Moderate alcohol consumption tied to slower RRMS disability pace
Light to moderate drinkers see less disability progression, study shows
People with relapsing-remitting multiple sclerosis (RRMS) who drink low to moderate amounts of alcohol have significantly less disability progression in the years following diagnosis than non-drinkers, a study found. The trend was especially pronounced among women.
Although the findings suggest that drinking alcohol may have beneficial effects in some multiple sclerosis (MS) patients, the researchers stressed that alcohol has known adverse effects and should not be used to avoid disease progression.
Instead, they said the study’s results should be a basis for future research to better understand the biological mechanisms linking alcohol to better disease outcomes to support the development of new MS treatments.
“Communicating and implementing data on the potential beneficial effects of alcohol in MS is challenging, given the well-documented adverse effects of alcohol consumption on human health,” the scientists wrote. “However, we believe that this knowledge should be disseminated because further research into underlying mechanisms may offer insights into how to mitigate disease progression through the development of alternative treatments or dietary interventions that do not involve alcohol.”
The study, “Association Between Alcohol Consumption and Disability Accumulation in Multiple Sclerosis,” was published in Neurology Neuroimmunology and Neuroinflammation.
Half of patients report light to moderate alcohol consumption
Consuming alcohol has profound and complex effects on human health, but the effects of alcohol on MS progression have been hard to discern. Some studies have suggested that MS patients who drink alcohol tend to have worse disability, but other research has suggested the opposite.
To gain greater insight, scientists analyzed data from two large MS studies in Sweden, collectively covering 9,051 patients. Around the time patients were diagnosed, they provided information on their alcohol intake.
About half of the patients reported low to moderate alcohol consumption, drinking some alcohol but no more than 108 grams (about eight standard drinks) per week for women or 168 grams (about 12 standard drinks) per week for men. One standard drink, equivalent to a tall pour of beer, a glass of wine, or a shot of hard liquor, contains about 14 grams of alcohol.
Another 44% of patients in the study did not drink any alcohol, while the remaining 6% were high consumers of alcohol. The researchers constructed statistical models to compare disability outcomes among these three groups, taking into account other factors such as age, smoking status, disease duration, treatment, and physical activity.
Results showed that, compared with nondrinkers, patients who drank low to moderate amounts of alcohol had significantly lower likelihood of disability progression. Specifically, as assessed by the Expanded Disability Status Scale (EDSS), light to moderate drinkers were about 11% to 16% less likely to have a first event of clinical progression.
These patients were also less likely to reach moderate or significant disability, defined as scores of 3 and 4 on the EDSS scale, or to experience a worsening in physical quality of life, as measured with the Multiple Sclerosis Impact Scale 29 (MSIS-29).
No similar relationship seen for PPMS
There weren’t any significant differences in disability progression trends between non-drinkers and heavy drinkers, but overall trends indicated that alcohol consumption was associated with a slight but significant reduced risk of disability progression.
More granular analyses showed that the relationship between alcohol and disability progression was only significant in patients who had RRMS at disease onset, but not among those who were initially diagnosed with primary progressive MS (PPMS).
“The inverse relationship between alcohol consumption and disease progression was confined to relapsing-remitting MS,” the researchers wrote.
Gender-stratified analyses showed similar trends in both men and women, but the difference was notably larger among women, and in men it was not statistically significant.
“Although our findings indicate that alcohol consumption ameliorates disease progression in both sexes, the association was less pronounced and nonsignificant in men,” the researchers wrote. They said that these differences may be related to variations in sex-related hormones like testosterone and estrogen, but noted a need for more research.
“Given the complexity of interaction effects, careful consideration should be given to subgroup analyses across diverse patient populations,” the scientists concluded, emphasizing a need for further investigation into the effects of alcohol in MS.
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