- |||||||||| Journal: Trends of Industry Payments in Neurology Subspecialties. (Pubmed Central) - Sep 4, 2020
Conclusions From 2014 to 2018, the total industry-to-physician payments for neurology subspecialties increased while the distribution of industry-to-physician payments for various neurology subspecialties showed notable changes. The introduction of newer medications in a subspecialty coincided with higher industry payments. Identification of these trends and potential motives of the industry spending is critical to address any potential physician bias in prescribing medications.
- |||||||||| teriflunomide / Generic mfg.
[VIRTUAL] Teriflunomide: An Immune Modulating Drug with Antiviral Properties () - Sep 3, 2020 - Abstract #MSDC2020MSDC_1652;
Identification of these trends and potential motives of the industry spending is critical to address any potential physician bias in prescribing medications. present findings confirm our previously published in the TMEV-IDD model, TERI treatment shows both anti-inflammatory and antiviral properties, without any significant impact on disability progression.
- |||||||||| teriflunomide / Generic mfg.
[VIRTUAL] Teriflunomide Enhanced Innate and Adaptive Immune Regulatory Function in Treating Multiple Sclerosis () - Sep 3, 2020 - Abstract #MSDC2020MSDC_1641;
P=N/A
Furthermore, teriflunomide decreased CXCR3 expression on T helper (Th) cells, which suggests impediment of pathogenic Th cells. Finally, teriflunomide showed a diminishing trend of the frequency of total B cells (specifically switched memory B cells) while it increased naïve B cells and downregulated the expression of co-stimulatory molecules CD80 and CD86.Conclusions In conclusion, teriflunomide promotes a tolerogenic immune response and suppresses the pathogenic immune response in relapsing MS patients.
- |||||||||| dimethyl fumarate / Generic mfg., Rituxan (rituximab) / Biogen, Zenyaku Kogyo, Roche
[VIRTUAL] Descriptive data analysis of covid-19 among patients with multiple sclerosis; A cross-sectional study of southern Iran () - Sep 3, 2020 - Abstract #MSDC2020MSDC_1640;
P< 0.05 was considered statistically significant.Results The frequency of DMT were as follow: rituximab 27.6%, interferons 27.3%, fingolimod 12.5%, dimethyl fumarate 9.1%, glatiramer acetate 7.3%, teriflunomide 1.9%, natalizumab 1.3%...Patients with hyperthyroidism and CVD were approximately 21.3 and 3.6 times higher at risk of infection.( OR=21.3 95% CL2.95-55.08 P=0.002) (OR=3.69 95% CL1.47-9.21, P=0.005) respectively.Conclusions In general, risk of covid- 19 infection and severity and mortality in pwMS seems not to be more than other population; however, type of disease modifying drug, comorbidities and physical disability are the main factors which may threaten these patients. our study showed PPMS and CIS types as well as cases with hyperthyroid and cardiovascular diseases are in a higher risk than the other MS patients.
- |||||||||| Plegridy (PEG-interferon β-1a) / Biogen, Lemtrada (alemtuzumab) / Sanofi
[VIRTUAL] New findings from the 2020 MS Barometer on MS prevalence, practicing neurologists and use of disease-modifying drugs across Europe () - Sep 3, 2020 - Abstract #MSDC2020MSDC_1630;
For all questions related to DMDs, respondents were asked to consider the following treatments: interferon-beta 1a, peginterferon-beta 1a, interferon-beta 1b, glatiramer acetate, teriflunomide, dimethyl fumerate, fingolimod, cladribine (oral), siponimod, natalizumab, alemtuzumab, and ocrelizumab...Countries reported a median of 51% of people with MS on DMDs. Across Europe the survey found approximately 61,000 practicing neurologists.
