TY - JOUR
T1 - Smoking status and vascular risk factors as predictors of disability in AQP4-NMOSD and MOGAD
AU - Chan, Fiona
AU - Berhanu, David
AU - Samadzadeh, Sara
AU - Francis, Anna
AU - Asgari, Nasrin
AU - Paul, Friedemann
AU - Leite, M Isabel
AU - Geraldes, Ruth
AU - Palace, Jacqueline
PY - 2025/5
Y1 - 2025/5
N2 - BACKGROUND: Smoking and vascular risk factors (VRFs) are reported to have adverse effects in multiple sclerosis but data are limited in aquaporin-4 antibody-positive neuromyelitis optica spectrum disorder (AQP4-NMOSD) and myelin oligodendrocyte glycoprotein antibody disease (MOGAD). This study aimed to measure their impact on disability.METHODS: Smoking status was defined as never, past or current smokers and VRF comprised of ⩾1: hypertension, dyslipidemia, high body mass index or diabetes. Logistic regression models were fitted to predict their influence on recovery from onset attack and first optic neuritis (ON) attack.RESULTS: A total of 442 patients were included. Current MOGAD smokers had a higher risk of disability from onset attack and first ON attack than never smokers (odds ratio (OR) 2.9, 95% confidence interval (CI) 1.3-6.9; OR 3.3, 95% CI 1.4-7.8). VRF in MOGAD was not predictive of disability. Current AQP4-NMOSD smokers and VRFs had a higher risk of residual disability from onset attacks (OR 7.5, 95% CI 2.1-27.7; OR 1.9, 95% CI 1.0-3.4). VRF was associated with higher risk of visual disability (OR 2.6, 95% CI 1.08-6.46) while smoking status was not.CONCLUSIONS: Current smoking status detrimentally influenced onset attack recovery in AQP4-NMOSD and MOGAD patients, including visual recovery in MOGAD. Non-smoking VRFs influenced clinical and visual outcomes in AQP4-NMOSD.
AB - BACKGROUND: Smoking and vascular risk factors (VRFs) are reported to have adverse effects in multiple sclerosis but data are limited in aquaporin-4 antibody-positive neuromyelitis optica spectrum disorder (AQP4-NMOSD) and myelin oligodendrocyte glycoprotein antibody disease (MOGAD). This study aimed to measure their impact on disability.METHODS: Smoking status was defined as never, past or current smokers and VRF comprised of ⩾1: hypertension, dyslipidemia, high body mass index or diabetes. Logistic regression models were fitted to predict their influence on recovery from onset attack and first optic neuritis (ON) attack.RESULTS: A total of 442 patients were included. Current MOGAD smokers had a higher risk of disability from onset attack and first ON attack than never smokers (odds ratio (OR) 2.9, 95% confidence interval (CI) 1.3-6.9; OR 3.3, 95% CI 1.4-7.8). VRF in MOGAD was not predictive of disability. Current AQP4-NMOSD smokers and VRFs had a higher risk of residual disability from onset attacks (OR 7.5, 95% CI 2.1-27.7; OR 1.9, 95% CI 1.0-3.4). VRF was associated with higher risk of visual disability (OR 2.6, 95% CI 1.08-6.46) while smoking status was not.CONCLUSIONS: Current smoking status detrimentally influenced onset attack recovery in AQP4-NMOSD and MOGAD patients, including visual recovery in MOGAD. Non-smoking VRFs influenced clinical and visual outcomes in AQP4-NMOSD.
KW - Adult
KW - Aquaporin 4/immunology
KW - Autoantibodies/immunology
KW - Demyelinating Autoimmune Diseases, CNS/immunology
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease
KW - Myelin-Oligodendrocyte Glycoprotein/immunology
KW - Neuromyelitis Optica/immunology
KW - Risk Factors
KW - Smoking/epidemiology
KW - Myelin oligodendrocyte glycoprotein antibody disease
KW - Disability
KW - Aquaporin-4 antibody-positive neuromyelitis optica spectrum disorder
KW - Comorbidities
KW - Vascular risk factors
KW - Smoking
U2 - 10.1177/13524585251325069
DO - 10.1177/13524585251325069
M3 - Article
C2 - 40088045
SN - 1352-4585
VL - 31
SP - 658
EP - 667
JO - Multiple Sclerosis Journal
JF - Multiple Sclerosis Journal
IS - 6
M1 - 13524585251325069
ER -