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Lapses in DMT Increases Risk of Relapse in MS Patients

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Lapses in DMT Increases Risk of Relapse in MS Patients
REPORTING FROM CMSC 2019

Key clinical point: Lapses in the use of MS disease-modifying oral therapy increases the risk for relapse, hospitalization, emergency department visits, and outpatient visits, and leads to higher healthcare costs.

Major finding: Over an 18-month follow-up period, those with drug lapses of more than 60 days had 28% more relapses than did the other subjects (mean 1.2 vs. 0.8; P less than .0001).

Study details: A claims database study of 8,779 patients with MS during 2011-2015

Disclosures: EMD Serono, a division of Merck KGaA, provided funding for the study. Dr. Nicholas disclosed grant support from EMD Serono, and two other study authors are employees of the company. Another two authors worked for a consulting firm that received funding from EMD Serono to conduct the study.

Citation: REPORTING FROM CMSC 2019

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REPORTING FROM CMSC 2019
REPORTING FROM CMSC 2019

Key clinical point: Lapses in the use of MS disease-modifying oral therapy increases the risk for relapse, hospitalization, emergency department visits, and outpatient visits, and leads to higher healthcare costs.

Major finding: Over an 18-month follow-up period, those with drug lapses of more than 60 days had 28% more relapses than did the other subjects (mean 1.2 vs. 0.8; P less than .0001).

Study details: A claims database study of 8,779 patients with MS during 2011-2015

Disclosures: EMD Serono, a division of Merck KGaA, provided funding for the study. Dr. Nicholas disclosed grant support from EMD Serono, and two other study authors are employees of the company. Another two authors worked for a consulting firm that received funding from EMD Serono to conduct the study.

Citation: REPORTING FROM CMSC 2019

Key clinical point: Lapses in the use of MS disease-modifying oral therapy increases the risk for relapse, hospitalization, emergency department visits, and outpatient visits, and leads to higher healthcare costs.

Major finding: Over an 18-month follow-up period, those with drug lapses of more than 60 days had 28% more relapses than did the other subjects (mean 1.2 vs. 0.8; P less than .0001).

Study details: A claims database study of 8,779 patients with MS during 2011-2015

Disclosures: EMD Serono, a division of Merck KGaA, provided funding for the study. Dr. Nicholas disclosed grant support from EMD Serono, and two other study authors are employees of the company. Another two authors worked for a consulting firm that received funding from EMD Serono to conduct the study.

Citation: REPORTING FROM CMSC 2019

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Lapses in DMT Increases Risk of Relapse in MS Patients
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Adherence to Oral Treatments for MS is Poor

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Adherence to Oral Treatments for MS is Poor
Nicholas J et al. CMSC 2019. Abstract DXT34.

Key clinical point: Adherence to current oral therapies for multiple sclerosis (MS) is poor.

Major finding: Almost half of patients with MS discontinue their initial oral therapy.

Study details: A retrospective administrative claims study of 8,251 patients with MS.

Disclosures: The authors received no financial support for this study. Dr. Nicholas reported receiving grant support from EMD Serono.

Citation: Nicholas J et al. CMSC 2019. Abstract DXT34.

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Nicholas J et al. CMSC 2019. Abstract DXT34.
Nicholas J et al. CMSC 2019. Abstract DXT34.

Key clinical point: Adherence to current oral therapies for multiple sclerosis (MS) is poor.

Major finding: Almost half of patients with MS discontinue their initial oral therapy.

Study details: A retrospective administrative claims study of 8,251 patients with MS.

Disclosures: The authors received no financial support for this study. Dr. Nicholas reported receiving grant support from EMD Serono.

Citation: Nicholas J et al. CMSC 2019. Abstract DXT34.

Key clinical point: Adherence to current oral therapies for multiple sclerosis (MS) is poor.

Major finding: Almost half of patients with MS discontinue their initial oral therapy.

Study details: A retrospective administrative claims study of 8,251 patients with MS.

Disclosures: The authors received no financial support for this study. Dr. Nicholas reported receiving grant support from EMD Serono.

Citation: Nicholas J et al. CMSC 2019. Abstract DXT34.

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Adherence to Oral Treatments for MS is Poor
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Changes in Brain Networks May Predict MS Worsening

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Changes in Brain Networks May Predict MS Worsening

Key clinical point: Structural and functional network MRI measures predict long-term worsening in multiple sclerosis.

Major finding: The odds ratio of worsening for patients with abnormally high baseline resting state functional connectivity is 1.67.

Study details: A prospective imaging study of 233 patients with multiple sclerosis and 77 healthy controls.

Disclosures: Dr. Filippi has received research support from Biogen, Merck Serono, Novartis, Teva, and Roche.

Citation: Filippi M et al. AAN 2019, Abstract S49.004.

