Multiple sclerosis and related disorders · 2026
Impact of smoking on clinical outcomes in NMOSD and MOGAD: A meta-analysis.
СтатьяМетаанализСистематический обзорНазвание и аннотация: Перевод в очереди
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Alrabadi Bassel, Matar Hasan, Bandak Natalie, Khlaif Durrah, Alrabadi Fadi, Almohammed Own S, Abu-Irsheid Loay, Al Kayed Hadeel
Аннотация
BACKGROUND: Neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) are autoimmune inflammatory disorders of the central nervous system. Smoking is a recognized risk factor for several autoimmune diseases; however, its impact on clinical outcomes in NMOSD and MOGAD remains uncertain. We performed a systematic review and meta-analysis to evaluate the association between smoking and disease outcomes in these disorders.
METHODS: A systematic search of the literature was conducted in PubMed, Scopus and Cochrane Library to identify studies evaluating smoking-related outcomes in NMOSD and MOGAD from inception to May 2026. Random-effects meta-analyses were performed.
RESULTS: Ten studies published between 2014 and 2026 were included. Meta-analysis of six studies demonstrated no significant association between smoking and NMOSD-AQP4 incidence (RR = 0.76, 95% CI 0.48-1.20; p = 0.24). In contrast, smokers had a significantly higher risk of incomplete recovery following relapses compared with non-smokers (RR = 1.73, 95% CI 1.36-2.20; p < 0.0001). Disease-specific analyses showed a stronger association in MOGAD (RR = 2.41, 95% CI 1.82-3.19; p < 0.0001) than in NMOSD-AQP4 (RR = 1.62, 95% CI 1.38-1.90; p < 0.0001). Qualitative synthesis further suggested poorer MRI lesion resolution among smokers, while evidence regarding relapse activity remained inconsistent.
CONCLUSIONS: Smoking is associated with significantly poorer recovery following relapses in both NMOSD-AQP4 and MOGAD, particularly in MOGAD. These findings identify smoking as a potentially modifiable factor that may contribute to disability accumulation and support the incorporation of smoking cessation counseling into routine disease management.
METHODS: A systematic search of the literature was conducted in PubMed, Scopus and Cochrane Library to identify studies evaluating smoking-related outcomes in NMOSD and MOGAD from inception to May 2026. Random-effects meta-analyses were performed.
RESULTS: Ten studies published between 2014 and 2026 were included. Meta-analysis of six studies demonstrated no significant association between smoking and NMOSD-AQP4 incidence (RR = 0.76, 95% CI 0.48-1.20; p = 0.24). In contrast, smokers had a significantly higher risk of incomplete recovery following relapses compared with non-smokers (RR = 1.73, 95% CI 1.36-2.20; p < 0.0001). Disease-specific analyses showed a stronger association in MOGAD (RR = 2.41, 95% CI 1.82-3.19; p < 0.0001) than in NMOSD-AQP4 (RR = 1.62, 95% CI 1.38-1.90; p < 0.0001). Qualitative synthesis further suggested poorer MRI lesion resolution among smokers, while evidence regarding relapse activity remained inconsistent.
CONCLUSIONS: Smoking is associated with significantly poorer recovery following relapses in both NMOSD-AQP4 and MOGAD, particularly in MOGAD. These findings identify smoking as a potentially modifiable factor that may contribute to disability accumulation and support the incorporation of smoking cessation counseling into routine disease management.