- |||||||||| dimethyl fumarate / Generic mfg., Rituxan (rituximab) / Biogen, Zenyaku Kogyo, Roche
[VIRTUAL] Disease modifying treatment changes in pediatric onset multiple sclerosis patients over the past 10 years. A single center retrospective study. () - Sep 3, 2020 - Abstract #MSDC2020MSDC_1617;
DMT: injectables-glatiramer acetate, interferons; per os (PO)-fingolimod, dimethyl fumarate, teriflunomide; infusion-rituximab, natalizumab, ocrelizumab.Results Of the 124 POMS patients, 41.1% were male and 58.8% were female, with mean age of diagnosis at 15 years (standard deviation +/- 3)...The AAR for injectables, orals and infusions were 0.13, 0.17 and 0.026, respectively.Conclusions At this tertiary care institution, nearly half of patients with POMS have changed DMT either due to disease progression or side effects. Those on infusion therapies were seen to be more likely to remain on their treatment, have lower ARR and less disease progression compared to other treatment options.
- |||||||||| dimethyl fumarate / Generic mfg., Lemtrada (alemtuzumab) / Sanofi
[VIRTUAL] Real-life experience with sNFL in Multiple Sclerosis patients, as monitoring and treatment decision biomarker () - Sep 3, 2020 - Abstract #MSDC2020MSDC_1594;
sNFL were cross-sectionally evaluated in 830 relapsing remitting (RR), 53 primary progressive (PP) and 78 secondary progressive (SP) MS patients at different disease stages including diagnostic time, immediately before treatment, and during treatment with the main disease modifying treatments (DMTs): Interferon-beta, Glatiramer acetate, DimethylFumarate, Teriflunomide, Natalizumab, Alemtuzumab, Fingolimod, anti-CD20...Cut-off values specific for age decade were applied to discriminate patients samples in different contexts, showing correlation with disease subtype, clinical activity and DMTs efficacy. Our study shows that clinically applicable cut-offs can enable the implementation of sNFL in everyday clinical practice in individual patients, demonstrating its potential as monitoring and treatment decision biomarker.
- |||||||||| dimethyl fumarate / Generic mfg.
[VIRTUAL] Reported Covid19 symptoms in patients on oral Disease Modifying Treatmentss (DMTs) at a single centre () - Sep 3, 2020 - Abstract #MSDC2020MSDC_1542;
To identify how this compares to national infection rate, whether there was a link to lymphocyte counts prior to infection and how many patients stopped or interrupted treatment.Methods Patients on oral DMTs (dimethyl fumarate (DMF), teriflunomide (TF) & fingolimod (FING)) were identified through a local database...One patient taking DMF died due to COVID-19. Further data will be presented on the average lymphocyte counts in those who did not report symptoms, number of patients who went on to be tested for COVID-19 and the number who stopped or interrupted treatment.Conclusions Results present real world data on COVID-19 infection in patients on oral DMTs for MS and how these relate to lymphocyte count and infections rates in general population.
- |||||||||| teriflunomide / Generic mfg.
Enrollment closed: Mechanistic Studies of Teriflunomide in RRMS (clinicaltrials.gov) - Aug 31, 2020
P=N/A, N=30, Active, not recruiting,
Active, not recruiting --> Completed Recruiting --> Active, not recruiting
- |||||||||| teriflunomide / Generic mfg.
Journal: Teriflunomide preserves peripheral nerve mitochondria from oxidative stress-mediated alterations. (Pubmed Central) - Aug 28, 2020
No effects were observed at 5 µM TFN, while some shape and motility parameters were restored to control levels at 50 µM TFN. Thus, our data demonstrate an undescribed link between DHODH and mitochondrial dynamics and point to a potential neuroprotective effect of DHODH inhibition in the context of oxidative stress-induced damage of axonal mitochondria.
