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Mult Scler. 2014 Jul;20(8):1081-5. doi: 10.1177/1352458513515086. Epub 2013 Dec 5.

Smokers run increased risk of developing anti-natalizumab antibodies.

Author information

1
Institute of Environmental Medicine, Karolinska Institutet, Sweden anna.hedstrom@ki.se.
2
Institute of Environmental Medicine, Karolinska Institutet, Sweden.
3
Multiple Sclerosis Research Group, Department of Clinical Neuroscience and Center for Molecular Medicine, Karolinska Institutet at Karolinska University Hospital, Sweden.
4
Neuroimmunology Unit, Department of Clinical Neuroscience and Center for Molecular Medicine, Karolinska Institutet at Karolinska University Hospital, Sweden.

Abstract

BACKGROUND:

Smoking may contribute to the induction of neutralizing antibodies to interferon β-1a.

OBJECTIVE:

In this study, we aimed to investigate the influence of smoking on the risk of developing antibodies to natalizumab, another biological drug in the treatment of multiple sclerosis.

METHODS:

This report is based on 1338 natalizumab-treated multiple sclerosis patients included in either of two Swedish case-control studies in which information on smoking habits was collected. Using logistic regression, patients with different smoking habits were compared regarding risk of developing anti-natalizumab antibodies, by calculating odds ratios with 95% confidence intervals.

RESULTS:

Compared with nonsmokers, the odds ratio of developing anti-natalizumab antibodies was 2.4 (95% CI 1.2-4.4) for patients who smoked at the time of screening, and a significant trend showed higher risk of developing antibodies with higher intensity of smoking. When smoking within two years prior to screening was considered, the odds ratio of developing anti-natalizumab antibodies was 2.7 (1.5-5.1).

INTERPRETATIONS:

The finding strengthens our hypothesis of the lungs as immune-reactive organs on irritation in relation to autoimmune responses, and may also be of clinical relevance since antibodies against natalizumab abrogate the therapeutic effect of the treatment.

KEYWORDS:

Multiple sclerosis; Tysabri; immunology; smoking

PMID:
24311118
DOI:
10.1177/1352458513515086
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