Patients With MS Who Use Tobacco at Greater Risk for Disease Activity

Multiple sclerosis disease activity was less likely to decrease among tobacco users.

The following article is part of conference coverage from the 34th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) in Berlin, Germany. Neurology Advisor’s staff will be reporting breaking news associated with research conducted by leading experts in neurology. Check back for the latest news from ECTRIMS 2018.

Individuals with multiple sclerosis who use tobacco are at greater risk for inflammatory disease activity, even among a population treated with disease-modifying therapies. This research was recently presented at the 34th Congress of the European Committee for Treatment and Research in Multiple Sclerosis, held October 10-12, 2018, in Berlin, Germany.

Participants were followed for 2 years. Propensity score weighting was used to analyze their disease activity and rates of disease-modifying therapy discontinuation, with covariates including baseline MRI characteristics, clinical characteristics, and demographics. Following adjustment for propensity scores, the study researchers calculated odds ratios for tobacco users vs non-tobacco users.

This study included 659 participants with multiple sclerosis who were given either dimethyl fumarate or fingolimod, 164 of whom were tobacco users and 495 of whom did not use tobacco. At the 2-year mark, disease-modifying therapy discontinuation was roughly equal in the tobacco and non-tobacco groups (39.4% and 34.4%, respectively; odds ratio [OR] 1.17; 95% CI, 0.79-1.75). Disease activity was less likely to decrease among tobacco users (OR 0.61; 95% CI, 0.44-0.83), and tobacco users also demonstrated higher but statistically non-significant new gadolinium-enhancing lesions (OR 1.39; 95% CI, 0.80-2.60), incident T2 lesions (OR 1.62; 95% CI, 0.94-2.79), annualized relapse rates (OR 1.38; 95% CI, 0.97-1.96), and depression (OR 1.38; 95% CI, 0.84-2.27). Type of disease-modifying therapy did not independently impact disease activity endpoints.

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The study researchers concluded that “tobacco users were less likely to achieve absence of disease activity compared to non-tobacco users in a population of patients treated with oral [disease modifying therapies]. This finding suggests that tobacco is a negative risk factor for inflammatory disease activity and warrants further exploration with larger studies.”

Disclosures: Several researchers report fiscal compensation from pharmaceutical companies. For a full list of disclosures, view the reference.

For more coverage of ECTRIMS 2018, click here.


Hersh C, Harris H, Ayers M, et al. Comparative effect of tobacco versus non-tobacco use on disease outcomes and discontinuation of oral disease-modifying therapies in clinical practice. Presented at: 34th Congress of the European Committee for Treatment and Research in Multiple Sclerosis. October 10-12, 2018; Berlin, Germany. Poster P407.