- |||||||||| dimethyl fumarate / Generic mfg., Rituxan (rituximab) / Biogen, Zenyaku Kogyo, Roche, Lemtrada (alemtuzumab) / Sanofi
[VIRTUAL] Comparison of Treatment Choices in a Single Center Pediatric Onset Multiple Sclerosis Registry () - Aug 25, 2020 - Abstract #MSDC2020MSDC_1484;
Three treatments are approved in Turkey: interferon-β, glatiramer acetate, fingolimod, other agents still being on off-label use.Objectives We aimed to evaluate POMS patients under new generation therapies (NGT) (teriflunomide, dimethyl fumarate, fingolimod, rituximab, ocrelizumab, natalizumab, alemtuzumab)...Only a few patients needed second-line treatments as a first-choice option in our POMS group. We did not observe any significant difference between clinical and MRI status among POMS patients under the first-line of newer drugs, although the latter was associated with a slightly lower EDSS score.
- |||||||||| [VIRTUAL] Multiple sclerosis and NMOSD testing and treatment availability in Latin America () - Aug 25, 2020 - Abstract #MSDC2020MSDC_1420;
Siponimod was not available in any conutry of the region...MS treatments was completely covered by the health care system in most of the surveyed countries.Conclusions the present study allows an understanding of the delivery of care for MS and NMOSD in the region. This information will allow us to make health care policies in affected patients that will improve the care in LATAM.
- |||||||||| [VIRTUAL] Telemedicine in/outside the pandemic: a survey about satisfaction of this tool in a cohort of multiple sclerosis patients and their neurologists () - Aug 25, 2020 - Abstract #MSDC2020MSDC_1412;
Treatments were almost equally distributed across first and second-line drugs (10% interferon, 10% glatiramer acetate, 14% teriflunomide, 22% dimethylfumarate, 23% fingolimod, 3% cladribine, 8% alemtuzumab, 10% ocrelizumab)...So far, we can conclude that telemedicine is a useful tool to overcome space-time limits, giving the best care to all patients in any condition. However, it cannot replace but only integrate traditional medicine.
- |||||||||| teriflunomide / Generic mfg., Arzerra (ofatumumab) / Novartis, Genmab
Clinical Trial,Phase III, Journal: Ofatumumab versus Teriflunomide in Multiple Sclerosis. (Pubmed Central) - Aug 22, 2020
P3
Among patients with multiple sclerosis, ofatumumab was associated with lower annualized relapse rates than teriflunomide. (Funded by Novartis; ASCLEPIOS I and II ClinicalTrials.gov numbers, NCT02792218 and NCT02792231.).
- |||||||||| Tysabri (natalizumab) / Biogen, dimethyl fumarate / Generic mfg., Lemtrada (alemtuzumab) / Sanofi
[VIRTUAL] Effects of natalizumab on patient-reported MS outcomes using prospective data from the Australian MS longitudinal study () - Aug 16, 2020 - Abstract #MSDC2020MSDC_1260;
We used marginal structural models to estimate causal effect of natalizumab versus other DMT comparators (any other DMT, classic injectables, oral therapies (teriflunomide and dimethyl fumarate), higher efficacy DMTs (fingolimod, alemtuzumab and mitoxantrone), fingolimod, and alemtuzumab), while adjusting for time-varying confounders and intermediates of treatment effects.Results The analysis included 2836 observations...The use of natalizumab was associated with a marginal decrease in self-reported progression in the previous 12 months while the use of injectable DMTs and fingolimod were associated with an increased self-reported progression. The use of natalizumab was associated with a reduction in work productivity loss due to absenteeism compared to a worsening for any other DMT, and similar trends were less pronounced for presenteeism and total work productivity loss.Conclusions Compared to other DMTs, the use of natalizumab was associated with superior effects over time for several MS symptoms and absenteeism.
- |||||||||| teriflunomide / Generic mfg., FTY720, fingolimod / Generic mfg., Novus Therap
[VIRTUAL] Usage trend of oral drugs for multiple sclerosis in Argentina () - Aug 16, 2020 - Abstract #MSDC2020MSDC_969;
We found a tendency in increasing use of oDMDs after a first switch (P1: 59.6%, P2: 73.1%) or second switch (P1: 59.6%, P2: 73.1%). Multivariate analysis showed that disease evolution (OR=1.06, p=0.04), and year of starting treatment (OR=0.66, p<0.01) were independently associated with choice of oDMDs.Conclusions We have identified an increasing tendency in the use of oDMDs as initial treatment of RMS regarding its approval in Argentina.
