS) is a leading cause of disability in young adults. Susceptibility to MS is determined by environmental exposure on the background of genetic risk factors. A previous meta-analysis suggested that smoking was an important risk factor for MS but many other studies have been publi...

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Main Authors: Adam E Handel, Alexander J Williamson, Giulio Disanto, Ruth Dobson, Gavin Giovannoni, Sreeram V Ramagopalan
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2011-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC3020969?pdf=render
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author Adam E Handel
Alexander J Williamson
Giulio Disanto
Ruth Dobson
Gavin Giovannoni
Sreeram V Ramagopalan
author_facet Adam E Handel
Alexander J Williamson
Giulio Disanto
Ruth Dobson
Gavin Giovannoni
Sreeram V Ramagopalan
author_sort Adam E Handel
collection DOAJ
description Multiple sclerosis (MS) is a leading cause of disability in young adults. Susceptibility to MS is determined by environmental exposure on the background of genetic risk factors. A previous meta-analysis suggested that smoking was an important risk factor for MS but many other studies have been published since then.We performed a Medline search to identify articles published that investigated MS risk following cigarette smoking. A total of 14 articles were included in this study. This represented data on 3,052 cases and 457,619 controls. We analysed these studies in both a conservative (limiting our analysis to only those where smoking behaviour was described prior to disease onset) and non-conservative manner. Our results show that smoking is associated with MS susceptibility (conservative: risk ratio (RR) 1.48, 95% confidence interval (CI) 1.35-1.63, p < 10⁻¹⁵; non-conservative: RR 1.52, 95% CI 1.39-1.66, p < 10⁻¹⁹). We also analysed 4 studies reporting risk of secondary progression in MS and found that this fell just short of statistical significance with considerable heterogeneity (RR 1.88, 95% CI 0.98-3.61, p = 0.06).Our results demonstrate that cigarette smoking is important in determining MS susceptibility but the effect on the progression of disease is less certain. Further work is needed to understand the mechanism behind this association and how smoking integrates with other established risk factors.
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spelling doaj.art-fbaba159a9e748bc8dc26fecda32aef12022-12-21T22:54:48ZengPublic Library of Science (PLoS)PLoS ONE1932-62032011-01-0161e1614910.1371/journal.pone.0016149Smoking and multiple sclerosis: an updated meta-analysis.Adam E HandelAlexander J WilliamsonGiulio DisantoRuth DobsonGavin GiovannoniSreeram V RamagopalanMultiple sclerosis (MS) is a leading cause of disability in young adults. Susceptibility to MS is determined by environmental exposure on the background of genetic risk factors. A previous meta-analysis suggested that smoking was an important risk factor for MS but many other studies have been published since then.We performed a Medline search to identify articles published that investigated MS risk following cigarette smoking. A total of 14 articles were included in this study. This represented data on 3,052 cases and 457,619 controls. We analysed these studies in both a conservative (limiting our analysis to only those where smoking behaviour was described prior to disease onset) and non-conservative manner. Our results show that smoking is associated with MS susceptibility (conservative: risk ratio (RR) 1.48, 95% confidence interval (CI) 1.35-1.63, p < 10⁻¹⁵; non-conservative: RR 1.52, 95% CI 1.39-1.66, p < 10⁻¹⁹). We also analysed 4 studies reporting risk of secondary progression in MS and found that this fell just short of statistical significance with considerable heterogeneity (RR 1.88, 95% CI 0.98-3.61, p = 0.06).Our results demonstrate that cigarette smoking is important in determining MS susceptibility but the effect on the progression of disease is less certain. Further work is needed to understand the mechanism behind this association and how smoking integrates with other established risk factors.http://europepmc.org/articles/PMC3020969?pdf=render
spellingShingle Adam E Handel
Alexander J Williamson
Giulio Disanto
Ruth Dobson
Gavin Giovannoni
Sreeram V Ramagopalan
Smoking and multiple sclerosis: an updated meta-analysis.
PLoS ONE
title Smoking and multiple sclerosis: an updated meta-analysis.
title_full Smoking and multiple sclerosis: an updated meta-analysis.
title_fullStr Smoking and multiple sclerosis: an updated meta-analysis.
title_full_unstemmed Smoking and multiple sclerosis: an updated meta-analysis.
title_short Smoking and multiple sclerosis: an updated meta-analysis.
title_sort smoking and multiple sclerosis an updated meta analysis
url http://europepmc.org/articles/PMC3020969?pdf=render
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AT gavingiovannoni smokingandmultiplesclerosisanupdatedmetaanalysis
AT sreeramvramagopalan smokingandmultiplesclerosisanupdatedmetaanalysis