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Key clinical point: Structural and functional network MRI measures predict long-term worsening in multiple sclerosis.

Major finding: The odds ratio of worsening for patients with abnormally high baseline resting state functional connectivity is 1.67.

Study details: A prospective imaging study of 233 patients with multiple sclerosis and 77 healthy controls.

Disclosures: Dr. Filippi has received research support from Biogen, Merck Serono, Novartis, Teva, and Roche.

Citation: Filippi M et al. AAN 2019, Abstract S49.004.

Key clinical point: Structural and functional network MRI measures predict long-term worsening in multiple sclerosis.

Major finding: The odds ratio of worsening for patients with abnormally high baseline resting state functional connectivity is 1.67.

Study details: A prospective imaging study of 233 patients with multiple sclerosis and 77 healthy controls.

Disclosures: Dr. Filippi has received research support from Biogen, Merck Serono, Novartis, Teva, and Roche.

Citation: Filippi M et al. AAN 2019, Abstract S49.004.

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Changes in Brain Networks May Predict MS Worsening
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Sugary Drink Intake May be Associated with MS Severity

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Sugary Drink Intake May be Associated with MS Severity
Meier-Gerdingh E et al. AAN 2019, Abstract P4.2-063.

Key clinical point: Among patients with multiple sclerosis, consumption of sugar-sweetened beverages may be associated with more severe disability.

Major finding: Patients in the top quartile of sugar-sweetened beverage intake had an average EDSS of 4.1 and patients in the bottom quartile had an average EDSS of 3.4.

Study details: Cross-sectional study of 135 patients with MS.

Disclosures: Dr. Meier-Gerdingh had no disclosures. Coauthors reported research support and personal compensation from pharmaceutical companies.

Citation: Meier-Gerdingh E et al. AAN 2019, Abstract P4.2-063.

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Meier-Gerdingh E et al. AAN 2019, Abstract P4.2-063.
Meier-Gerdingh E et al. AAN 2019, Abstract P4.2-063.

Key clinical point: Among patients with multiple sclerosis, consumption of sugar-sweetened beverages may be associated with more severe disability.

Major finding: Patients in the top quartile of sugar-sweetened beverage intake had an average EDSS of 4.1 and patients in the bottom quartile had an average EDSS of 3.4.

Study details: Cross-sectional study of 135 patients with MS.

Disclosures: Dr. Meier-Gerdingh had no disclosures. Coauthors reported research support and personal compensation from pharmaceutical companies.

Citation: Meier-Gerdingh E et al. AAN 2019, Abstract P4.2-063.

Key clinical point: Among patients with multiple sclerosis, consumption of sugar-sweetened beverages may be associated with more severe disability.

Major finding: Patients in the top quartile of sugar-sweetened beverage intake had an average EDSS of 4.1 and patients in the bottom quartile had an average EDSS of 3.4.

Study details: Cross-sectional study of 135 patients with MS.

Disclosures: Dr. Meier-Gerdingh had no disclosures. Coauthors reported research support and personal compensation from pharmaceutical companies.

Citation: Meier-Gerdingh E et al. AAN 2019, Abstract P4.2-063.

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Researchers Examine Vitamin D, Skin Pigmentation, and Outcomes of Pediatric MS

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Researchers Examine Vitamin D, Skin Pigmentation, and Outcomes of Pediatric MS
Dunn C et al. AAN 2019, Abstract S19.007.

Key clinical point: The relationship between vitamin D status and MS outcome in children relates to skin pigmentation.

Major finding: About 46% of children with MS were HLA-DRB1*15 positive.

Study details: A multisite, prospective study of 259 children with MS.

Disclosures: Ms. Dunn had no disclosures, but various coauthors have received compensation from companies such as Novartis, Merck, Teva, Celgene, and Genentech.

Citation: Dunn C et al. AAN 2019, Abstract S19.007.

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Dunn C et al. AAN 2019, Abstract S19.007.
Dunn C et al. AAN 2019, Abstract S19.007.

Key clinical point: The relationship between vitamin D status and MS outcome in children relates to skin pigmentation.

Major finding: About 46% of children with MS were HLA-DRB1*15 positive.

Study details: A multisite, prospective study of 259 children with MS.

Disclosures: Ms. Dunn had no disclosures, but various coauthors have received compensation from companies such as Novartis, Merck, Teva, Celgene, and Genentech.

Citation: Dunn C et al. AAN 2019, Abstract S19.007.

Key clinical point: The relationship between vitamin D status and MS outcome in children relates to skin pigmentation.

Major finding: About 46% of children with MS were HLA-DRB1*15 positive.

Study details: A multisite, prospective study of 259 children with MS.

