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Major MS Risk Factors Independently Impact Disease Course, Study Says

A study looking at major known MS risk factors, like gene variants, obesity and smoking, suggests they contribute to variability and influence progression.

Risk factors often associated with multiple sclerosis (MS), such as genetic background, obesity and smoking, contribute independently to the disease’s variability and may be an early influence on progression, a study reported.

The retrospective study, “Multiple sclerosis risk factors contribute to onset heterogeneity,” was published in the journal Multiple Sclerosis and Related Disorders.

MS, a neurodegenerative and autoimmune disease, is associated with both genetic and environmental risk factors. Although both have been thoroughly investigated, the “processes contributing to heterogeneity in the clinical manifestation of the disease remain unclear,” the researchers wrote.

Multiple studies show that each patient’s characteristics at disease onset — such as age, number of impaired functional domains (NIFDs; functions ranging from walking and balance, to problems with vision, fatigue, or limb numbness or pain), time to second relapse (TT2R), and early relapse activity (ERA) — can help to predict MS activity and progression. But factors are also likely to play a role in early disease presentation.

To pinpoint the mechanisms involved in disease variability and progression, researchers at Case Western Reserve University investigated the influence of those factors with known links to early disease presentation.

Their study analyzed data on 1,515 people in the Accelerated Cure Project Repository, an open-access resource containing clinical records from a U.S. population of MS patients. Machine learning and mathematical models were used to assess the relevance of each measure for each disease outcome.

Most patients were female (77.9%) and diagnosed with relapsing-remitting MS (RRMS). Their average age at onset was 33.4 years, and mean time to a second relapse was 3.6 years, the study found. Two was the median number for both problems in functional domains and relapses in the first two years.

Data revealed that genetic factors — including the presence of the HLA-DRB1*15:01 allele, an established genetic risk factor — and smoking were linked to earlier age at MS onset. In fact, the study found nearly half of patients of European ancestry were carriers of that gene variant, and 32.8% were recent smokers. Conversely, male patients and those who were obese, had lower education levels, or were diagnosed with primary progressive MS (PPMS) tended to be older at disease onset.

Read on: Major MS Risk Factors Independently Impact Disease Course, Study Says

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