Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026
Smoking and disability outcomes in multiple sclerosis: a systematic review and meta-analysis.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Alrabadi Bassel, Alghzawi Yousef, Alshakhshir Alwaleed Emad, Bandak Natalie, Matar Hasan I, Badwan Aseel, Mann Govind, Obeidat Ahmed Z
Аннотация
BACKGROUND: Smoking is a well-established environmental risk factor for multiple sclerosis (MS), yet its impact on disability progression remains incompletely understood, with conflicting evidence across studies.
OBJECTIVE: This review evaluated smoking and clinical outcomes in MS. Disability progression was the primary outcome; disability severity, imaging, relapse recovery, functional status, and patient-reported outcomes were secondary outcomes.
METHODS: A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines. PubMed, Scopus, Web of Science, and the Cochrane Library were searched from inception through the 4th of March 2026.
RESULTS: Eighteen studies were included. Smoking was not significantly associated with increased EDSS (SMD = 0.09, 95% CI [-0.04; 0.22]) or MSSS (SMD = 0.10, 95% CI [-0.15; 0.36]). Similarly, no significant associations were observed for progression to EDSS ≥4 (HR = 1.27, 95% CI [0.90; 1.81]) or EDSS ≥6 (HR = 1.20, 95% CI [0.65; 2.23]). T2 lesion volume was not significantly associated with smoking under the prespecified random-effects model. Broadly defined disability progression was not significantly associated with smoking, although the estimate was imprecise and heterogeneity was substantial (HR = 1.88, 95% CI [0.82; 4.32]). High heterogeneity was observed across several outcomes. Narrative findings suggested possible associations with poorer quality of life, greater fatigue, respiratory symptoms, and poorer relapse recovery, although these outcomes were heterogeneous and were not direct measures of longitudinal disability progression.
CONCLUSION: Smoking was generally associated with trends toward worse clinical outcomes in multiple sclerosis; however, statistically significant effects were not consistently observed across pooled analysis.
OBJECTIVE: This review evaluated smoking and clinical outcomes in MS. Disability progression was the primary outcome; disability severity, imaging, relapse recovery, functional status, and patient-reported outcomes were secondary outcomes.
METHODS: A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines. PubMed, Scopus, Web of Science, and the Cochrane Library were searched from inception through the 4th of March 2026.
RESULTS: Eighteen studies were included. Smoking was not significantly associated with increased EDSS (SMD = 0.09, 95% CI [-0.04; 0.22]) or MSSS (SMD = 0.10, 95% CI [-0.15; 0.36]). Similarly, no significant associations were observed for progression to EDSS ≥4 (HR = 1.27, 95% CI [0.90; 1.81]) or EDSS ≥6 (HR = 1.20, 95% CI [0.65; 2.23]). T2 lesion volume was not significantly associated with smoking under the prespecified random-effects model. Broadly defined disability progression was not significantly associated with smoking, although the estimate was imprecise and heterogeneity was substantial (HR = 1.88, 95% CI [0.82; 4.32]). High heterogeneity was observed across several outcomes. Narrative findings suggested possible associations with poorer quality of life, greater fatigue, respiratory symptoms, and poorer relapse recovery, although these outcomes were heterogeneous and were not direct measures of longitudinal disability progression.
CONCLUSION: Smoking was generally associated with trends toward worse clinical outcomes in multiple sclerosis; however, statistically significant effects were not consistently observed across pooled analysis.