- |||||||||| dimethyl fumarate / Generic mfg.
[VIRTUAL] Treatment discontinuation and restart among patients with multiple sclerosis using disease-modifying therapies () - Aug 16, 2020 - Abstract #MSDC2020MSDC_966;
Natalizumab had the lowest rate of discontinuation (37%) and restart (20%)...Similarly, GA and IFN β-1b had the highest discontinuation and restart rates among those with a second course.Conclusions Over 2 to 10.5 years of follow-up, treatment discontinuation and extended treatment gaps occurred frequently among DMT-treated patients with MS. Returning to the same DMT was surprisingly common.
- |||||||||| Rituxan (rituximab) / Biogen, Zenyaku Kogyo, Roche
[VIRTUAL] The presence of SARS CoV2 antibodies in MS patients () - Aug 16, 2020 - Abstract #MSDC2020MSDC_963;
To begin to address this question, we evaluated our patients who were clinically diagnosed with Covid-19 for antibodies (Ab).Objectives To determine the frequency of SARS-CoV-2 Ab in our patients with Covid-19 and co-morbid MS, and describe their clincal characteristics.Methods This is a case series of pwMS who are patients of the Holy Name MS Center and were either proven by PCR or highly suspected of active COVID-19 infection as of July 15, 2020.Results Of the 11 patients included, 91% (n=10) were female, average age 50.5 years (range 34-64 years); 7 patients treated with an anti-CD 20 monoclonal Ab (6 ocrelizumab (OCR), 1 rituximab (RTX)), 1 teriflunomide, 1 interferon beta-1a, and 2 patients not on DMT...Will OCR treated patients be at a unique risk to suffering reinfection from COVID-19 given they are less likely to seroconvert? And, how effective will a future vaccine be in patients treated with OCR (and similar monoclonal antibodies)?
- |||||||||| teriflunomide / Generic mfg.
[VIRTUAL] Teriflunomide safety and efficacy in advanced progressive multiple sclerosis () - Aug 16, 2020 - Abstract #MSDC2020MSDC_959;
After adjustment for age, sex, and baseline EDSS, sustained EDSS progression did not differ between groups (Hazard Ratio =1.17; 95% Confidence Interval: 0.45, 3.08; p=0.75). Sustained T25FW worsening after adjustment also did not differ (Hazard Ratio =0.56; 95% Confidence Interval: 0.2, 1.53; p=0.26).Conclusions In an advanced progressive multiple sclerosis population no substantial differences in tolerability, safety, sustained EDSS progression, or sustained T25FW worsening over time were observed between glatiramer acetate and teriflunomide treated groups.
- |||||||||| dimethyl fumarate / Generic mfg., Mavenclad (cladribine) / EMD Serono
[VIRTUAL] Real-world experience with Cladribine Tablets in the MSBase Registry () - Aug 16, 2020 - Abstract #MSDC2020MSDC_950;
Of all RRMS patients switching to cladribine tablets with a treatment gap of <6 months, the most common immediate prior DMDs were fingolimod (17%), followed by natalizumab, teriflunomide and dimethylfumarate (all appx...First-line use was uncommon. ARR was low, consistent with clinical trial data, and early discontinuations were very rare.
- |||||||||| teriflunomide / Generic mfg.
[VIRTUAL] Experience with teriflunomide in a specialized multiple sclerosis unit () - Aug 16, 2020 - Abstract #MSDC2020MSDC_921;
3 patients had severe diarrhea and 2 peripheral neuropathy. 5 patients had significant hair fragility that was treated but did not cause discontinuation of teriflunomide.Conclusions Teriflunomide is an optimal, suitable and effective drug for relapsing-remitting with known and mild-to-moderate adverse events.
