Poor air quality worsens MS – ECTRIMS 2017
Highlights from the 7th Joint ECTRIMS-ACTRIMS MEETING, OCTOBER 25-28, Paris, France
A study in France has reported that some MS relapses may be atrributable to air pollution, especially during the winter months (Jeanjean and colleagues. ECTRIMS 2017; abstract P490).
The researchers compared relapse data from an MS registry in Strasbourg with air-quality data. They found that during winter, there was a small association between relapses and some pollutants (small particulates, nitrogen dioxide) in the air. In summer, ozone levels were associated with a 17% increased risk of having a relapse. Other toxic substances, such as carbon monoxide and benzene, didn’t appear to be associated with relapses. The same group of researchers previously reported that higher levels of small particulates in the air increased the risk of a relapse by 35% (see Wellness and lifestyle highlighted at ECTRIMS 2015, MSology, October 29, 2015).
Air quality is also affected by smoking, which is known to affect MS (see Smoking: how bad is it?, MSology, March 6, 2014). Three new studies presented at ECTRIMS looked at how smoking affects a person’s response to an MS medication. A study in Spain found that smokers were more likely to have a poor response to treatment (Sequeira and colleagues. ECTRIMS 2017; abstract P486). The risk of a poor response increased according to the amount smoked: the risk was about 3 times higher with 1-10 pack-years, and about 3.5 times higher for more than 20 pack-years.
The second study found that smokers taking Tysabri had 35% more relapses compared to non-smokers on Tysabri (Petersen and colleagues. ECTRIMS 2017; abstract P495). The third study examined side effects in two clinical trials of Tecfidera (Pellegrini and colleagues. ECTRIMS 2017; abstract P794). They found that smokers – especially women who smoked – were more likely to have gastrointestinal problems while taking Tecfidera, and more likely to stop treatment because of these side effects. So smoking seems to cause a triple-whammy: it worsens MS, it makes MS less likely to respond to treatment, and makes treatment more difficult to take.
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