Literature Monitor

Key clinical point: Teriflunomide may be more cost effective than interferon beta-1b for relapsing MS patients.

Major finding: Over the course of 20 years, the cost of treatment with teriflunomide would cost $567,767, compared with the cost of treatment for interferon beta of $620,191 for patients in China.

Study details: A Markov cost model was developed for the study. Eleven neurologists were surveyed throughout China about costs related to treatment for RMS including acquisition and administration, patient monitoring, treating relapse, and the management of adverse events.

Disclosures: This study was funded by Sanofi China. Two study investigators reported being employees of the company.

Citation: Xu Y, et al. Clin Drug Investig. 2019 Mar;39(3):331-340. doi: 10.1007/s40261-019-00750-3.

Key clinical point: Teriflunomide may be more cost effective than interferon beta-1b for relapsing MS patients.

Major finding: Over the course of 20 years, the cost of treatment with teriflunomide would cost $567,767, compared with the cost of treatment for interferon beta of $620,191 for patients in China.

Study details: A Markov cost model was developed for the study. Eleven neurologists were surveyed throughout China about costs related to treatment for RMS including acquisition and administration, patient monitoring, treating relapse, and the management of adverse events.

Disclosures: This study was funded by Sanofi China. Two study investigators reported being employees of the company.

Citation: Xu Y, et al. Clin Drug Investig. 2019 Mar;39(3):331-340. doi: 10.1007/s40261-019-00750-3.

Key clinical point: Teriflunomide may be more cost effective than interferon beta-1b for relapsing MS patients.

Major finding: Over the course of 20 years, the cost of treatment with teriflunomide would cost $567,767, compared with the cost of treatment for interferon beta of $620,191 for patients in China.

Study details: A Markov cost model was developed for the study. Eleven neurologists were surveyed throughout China about costs related to treatment for RMS including acquisition and administration, patient monitoring, treating relapse, and the management of adverse events.

Disclosures: This study was funded by Sanofi China. Two study investigators reported being employees of the company.

Citation: Xu Y, et al. Clin Drug Investig. 2019 Mar;39(3):331-340. doi: 10.1007/s40261-019-00750-3.

Key clinical point: Polypharmacy frequency can have a negative effect on relapsing-remitting multiple sclerosis (RRMS) patients.

Major finding: The proportion of polypharmacy among patients with a secondary illness to RRMS was four times higher than in patients without a secondary illness. Patients with polypharmacy were older, had a lower level of education, and had higher comorbidities than patients without polypharmacy.

Study details: Subgroups of 145 RRMS patients were analyzed. The subgroups were patients with polypharmacy, patients without polypharmacy, patients with secondary illness, and patients without secondary illness.

Disclosures: Michael Hecker support from Bayer HealthCare, Biogen, Novartis and Teva. Uwe Klaus Zettl received support from Almirall, Bayer HealthCare, Biogen, Merck Serono, Novartis, Sanofi and Teva. Niklas Frahm has no relevant conflicts of interest.

Citation: Frahm N, et al. PLoS One. 2019 Jan 24;14(1):e0211120. doi: 10.1371/journal.pone.0211120.

Key clinical point: Polypharmacy frequency can have a negative effect on relapsing-remitting multiple sclerosis (RRMS) patients.

Major finding: The proportion of polypharmacy among patients with a secondary illness to RRMS was four times higher than in patients without a secondary illness. Patients with polypharmacy were older, had a lower level of education, and had higher comorbidities than patients without polypharmacy.

Study details: Subgroups of 145 RRMS patients were analyzed. The subgroups were patients with polypharmacy, patients without polypharmacy, patients with secondary illness, and patients without secondary illness.

Disclosures: Michael Hecker support from Bayer HealthCare, Biogen, Novartis and Teva. Uwe Klaus Zettl received support from Almirall, Bayer HealthCare, Biogen, Merck Serono, Novartis, Sanofi and Teva. Niklas Frahm has no relevant conflicts of interest.

Citation: Frahm N, et al. PLoS One. 2019 Jan 24;14(1):e0211120. doi: 10.1371/journal.pone.0211120.

Key clinical point: Polypharmacy frequency can have a negative effect on relapsing-remitting multiple sclerosis (RRMS) patients.

Major finding: The proportion of polypharmacy among patients with a secondary illness to RRMS was four times higher than in patients without a secondary illness. Patients with polypharmacy were older, had a lower level of education, and had higher comorbidities than patients without polypharmacy.

Study details: Subgroups of 145 RRMS patients were analyzed. The subgroups were patients with polypharmacy, patients without polypharmacy, patients with secondary illness, and patients without secondary illness.