- |||||||||| dimethyl fumarate / Generic mfg.
[VIRTUAL] Comparative effectiveness of dimethyl fumarate versus other disease-modifying therapies in Multiple Sclerosis: a large population-based cohort study () - Aug 16, 2020 - Abstract #MSDC2020MSDC_896;
Background Previous real-world comparative research of Multiple Sclerosis (MS) disease modifying therapies (DMTs) provided conflicting results on the effectiveness of the dimethyl fumarate (DMF) in comparison to the injectable immunomodulatory drugs (IID), and the two other oral drugs, fingolimod (FTY) and teriflunomide (TERI), in reducing relapses.Objectives To assess the effectiveness of DMF on annual rate of relapse (ARR) in MS compared to IID, TERI and FTY, in real life setting.Methods This cohort study included all patients identified in the French national claims-based database (SNDS) initiating IID, TERI, FTY or DMF from the 2015/07/01 to the 2017/12/31, with at least 4.5-year history and with 1 to 3.5 years of follow-up...During the index treatment exposure, DMF significantly reduced ARR compared to IID (RR 0.72, 95%CI [0.61 - 0.86]) and TERI (RR 0.81, 95%CI [0.68 - 0.96]). No significant difference on ARR was found between DMF and FTY patients (RR 1.38, 95%CI [0.95 - 1.99]), but the specific indication of FTY for the treatment of MS patients with high activity of the disease makes the comparison between both groups difficult.Conclusions Based on real-life data, DMF offers an effective treatment option to reduce the risk of relapse for patients with RRMS compared to other commonly used agents for RRMS including another oral drug, TERI.
- |||||||||| dimethyl fumarate / Generic mfg., teriflunomide / Generic mfg.
[VIRTUAL] A comparative study of teriflunomide and dimethyl fumarate within the Swedish MS Registry () - Aug 16, 2020 - Abstract #MSDC2020MSDC_877;
Furthermore, there was no difference by matched treatment group in the rate of six-month confirmed disability progression (HR 0.55; 95% CI 0.27, 1.12; p=0.100; reference=teriflunomide) or six-month confirmed disability improvement (HR 1.17; 95% CI 0.57, 2.36; p=0.672; reference=teriflunomide). MSIS-29 quality of life scores were also similar over time between the two groups.Conclusions This population-based real-world study performed on the Swedish MS registry shows similarities in treatment persistence, clinical effectiveness and quality of life outcomes of teriflunomide and dimethyl fumarate.
- |||||||||| [VIRTUAL] Comorbid Anxiety, Depression, and Fatigue Symptoms by Disease Modifying Therapy: A National Multiple Sclerosis Cohort () - Aug 16, 2020 - Abstract #MSDC2020MSDC_519;
DMTs were classified in LED (interferon beta-1a, interferon beta-1b, peginterferon beta-1a, glatiramer acetate), MED (teriflunomide, fingolimod, siponimod, dimethyl fumarate), and HED (alemtuzumab, ocrelizumab, rituximab, natalizumab, cladribine)...LED-treated patients had lower fatigue and depression scores compared to those on HED. Indication biases may have influenced our results; longitudinal studies taking into account prior DMT history and indicators for specific DMTs should evaluate whether certain DMT classes affect future depression, anxiety, or fatigue levels.
- |||||||||| [VIRTUAL] A real-world analysis of ocrelizumab treatment patterns among multiple sclerosis patients in Saskatchewan, Canada () - Aug 16, 2020 - Abstract #MSDC2020MSDC_501;
22 patients (19%) switched from dimethyl fumarate; followed by 11 patients (9.5%) from glatiramer acetate, 9 patients (7.8%) from teriflunomide, 6 patients (5.2%) from interferon-beta 1a, 5 patients (4.3%) from natalizumab, 4 patients (3.4%) from alemtuzumab, 3 patients (2.6%) from fingolimod and 2 patients (1.7%) from interferon-beta 1b...Twenty four patients had a comorbid diagnosis of depression.Conclusions The majority of patients who started on ocrelizumab had RRMS. The most common reason to switch to ocrelizumab was due to adverse events or persistence of relapses.