Disclosures: Ms. Dunn had no disclosures, but various coauthors have received compensation from companies such as Novartis, Merck, Teva, Celgene, and Genentech.

Citation: Dunn C et al. AAN 2019, Abstract S19.007.

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Immunotherapy Induces Improvements in PML

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Immunotherapy Induces Improvements in PML
Cortese I et al. AAN 2019, Abstract Plen01.002.

Key clinical point: Adoptive transfer of donor-derived T cells represents a potentially life-saving strategy for patients with progressive multifocal leukoencephalopathy.

Major finding: Seven of 12 patients stabilized and, in some cases, experienced significant neurological improvement.

Study details: A pilot study including 12 patients with refractory PML.

Disclosures: The study was funded by NINDS. The investigators disclosed no conflicts related to the study.

Citation: Cortese I et al. AAN 2019, Abstract Plen01.002.

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Cortese I et al. AAN 2019, Abstract Plen01.002.
Cortese I et al. AAN 2019, Abstract Plen01.002.

Key clinical point: Adoptive transfer of donor-derived T cells represents a potentially life-saving strategy for patients with progressive multifocal leukoencephalopathy.

Major finding: Seven of 12 patients stabilized and, in some cases, experienced significant neurological improvement.

Study details: A pilot study including 12 patients with refractory PML.

Disclosures: The study was funded by NINDS. The investigators disclosed no conflicts related to the study.

Citation: Cortese I et al. AAN 2019, Abstract Plen01.002.

Key clinical point: Adoptive transfer of donor-derived T cells represents a potentially life-saving strategy for patients with progressive multifocal leukoencephalopathy.

Major finding: Seven of 12 patients stabilized and, in some cases, experienced significant neurological improvement.

Study details: A pilot study including 12 patients with refractory PML.

Disclosures: The study was funded by NINDS. The investigators disclosed no conflicts related to the study.

Citation: Cortese I et al. AAN 2019, Abstract Plen01.002.

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Criterion Based on the Central Vein Sign Distinguishes Between MS and Mimics

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Criterion Based on the Central Vein Sign Distinguishes Between MS and Mimics
Sinnecker T et al. AAN 2019, Abstract S6.002.

Key clinical point: Applying a criterion of three lesions with the central vein sign distinguishes between multiple sclerosis and its mimics.

Major finding: The criterion has a sensitivity and specificity of 61.9% and 89.0%, respectively.

Study details: A multicenter study of 606 participants with clinically isolated syndrome, multiple sclerosis, and multiple sclerosis mimics.

Disclosures: Dr. Sinnecker reported receiving personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Actelion.

Citation: Sinnecker T et al. AAN 2019, Abstract S6.002.

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Sinnecker T et al. AAN 2019, Abstract S6.002.
Sinnecker T et al. AAN 2019, Abstract S6.002.

Key clinical point: Applying a criterion of three lesions with the central vein sign distinguishes between multiple sclerosis and its mimics.

Major finding: The criterion has a sensitivity and specificity of 61.9% and 89.0%, respectively.

Study details: A multicenter study of 606 participants with clinically isolated syndrome, multiple sclerosis, and multiple sclerosis mimics.

Disclosures: Dr. Sinnecker reported receiving personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Actelion.

Citation: Sinnecker T et al. AAN 2019, Abstract S6.002.

Key clinical point: Applying a criterion of three lesions with the central vein sign distinguishes between multiple sclerosis and its mimics.

Major finding: The criterion has a sensitivity and specificity of 61.9% and 89.0%, respectively.

Study details: A multicenter study of 606 participants with clinically isolated syndrome, multiple sclerosis, and multiple sclerosis mimics.

Disclosures: Dr. Sinnecker reported receiving personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Actelion.

Citation: Sinnecker T et al. AAN 2019, Abstract S6.002.

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Multiple Sclerosis May Not Flare Up After Pregnancy

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Multiple Sclerosis May Not Flare Up After Pregnancy
Langer-Gould A et al. AAN 2019, Abstract S6.007.

Key clinical point: Women with MS may be able to have children, breastfeed, and resume treatment without experiencing an increased risk of relapse during the postpartum period.

Major finding: Patients’ annualized relapse rate was 0.39 pre-pregnancy, 0.07-0.14 during pregnancy, 0.27 in the first 3 months postpartum, and 0.37 at 4-6 months postpartum.

Study details: An analysis of prospectively collected data from 466 pregnancies among 375 women with MS between 2008 and 2016.

Disclosures: The study was supported by the National Multiple Sclerosis Society. The researchers had no disclosures.

Citation: Langer-Gould A et al. AAN 2019, Abstract S6.007.

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Langer-Gould A et al. AAN 2019, Abstract S6.007.
Langer-Gould A et al. AAN 2019, Abstract S6.007.