Disclosures: Michael Hecker support from Bayer HealthCare, Biogen, Novartis and Teva. Uwe Klaus Zettl received support from Almirall, Bayer HealthCare, Biogen, Merck Serono, Novartis, Sanofi and Teva. Niklas Frahm has no relevant conflicts of interest.

Citation: Frahm N, et al. PLoS One. 2019 Jan 24;14(1):e0211120. doi: 10.1371/journal.pone.0211120.

Key clinical point: Two algorithms identified in a new study can be used for future clinical research of relapsing-remitting multiple sclerosis (RRMS). Major finding: Using EHRs and the coded health care claims of 5,308 patients with possible MS, 837 and 2,271 were identified as having RRMS, respectively. There were also 779 patients identified using both algorithms.

Study details: Two different algorithms “unstructured clinical notes (EHR clinical notes-based algorithm) and structured/coded data (claims-based algorithms)” were used to identify patients with RRMS.

Disclosures: The investigators reported no conflicts of interest.

Citation: Van Le H, et al. Value Health. 2019 Jan;22(1):77-84. doi: 10.1016/j.jval.2018.06.014.

Key clinical point: Two algorithms identified in a new study can be used for future clinical research of relapsing-remitting multiple sclerosis (RRMS). Major finding: Using EHRs and the coded health care claims of 5,308 patients with possible MS, 837 and 2,271 were identified as having RRMS, respectively. There were also 779 patients identified using both algorithms.

Study details: Two different algorithms “unstructured clinical notes (EHR clinical notes-based algorithm) and structured/coded data (claims-based algorithms)” were used to identify patients with RRMS.

Disclosures: The investigators reported no conflicts of interest.

Citation: Van Le H, et al. Value Health. 2019 Jan;22(1):77-84. doi: 10.1016/j.jval.2018.06.014.

Key clinical point: Two algorithms identified in a new study can be used for future clinical research of relapsing-remitting multiple sclerosis (RRMS). Major finding: Using EHRs and the coded health care claims of 5,308 patients with possible MS, 837 and 2,271 were identified as having RRMS, respectively. There were also 779 patients identified using both algorithms.

Study details: Two different algorithms “unstructured clinical notes (EHR clinical notes-based algorithm) and structured/coded data (claims-based algorithms)” were used to identify patients with RRMS.

Disclosures: The investigators reported no conflicts of interest.

Citation: Van Le H, et al. Value Health. 2019 Jan;22(1):77-84. doi: 10.1016/j.jval.2018.06.014.

Key clinical point: ARMSS-rate at 2 years accurately predicts disease course over the subsequent 8 years.

Major finding: ARMSS-rate at 2 years had an area under the curve of 0.921 for predicting the next 8 years of ARMSS-rate.

Study details: An analysis of data for 4,514 participants in the Swedish MS Registry.

Disclosures: Dr. Ramanujam had no conflicts of interest to disclose. He receives funding from the MultipleMS Project, which is part of the EU Horizon 2020 Framework.

Citation: Manouchehrinia A et al. ECTRIMS 2019. Abstract 218.

Key clinical point: ARMSS-rate at 2 years accurately predicts disease course over the subsequent 8 years.

Major finding: ARMSS-rate at 2 years had an area under the curve of 0.921 for predicting the next 8 years of ARMSS-rate.

Study details: An analysis of data for 4,514 participants in the Swedish MS Registry.

Disclosures: Dr. Ramanujam had no conflicts of interest to disclose. He receives funding from the MultipleMS Project, which is part of the EU Horizon 2020 Framework.

Citation: Manouchehrinia A et al. ECTRIMS 2019. Abstract 218.

Key clinical point: ARMSS-rate at 2 years accurately predicts disease course over the subsequent 8 years.

Major finding: ARMSS-rate at 2 years had an area under the curve of 0.921 for predicting the next 8 years of ARMSS-rate.

Study details: An analysis of data for 4,514 participants in the Swedish MS Registry.

Disclosures: Dr. Ramanujam had no conflicts of interest to disclose. He receives funding from the MultipleMS Project, which is part of the EU Horizon 2020 Framework.

Citation: Manouchehrinia A et al. ECTRIMS 2019. Abstract 218.

Key clinical point: Patients with MS who quit smoking tobacco may experience improved cognitive function.

Major finding: Former smokers with MS scored an average of 3.6 points lower on the Processing Speed Test than never smokers, and current smokers scored 5.9 points lower.

Study details: This cross-sectional study included 997 patients with MS who had cognitive function test scores and brain MRIs.

Disclosures: The study presenter reported having no relevant financial interests.

Citation: Alshehri E et al. ECTRIMS 2019. Abstract P461.

Key clinical point: Patients with MS who quit smoking tobacco may experience improved cognitive function.

Major finding: Former smokers with MS scored an average of 3.6 points lower on the Processing Speed Test than never smokers, and current smokers scored 5.9 points lower.

