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The impact of bariatric surgery on disease activity and progression of multiple sclerosis: A nationwide matched cohort study
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Örebro University, School of Medical Sciences. Örebro University Hospital. Department of surgery.ORCID iD: 0000-0003-4958-1611
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
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2022 (English)In: Multiple Sclerosis Journal, ISSN 1352-4585, E-ISSN 1477-0970, Vol. 28, no 13, p. 2099-2105Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Surgical outcomes in patients with multiple sclerosis (MS) following metabolic surgery appear to be similar compared to those of the general bariatric population.

OBJECTIVE: To study the impact of metabolic surgery on the clinical course of MS.

METHODS: Using data from the Scandinavian Obesity Surgery Registry and the Swedish Multiple Sclerosis register, we compared disease outcomes in 122 cases of MS who had undergone metabolic surgery with those of 122 cases of MS without surgery, matched by a two-staged Propensity score match, including age at disease onset, sex, MS phenotype, body mass index, and preoperative severity of MS as measured by the Expanded Disability Status Scale.

RESULTS: The time to 6-month confirmed disability progression during the first five years postbaseline was shorter among the surgical patients (hazard ratio (HR) = 2.31, 95% confidence interval (CI) = 1.09-4.90; p = 0.03). No differences were observed regarding postoperative annual relapse rate (p = 0.24) or time to first postoperative relapse (p = 0.52).

CONCLUSION: Although metabolic surgery appears to be a safe and efficient treatment of obesity in patients with MS, the clinical course of the disease might be negatively affected. Long-term nutritional follow-up after surgery and supplementation maintenance are crucial, particularly among those with preoperative deficits.

Place, publisher, year, edition, pages
Sage Publications, 2022. Vol. 28, no 13, p. 2099-2105
Keywords [en]
Multiple sclerosis, disease progression, metabolic surgery
National Category
Surgery
Identifiers
URN: urn:nbn:se:oru:diva-100116DOI: 10.1177/13524585221107095ISI: 000823668100001PubMedID: 35796505Scopus ID: 2-s2.0-85133821099OAI: oai:DiVA.org:oru-100116DiVA, id: diva2:1682056
Funder
Forte, Swedish Research Council for Health, Working Life and WelfareThe Swedish Brain FoundationStockholm County Council
Note

Funding agencies:

Orebro County Council

NEURO Sweden

Swedish Foundation for MS Research

Available from: 2022-07-08 Created: 2022-07-08 Last updated: 2023-12-08Bibliographically approved

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