risk factors

People with relapsing-remitting multiple sclerosis (RRMS) who started fasting or adopted a ketogenic diet — one low in carbs and rich in fat — for 18 months showed reductions in risk factors for heart and metabolic disease that were similar to those who followed a standard healthy diet, according…

Infections and stressful life events in childhood may increase the risk of developing multiple sclerosis (MS), while childhood exercise is associated with lower MS risk, according to a study. The findings, part of the German National Cohort (NAKO) population study, imply that programs to encourage physical activity and prevent…

Factors including being male, smoking, and having more frequent relapses are linked to significantly increased risk of disease progression in multiple sclerosis (MS), according to a meta-analysis of several published studies. Other variables linked to disease progression included disability score and the use of disease-modifying therapies (DMTs). “Hence,…

The team at Multiple Sclerosis News Today has brought our audience the latest news about treatments, scientific research, and clinical trials in multiple sclerosis (MS) throughout 2024. Here is a list of the top 10 most-read articles we published this year. We look forward to continuing to serve…

An interplay between genetic and environmental risk factors, including tobacco smoke exposure, affects brain development in early childhood, which could increase the likelihood a person will develop multiple sclerosis (MS), according to a recent study. Among young children in the Netherlands, being at a high genetic risk for MS,…

When I was initially evaluated for multiple sclerosis (MS), I was asked if I had a family history of the disease. To my knowledge, I did not. Once I received my diagnosis, one of the first things that crossed my mind, after recovering from the initial shock…

Throughout 2023, Multiple Sclerosis News Today brought consistent coverage to our readers of the latest scientific research, developments in treatment, and clinical trials for multiple sclerosis (MS). Here is a list of the top 10 most-read stories we published last year, along with a brief description. We look…

The newest recipients of the MS Australia incubator grants will seek novel ways to prevent and treat multiple sclerosis (MS) and explore the prevalence and incidence of the neurodegenerative disorder in different parts of the country. One scientist will use the funding to explore disease risk factors — and…

Women who were exposed to sexual or emotional abuse as children may be at an increased risk of developing multiple sclerosis (MS) later in life, according to a large study in Norway. The risk was even higher among patients who experienced a combination of two or more types of abuse in…

The National Multiple Sclerosis Society (NMSS) has detailed its Pathways to Cures Roadmap and potential ways of addressing gaps and advancing each of the pathways, with a final goal of finding a cure for multiple sclerosis (MS) in all its forms. Details were in the report, “…

In this installment of our “Expert Voices” series, Multiple Sclerosis News Today asked Kassandra Munger to answer some of your questions about the connection between vitamin D levels and multiple sclerosis (MS). Munger received her bachelor’s in biology from the University of Rochester in 1997, master’s in…

Adverse childhood experiences (ACEs) did not increase the risk of multiple sclerosis (MS) development and were not associated with worse clinical outcomes, a recent study reported. These findings add to the complexity of the potential relationship between ACEs and MS that has emerged across several research studies. “Our primary…

Among people with multiple sclerosis (MS), a progressive disease type and the use of anti-CD20 therapies — such as ocrelizumab and rituximab — were associated with an increased risk of death from COVID-19, a new meta-analysis revealed. “We hope that these findings … may help neurologists in optimizing…

Moderate-to-severe bowel dysfunction was detected in 14.5% of adult people with multiple sclerosis (MS), an Italian study reports. The prevalence of bowel dysfunction was increased in women and in patients with progressive forms of MS, higher disability, older age, and longer disease duration. Despite the prevalence of bowel dysfunction…

Factors related to disease and personality, as well as specific health-related behaviors, are among the main determinants that can put people with multiple sclerosis (MS) at risk of unemployment, a study suggests. In particular, MS disease course, fatigue, self-efficacy (belief in one’s own abilities to cope, in this…

In people with multiple sclerosis (MS) under age 50, the presence of cardiovascular risk factors is associated with a greater loss of brain volume, including white and grey matter, a study showed. The brain’s white matter mainly consists of nerve fibers and is typically affected by MS, while…

Physical symptoms and poorer coping mechanisms are major risk factors for unemployment in younger and older people with multiple sclerosis (MS), while psychological problems have the greatest impact in middle-aged patients’ unemployment, a study suggests. These findings highlight that unemployment risk factors vary with age and call for interventions…

