Wstęp: W ostatnich doniesieniach zauważono negatywny wpływ palenia tytoniu na rozwój i przebieg stwardnienia rozsianego. Cel: Celem badania wieloośrodkowego (Bydgoszcz, Zabrze, Białystok, Szczecin) była analiza związku między paleniem tytoniu a aktywnością choroby u pacjentów ze stwardnieniem rozsianym leczonych lekami immunomodulującymi. Materiał i metoda: W badaniu uwzględniono dane demograficzne i kliniczne: płeć, wiek, palenie tytoniu (paczkolata), czas leczenia, stan niepełnosprawności w skali EDSS (Expanded Disability Status Scale, Rozszerzona Skala Niepełnosprawności Ruchowej). Ponadto określano aktywność choroby -poprzez ocenę rocznego wskaźnika rzutów (annualised relapse rate, ARR) po roku i 2 latach leczenia oraz aktywność choroby w badaniu rezonansu magnetycznego. Dane te poddano analizie statystycznej. Wyniki: Badana grupa objęła 114 chorych -57 (50%) osób niepalących i 57 (50%) palących. Średni czas leczenia wynosił 2,46 (±1,23) roku, średnia wartość EDSS -2,12 (±1,03) pkt, ARR w momencie rozpoczęcia terapii -1,46 w grupie osób palących i 1,36 wśród niepalących. Nowe zmiany demielinizacyjne w rezonansie magnetycznym po roku leczenia stwierdzono u 15 (26,3%) pacjentów palących i u 8 (14%) niepalących. Analiza statystyczna wykazała istotne zależności między paleniem tytoniu a nowymi zmianami w rezonansie magnetycznym w mózgowiu po roku leczenia (r = −0,21, p < 0,05). Wnioski: U osób palących leczonych immunomodulująco w porównaniu z osobami niepalącymi obserwuje się wyraźną progresję radiologiczną choroby w pierwszych 2 latach leczenia. Słowa kluczowe: stwardnienie rozsiane, leczenie immunomodulacyjne, nikotynizmIntroduction: Recent reports have shown that smoking has a negative impact on the development and course of multiple sclerosis. Aim: The aim of this multicentre (Bydgoszcz, Zabrze, Białystok, Szczecin) study was to analyse the relationship between smoking and disease activity in patients with relapsing-remitting multiple sclerosis on immunomodulatory therapy. Materials and methods: We evaluated demographic and clinical data, such as sex, age, smoking (pack-years), treatment duration, disability status according to the Expanded Disability Status Scale (EDSS). Furthermore, we determined disease activity based on both the annualised relapse rate (ARR) after one and 2 years of treatment and magnetic resonance imaging findings. The obtained data were analysed statistically. Results: The study group included 114 patients: 57 (50%) non-smokers and 57 (50%) smokers. Mean treatment duration was 2.46 (±1.23) years, mean EDSS was 2.12 (±1.03), and ARR at treatment initiation was 1.46 in smokers vs. 1.36 in non-smokers. New magnetic resonance demyelination lesions were found after 1 year of treatment in 15 (26.3%) smokers and 8 (14%) non-smokers. Statistical analysis showed significant relationships between smoking and new cerebral lesions in magnetic resonance imaging (r = −0.21, p < 0.05). Conclusions: Smokers on immunomodulatory therapy show marked radiological progression of the disease in the first 2 ...
Introduction. Multiple sclerosis (MS) is one of the most common autoimmune diseases worldwide, and various autoimmune comorbidities have been reported with MS. The aim of this study was to estimate the prevalence of autoimmune disease comorbidity in patients with MS and their relatives in a Polish population. Material and methods.In this retrospective multicentre study, we investigated a group of patients with MS, and their relatives, in terms of age, gender, and the presence of simultaneous autoimmune diseases such as Graves's disease, Hashimoto's thyroiditis, type 1 diabetes mellitus, myasthenia gravis, psoriasis, ulcerative enteritis, Crohn's disease, coeliac disease, rheumatoid arthritis, autoimmune hepatitis and systemic lupus erythematous.Results. This study included 381 patients with MS, of whom 52.23% were women. 27 patients (7.09%) had at least one autoimmune disease. The most common comorbidity was Hashimoto's thyroiditis (14 patients). 77 patients (21.45%) had relatives with an autoimmune disease, of which the most common was Hashimoto's thyroiditis. Conclusions.Our study revealed that the probability of autoimmune diseases co-occurring in patients with MS, and in their relatives, is higher and we found the greatest risk to be for Hashimoto's thyroiditis.
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