Study details: This cross-sectional study included 997 patients with MS who had cognitive function test scores and brain MRIs.

Disclosures: The study presenter reported having no relevant financial interests.

Citation: Alshehri E et al. ECTRIMS 2019. Abstract P461.

Key clinical point: Patients with MS who quit smoking tobacco may experience improved cognitive function.

Major finding: Former smokers with MS scored an average of 3.6 points lower on the Processing Speed Test than never smokers, and current smokers scored 5.9 points lower.

Study details: This cross-sectional study included 997 patients with MS who had cognitive function test scores and brain MRIs.

Disclosures: The study presenter reported having no relevant financial interests.

Citation: Alshehri E et al. ECTRIMS 2019. Abstract P461.

Key clinical point: Inflammatory pulmonary events occurring at age 11-15 years may be a risk factor for subsequent multiple sclerosis.

Major finding: Swedes who experienced pneumonia at age 11-15 years had an adjusted 2.8-fold increased risk of MS later in life.

Study details: This Swedish national registry cohort study included 6,109 MS patients and 49,479 controls matched for age, gender, and locale.

Disclosures: The presenter reported receiving research funding from F. Hoffmann–La Roche, Novartis, and AstraZeneca and serving on an advisory board for IQVIA.

Citation: Montgomery S. ECTRIMS 2019, Abstract 270.

Key clinical point: Inflammatory pulmonary events occurring at age 11-15 years may be a risk factor for subsequent multiple sclerosis.

Major finding: Swedes who experienced pneumonia at age 11-15 years had an adjusted 2.8-fold increased risk of MS later in life.

Study details: This Swedish national registry cohort study included 6,109 MS patients and 49,479 controls matched for age, gender, and locale.

Disclosures: The presenter reported receiving research funding from F. Hoffmann–La Roche, Novartis, and AstraZeneca and serving on an advisory board for IQVIA.

Citation: Montgomery S. ECTRIMS 2019, Abstract 270.

Key clinical point: Inflammatory pulmonary events occurring at age 11-15 years may be a risk factor for subsequent multiple sclerosis.

Major finding: Swedes who experienced pneumonia at age 11-15 years had an adjusted 2.8-fold increased risk of MS later in life.

Study details: This Swedish national registry cohort study included 6,109 MS patients and 49,479 controls matched for age, gender, and locale.

Disclosures: The presenter reported receiving research funding from F. Hoffmann–La Roche, Novartis, and AstraZeneca and serving on an advisory board for IQVIA.

Citation: Montgomery S. ECTRIMS 2019, Abstract 270.

Key clinical point: Continuing natalizumab treatment during pregnancy reduces the risk of relapse and does not increase risks to newborns.

Major finding: The annualized relapse rate among women who continued treatment after the first trimester was 0.09.

Study details: A comparison of two cohorts of women with multiple sclerosis who received treatment with natalizumab and became pregnant.

Disclosures: The authors received funding from companies such as Biogen, Merck Serono, and Teva.

Citation: Landi D et al. ECTRIMS 2019, Abstract 338.

Key clinical point: Continuing natalizumab treatment during pregnancy reduces the risk of relapse and does not increase risks to newborns.

Major finding: The annualized relapse rate among women who continued treatment after the first trimester was 0.09.

Study details: A comparison of two cohorts of women with multiple sclerosis who received treatment with natalizumab and became pregnant.

Disclosures: The authors received funding from companies such as Biogen, Merck Serono, and Teva.

Citation: Landi D et al. ECTRIMS 2019, Abstract 338.

Key clinical point: Continuing natalizumab treatment during pregnancy reduces the risk of relapse and does not increase risks to newborns.

Major finding: The annualized relapse rate among women who continued treatment after the first trimester was 0.09.

Study details: A comparison of two cohorts of women with multiple sclerosis who received treatment with natalizumab and became pregnant.

Disclosures: The authors received funding from companies such as Biogen, Merck Serono, and Teva.

Citation: Landi D et al. ECTRIMS 2019, Abstract 338.

Key clinical point: Multiple sclerosis (MS) patients who are heavy users of cannabis gain significantly improved cognitive function with a month of abstinence – but do they care?

Major finding: Twenty-eight days of abstinence from cannabis by MS patients who were heavy users resulted in significant improvements in cognition.

Study details: This was a randomized trial involving 40 MS patients who were long-term frequent users of cannabis for symptom relief.

Disclosures: Cecilia Meza, who presented the results, reported having no financial conflicts regarding the study, funded by the Multiple Sclerosis Society of Canada.

Citation: Meza C. ECTRIMS 2019, Abstract P542.

Key clinical point: Multiple sclerosis (MS) patients who are heavy users of cannabis gain significantly improved cognitive function with a month of abstinence – but do they care?