- |||||||||| dimethyl fumarate / Generic mfg.
[VIRTUAL] Seroconversion rate following HBV vaccination in clinical practice: the role of immunosenescence and concomitant DMT treatment () - Aug 16, 2020 - Abstract #MSDC2020MSDC_471;
At the time of vaccination 33 (32.7%) patients were treatment-naïve, while the remaining 68 (67.3%) were under the following DMTs: 27.7% BRACE, 8.9% teriflunomide, 12.9% dimethyl fumarate, 7.9% fingolimod and 9.9% natalizumab...The seroconversion rates were similar between BRACE-treated and treatment-naïve patients (85.2% vs 81.8%, p=1) but lower in the group of patients under non-BRACE DMTs comparing to BRACE- treated patients (54.1% vs 85.2%, p=0.014) and treatment-naïve patients (54.1% vs 81.8%, p=0.021).Conclusions Seroconversion following HBV vaccination was not influenced by age in our sample; however, treatment with DMTs other than BRACE was associated with a lower seroconversion rate following vaccination. Vaccination should then be considered at an early stage of MS treatment, preferably in naïve-RRMS or patients under BRACE DMTs.
- |||||||||| Lemtrada (alemtuzumab) / Sanofi
[VIRTUAL] Management of infectious risk in multiple sclerosis: implication for screening, prophylaxis and therapies () - Aug 16, 2020 - Abstract #MSDC2020MSDC_439;
Hepatitis B virus (HBV) reactivation may be harmful mainly for ocrelizumab and alemtuzumab treated patients.Objectives Aim of the study was to define the infectious risk in DMTs-treated MS patients with approaches tailored to individual patients.Methods At the Neuroinfectious Unit of Policlinico Umberto I (Rome), before starting or switching to DMTs, MS patients were evaluated for infectious risk...Beside preventing TB reactivation, TB prophylaxis based on two active molecules, allows an earlier starting of DMTs. Moreover, TB screening may contribute to reduce the transmission, morbidity, and mortality of active disease in global population.
- |||||||||| dimethyl fumarate / Generic mfg.
[VIRTUAL] Lymphopenia in patients treated with dimethyl fumarate. Risk factors and clinical significance. Experience in daily clinical practice () - Aug 16, 2020 - Abstract #MSDC2020MSDC_438;
Seventy-six percent of the patients had received previous treatments for RRMS, including glatiramer acetate(22.5%), interferon (32.5%), teriflunomide (15.5%) and fingolimod (2.5%), without posing a risk of developing grade II-III lymphopenia...Three of them maintained an ALC of less than 800 at least 6 months after the end of DMF.Conclusions In our series, lymphopenia is a frequent adverse effect, it appears especially in the first year and in most cases it remains, even months after stopping DMF. Therefore, surveillance should be increased and control of ALC should be maintained given the increased risk of infection if lymphopenia develops, especially in those patients with lower ACL at baseline.
- |||||||||| dimethyl fumarate / Generic mfg., Rituxan (rituximab) / Biogen, Zenyaku Kogyo, Roche
[VIRTUAL] Lymphocyte reconstitution following discontinuation of Dimethyl fumarate (DMF) due to lymphopenia in the Swedish post-market surveillance study IMSE-5 () - Aug 16, 2020 - Abstract #MSDC2020MSDC_436;
and three patients switched from natalizumab and fingolimod...The mean time from discontinuation to a new treatment initiation following DMF was 99.8 (SD 88.5) days; and 50% switched to rituximab and two patients to teriflunomide, and one to GA.Conclusions Data from the Swedish IMSE-5 study suggest that a lymphocyte reconstitution occurs within 12 weeks following the discontinuation of DMF. However, larger datasets will be needed to verify this finding Funding: The IMSE-5 study is funded in a scientific collaboration agreement with Biogen.
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