139. An Update of Systematic Review and Meta-analysis: The Effect of Cigarette Smoking on the Progression of Multiple Sclerosis

• Published in: Multiple sclerosis and related disorders 2024-12, Vol.92, p.106100, Article 106100
• Main Authors: Ali, Ahmed Essmat, Meshref, Mostafa Mahmoud, Abed, Elsayed, Mansour, Fathy Mahmoud, Atallah, Muhammed, Rashad, Mohamed Hamed, El-Adawy, Ahmad Farag Ibrahim, Hussein, Hussein Mohamed
• Format: Article
• Language: English
• ISSN: 2211-0348
• DOI: 10.1016/j.msard.2024.106100

Multiple sclerosis (MS) is one the most disabling diseases that attack young adults impacting their productivity and increasing the health burden. A previous systematic review and meta-analysis provided evidence on the risk of smoking on the severity of MS disability. However, evidence of progression was inconsequential. Several studies have been published in the last five years that could provide evidence on the progression of the disability status. Eminent databases including PubMed, Scopus, Web of Science, and Cochrane Library were searched for eligible studies based on predefined keywords from 2017 till November 2023. Three disability scores were included as primary outcomes: expanded disability status scale (EDSS), multiple sclerosis severity score (MSSS), and multiple sclerosis impact scale-29 (MSIS-29) as well as the cumulative smoking pack-years and T2 lesion count and volume as secondary outcomes. Both qualitative and quantitative analyses were carried out. The standard mean difference (SMD) was calculated along with a 95% confidence interval. Out of 806 articles, 24 articles were eligible for data analysis based on the inclusion and exclusion criteria. Pooled data analysis of EDSS (9 studies) showed that EDSS significantly was reduced in never-smokers by 0.218 scores compared to smokers (SMD= -0.218; 95% CI: -0.276 to -0.161; se= 0.029; p