Cigarette smoking increases the relapse rate in patients with relapsing-remitting multiple sclerosis who are being treated with interferon-beta, a study suggests. The findings suggest that RRMS patients who smoke may have fewer relapses if they quit. An article on the results, “Smoking affects the interferon beta treatment response in multiple sclerosis,” appeared in the journal Neurology. A number of studies have looked at the link between environmental and lifestyle factors and the risk of developing MS. These factors include how much sunlight and vitamin D patients get and whether they have an Epstein-Barr virus infection. Cigarette smoking is a well-documented risk factor in MS, but most of the studies on it have focused on the link between smoking and MS, or the link between smoking and the  disease's progression. “Studies that addressed the relationship between smoking and disease activity in RRMS are rarer,” the researchers wrote. The team decided to investigate whether smoking during interferon-beta treatment would affect relapse rates. Previous research had set the stage for the study by showing a link between smoking and gene mutations that make people more susceptible to developing MS. The mutations were in the HLA and NAT1 genes. The team looked at DNA from 834 RRMS patients in the Danish Multiple Sclerosis Biobank who were treated with interferon-beta. Well-known brand names of the treatment include Rebif, Avonex, and Plegridy. There are also other brand names and biosimilar drugs. Researchers also looked at patients’ medical records two years before they started on interferon-beta. Before making any conclusions on possible links between smoking and patients' relapse rate, the team adjusted for patients’ sex, age at the start of treatment, and number of relapses in the two years before treatment began. Their key conclusion was that smoking increased by more than a quarter the number of relapses in patients on interferon-beta therapy. “Each pack of cigarettes more per day during IFN-β [interferon-beta] treatment increased the number of relapses by 27%,” the team wrote. The researchers found no association among smoking, relapses, and mutations of the HLA or NAT1 genes. “Our results confirm that lifestyle factors are important in MS, suggesting that smoking cessation may be associated with a reduction in disease activity,” they wrote. “Although not formally proving that smoking cessation will decrease disease activity in RRMS, the results should encourage physicians to inform patients with MS about the harmful effect of smoking and increase focus on smoking cessation,” they observed.

Multiple sclerosis patients with high relapse rates but less physical impairment before starting on  Novartis’ Gilenya (fingolimod) are likely to experience a surge in disease activity if they stop the treatment, researchers in Turkey report. The study, which dealt with patients with relapsing forms of MS, referred to the surge as "severe disease reactivation," or SDR. Researchers published their article, “Factors Predictive of Severe Multiple Sclerosis Disease Reactivation After Fingolimod Cessation,” in the journal The Neurologist. Studies have shown that Gilenya, which the U.S. Food and Drug Administration approved in 2010, can benefit adults with relapsing MS. It reduces annualized relapse rates and prevents more brain lesions from forming, compared with standard interferon treatments. Lesions are damaged nerve cell areas. Despite its benefits, Gilenya is not recommended for patients with heart or liver problems, low levels of white blood cells, severe herpes virus infections or other infections. Also, patients who do not respond to Gilenya and women who are planning to become pregnant are advised to stop the treatment. Discontinuing Gilenya can lead to a return to pretreatment disease activity, or severe disease reactivation, in some patients. It is unclear why this happens and why it affects only some patients. To better understand what risk factors could be associated with reactivation, a team at Istanbul University compared the demographic and disease features of patients who developed SDR after stopping treatment with Gilenya. SDR was defined as including these elements within 6 months of Gilenya discontinuation: more than 5 gadolinium-enhanced lesions or a tumefactive demyelinating lesion detectable by magnetic resonance imaging, the disease progressing to the point that additional treatment with methylprednisolone or plasma exchange was required, and progressive physical disability reflected by a 1-point or more increase in patients' scores on the Expanded Disability Status Scale, or EDSS, Thirty-one patients at the university’s MS clinic who had discontinued Gilenya were included in the study. Eight experienced SDR and 11 relapses. The mean time for SDR patients' reactivation to occur was 2.6 months, researchers said. Patients had significantly higher levels of lymphocytes — white blood cells involved in autoimmunity — than during Gilenya treatment. When the team compared the disease features of SDR and non-SDR patients, they found that SDR patients had significantly higher annualized relapse rates before starting Gilenya and lower EDSS scores. “A higher ARR [annualized relapse rate] is the major contributory factor toward development of SDR,” the researchers wrote. “Patients who had higher ARRs before fingolimod [Gilenya] treatment must be closely followed up both clinically and radiologically in terms of the early signs of severe reactivation,” they wrote. About 38 percent of the SDR patients failed to respond to steroid treatment. They received a plasma exchange, which led to moderate improvement in their condition. Based on this finding, the researchers suggested that “plasmapheresis [plasma exchange] must be considered in patients exhibiting steroid-refractory SDR.” "In conclusion, SDR may be observed within the first 3 months after cessation of fingolimod," the team wrote. "This may be explained by the rapid influx of lymphocytes into the CNS [central nervous system]. Patients with higher annualized relapse rates and lower Expanded Disability Status Scale scores before commencing fingolimod treatment were more likely to exhibit SDR."