Major finding: Twenty-eight days of abstinence from cannabis by MS patients who were heavy users resulted in significant improvements in cognition.

Study details: This was a randomized trial involving 40 MS patients who were long-term frequent users of cannabis for symptom relief.

Disclosures: Cecilia Meza, who presented the results, reported having no financial conflicts regarding the study, funded by the Multiple Sclerosis Society of Canada.

Citation: Meza C. ECTRIMS 2019, Abstract P542.

Key clinical point: Multiple sclerosis (MS) patients who are heavy users of cannabis gain significantly improved cognitive function with a month of abstinence – but do they care?

Major finding: Twenty-eight days of abstinence from cannabis by MS patients who were heavy users resulted in significant improvements in cognition.

Study details: This was a randomized trial involving 40 MS patients who were long-term frequent users of cannabis for symptom relief.

Disclosures: Cecilia Meza, who presented the results, reported having no financial conflicts regarding the study, funded by the Multiple Sclerosis Society of Canada.

Citation: Meza C. ECTRIMS 2019, Abstract P542.

Key clinical point: Baseline levels of the neuropeptide neurofilament light (NfL) correlated with changes in brain volume at the 5- and 10-year marks in patients with multiple sclerosis.

Major finding: At 10 years, the correlation coefficient between baseline NfL and brain volume loss was –0.395 (P = 0.42).

Study details: Prospective cohort study that obtained baseline cerebrospinal fluid NfL levels and sequential brain MRIs in 44 patients with multiple sclerosis.

Disclosures: Dr. Bhan reported receiving research funding from Novartis Norway; two coauthors reported financial relationships with several pharmaceutical companies.

Citation: Bhan A et al. ECTRIMS 2019, Abstract P592.

Key clinical point: Baseline levels of the neuropeptide neurofilament light (NfL) correlated with changes in brain volume at the 5- and 10-year marks in patients with multiple sclerosis.

Major finding: At 10 years, the correlation coefficient between baseline NfL and brain volume loss was –0.395 (P = 0.42).

Study details: Prospective cohort study that obtained baseline cerebrospinal fluid NfL levels and sequential brain MRIs in 44 patients with multiple sclerosis.

Disclosures: Dr. Bhan reported receiving research funding from Novartis Norway; two coauthors reported financial relationships with several pharmaceutical companies.

Citation: Bhan A et al. ECTRIMS 2019, Abstract P592.

Key clinical point: Baseline levels of the neuropeptide neurofilament light (NfL) correlated with changes in brain volume at the 5- and 10-year marks in patients with multiple sclerosis.

Major finding: At 10 years, the correlation coefficient between baseline NfL and brain volume loss was –0.395 (P = 0.42).

Study details: Prospective cohort study that obtained baseline cerebrospinal fluid NfL levels and sequential brain MRIs in 44 patients with multiple sclerosis.

Disclosures: Dr. Bhan reported receiving research funding from Novartis Norway; two coauthors reported financial relationships with several pharmaceutical companies.

Citation: Bhan A et al. ECTRIMS 2019, Abstract P592.

Key clinical point: A small cohort of patients with CIS meeting MS diagnostic criteria stopped DMT after 5 years of no disease activity, and just under half had MS recurrence.

Major finding: Of the cohort of 46 patients, 23 had disease recurrence, with recurrence more likely among younger patients.

Study details: Cohort study of 46 patients with initial clinical episode of MS, meeting Barkhof criteria for MS on magnetic resonance imaging.

Disclosures: The authors reported no conflicts of interest. No external sources of funding were reported.

Citation: Monschein T et al. ECTRIMS 2019. Abstract P654.

Key clinical point: A small cohort of patients with CIS meeting MS diagnostic criteria stopped DMT after 5 years of no disease activity, and just under half had MS recurrence.

Major finding: Of the cohort of 46 patients, 23 had disease recurrence, with recurrence more likely among younger patients.

Study details: Cohort study of 46 patients with initial clinical episode of MS, meeting Barkhof criteria for MS on magnetic resonance imaging.

Disclosures: The authors reported no conflicts of interest. No external sources of funding were reported.

Citation: Monschein T et al. ECTRIMS 2019. Abstract P654.

Key clinical point: A small cohort of patients with CIS meeting MS diagnostic criteria stopped DMT after 5 years of no disease activity, and just under half had MS recurrence.

Major finding: Of the cohort of 46 patients, 23 had disease recurrence, with recurrence more likely among younger patients.

Study details: Cohort study of 46 patients with initial clinical episode of MS, meeting Barkhof criteria for MS on magnetic resonance imaging.

Disclosures: The authors reported no conflicts of interest. No external sources of funding were reported.

Citation: Monschein T et al. ECTRIMS 2019. Abstract P654.