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At first blush this is disappointing. Researchers found, based on "moderate quality of evidence," that diet likely has no effect on progression. They found similar results with exercise and vitamin D supplementation. But researchers admit after reviewing studies involving exercise and vitamin D supplementation that the "no effect" findings were based on "very low quality of evidence." So don't quit the gym just yet. -D
A systematic review of the effects of modifiable risk factor interventions on the progression of multiple sclerosis
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Susanne Hempel, Glenn D Graham, Ning Fu, Elena Estrada, Annie Y Chen, Isomi Miake-Lye, Jeremy N V Miles, Roberta Shanman, Paul G Shekelle, Jessica M Beroes, Mitchell T Wallin
First Published February 2, 2017
Abstract
Background:
Several risk factors are associated with multiple sclerosis (MS) progression and may be amenable to intervention.
Objective:
To systematically review the evidence for interventions targeting risk factors for MS progression.
Methods:
We searched six databases and existing reviews till March 2015 and consulted with experts to identify randomized controlled trials (RCTs) of interventions targeting MS risk factors (PROSPERO 2015:CRD42015016461).
Results:
In total, 37 RCTs met inclusion criteria. Expanded Disability Status Scale (EDSS) scores after exercise interventions did not differ compared with untreated controls (standardized mean differences (SMDs): 0.02; confidence interval (CI): −0.40, 0.44; I2: 0%; seven RCTs; very low quality of evidence (QoE)). Dietary interventions did not show a statistically significant effect on the relative risk (RR) of progression (RR: 0.86; CI: 0.67, 1.05; I2: 0%; four RCTs; moderate QoE) compared to placebo. EDSS scores after vitamin D supplementation were not significantly different from placebo (SMD: −0.15; CI: −0.33, 0.02; I2: 0%; five RCTs; very low QoE).
Conclusion:
We did not identify any risk factor interventions with significant effects on MS progression, but the overall QoE was limited. More adequately powered trials are needed on vitamin D supplementation, long-term exercise, and smoking cessation.
A systematic review of the effects of modifiable risk factor interventions on the progression of multiple sclerosis
Show all authors
Susanne Hempel, Glenn D Graham, Ning Fu, Elena Estrada, Annie Y Chen, Isomi Miake-Lye, Jeremy N V Miles, Roberta Shanman, Paul G Shekelle, Jessica M Beroes, Mitchell T Wallin
First Published February 2, 2017
Abstract
Background:
Several risk factors are associated with multiple sclerosis (MS) progression and may be amenable to intervention.
Objective:
To systematically review the evidence for interventions targeting risk factors for MS progression.
Methods:
We searched six databases and existing reviews till March 2015 and consulted with experts to identify randomized controlled trials (RCTs) of interventions targeting MS risk factors (PROSPERO 2015:CRD42015016461).
Results:
In total, 37 RCTs met inclusion criteria. Expanded Disability Status Scale (EDSS) scores after exercise interventions did not differ compared with untreated controls (standardized mean differences (SMDs): 0.02; confidence interval (CI): −0.40, 0.44; I2: 0%; seven RCTs; very low quality of evidence (QoE)). Dietary interventions did not show a statistically significant effect on the relative risk (RR) of progression (RR: 0.86; CI: 0.67, 1.05; I2: 0%; four RCTs; moderate QoE) compared to placebo. EDSS scores after vitamin D supplementation were not significantly different from placebo (SMD: −0.15; CI: −0.33, 0.02; I2: 0%; five RCTs; very low QoE).
Conclusion:
We did not identify any risk factor interventions with significant effects on MS progression, but the overall QoE was limited. More adequately powered trials are needed on vitamin D supplementation, long-term exercise, and smoking cessation.
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