Key clinical point: Women with MS may be able to have children, breastfeed, and resume treatment without experiencing an increased risk of relapse during the postpartum period.

Major finding: Patients’ annualized relapse rate was 0.39 pre-pregnancy, 0.07-0.14 during pregnancy, 0.27 in the first 3 months postpartum, and 0.37 at 4-6 months postpartum.

Study details: An analysis of prospectively collected data from 466 pregnancies among 375 women with MS between 2008 and 2016.

Disclosures: The study was supported by the National Multiple Sclerosis Society. The researchers had no disclosures.

Citation: Langer-Gould A et al. AAN 2019, Abstract S6.007.

Key clinical point: Women with MS may be able to have children, breastfeed, and resume treatment without experiencing an increased risk of relapse during the postpartum period.

Major finding: Patients’ annualized relapse rate was 0.39 pre-pregnancy, 0.07-0.14 during pregnancy, 0.27 in the first 3 months postpartum, and 0.37 at 4-6 months postpartum.

Study details: An analysis of prospectively collected data from 466 pregnancies among 375 women with MS between 2008 and 2016.

Disclosures: The study was supported by the National Multiple Sclerosis Society. The researchers had no disclosures.

Citation: Langer-Gould A et al. AAN 2019, Abstract S6.007.

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Multiple Sclerosis May Not Flare Up After Pregnancy
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Damage of the Lateral Geniculate Nucleus in MS

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Damage of the Lateral Geniculate Nucleus in MS
Papadopoulou, et al. Neurology. doi:10.1212/WNL.0000000000007450.

Key clinical point: Lateral geniculate nucleus (LGN) volume loss in multiple sclerosis (MS) indicates structural damage with potential functional relevance.

Major finding: LGN volume was reduced in patients with relapsing-remitting MS vs healthy controls and was associated with ganglion cell-inner plexiform layer (GC-IPL) thickness and correlated with optic radiation (OR) lesion volume.

Study details: A cross-sectional study of 34 patients with relapsing-remitting MS and 33 matched healthy controls.

Disclosures: The lead author received funding for speaker or travel honoraria from Sanofi-Genzyme, Bayer AG, Teva, UCB-Pharma AG, and Hoffmann-La Roche.

Citation: Papadopoulou, et al. Neurology. doi:10.1212/WNL.0000000000007450.

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Papadopoulou, et al. Neurology. doi:10.1212/WNL.0000000000007450.
Papadopoulou, et al. Neurology. doi:10.1212/WNL.0000000000007450.

Key clinical point: Lateral geniculate nucleus (LGN) volume loss in multiple sclerosis (MS) indicates structural damage with potential functional relevance.

Major finding: LGN volume was reduced in patients with relapsing-remitting MS vs healthy controls and was associated with ganglion cell-inner plexiform layer (GC-IPL) thickness and correlated with optic radiation (OR) lesion volume.

Study details: A cross-sectional study of 34 patients with relapsing-remitting MS and 33 matched healthy controls.

Disclosures: The lead author received funding for speaker or travel honoraria from Sanofi-Genzyme, Bayer AG, Teva, UCB-Pharma AG, and Hoffmann-La Roche.

Citation: Papadopoulou, et al. Neurology. doi:10.1212/WNL.0000000000007450.

Key clinical point: Lateral geniculate nucleus (LGN) volume loss in multiple sclerosis (MS) indicates structural damage with potential functional relevance.

Major finding: LGN volume was reduced in patients with relapsing-remitting MS vs healthy controls and was associated with ganglion cell-inner plexiform layer (GC-IPL) thickness and correlated with optic radiation (OR) lesion volume.

Study details: A cross-sectional study of 34 patients with relapsing-remitting MS and 33 matched healthy controls.

Disclosures: The lead author received funding for speaker or travel honoraria from Sanofi-Genzyme, Bayer AG, Teva, UCB-Pharma AG, and Hoffmann-La Roche.

Citation: Papadopoulou, et al. Neurology. doi:10.1212/WNL.0000000000007450.

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Survey of MS Patients Reveals Pregnancy-Related Concerns

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Survey of MS Patients Reveals Pregnancy-Related Concerns
Engel CE et al. ACTRIMS Forum 2019, Poster 307.

Key clinical point: Patients with multiple sclerosis report a wide range of concerns about family planning and pregnancy.

Major finding: Of the 137 respondents who did not become pregnant following diagnosis, 22 (16%) indicated that their decision was driven by multiple sclerosis–related concerns, including MS worsening with pregnancy (64%).

Study details: A survey of 174 women with confirmed MS diagnosis who received care at the University of Virginia Medical Center.

Disclosures: The study was supported by the ziMS Foundation.

Citation: Engel CE et al. ACTRIMS Forum 2019, Poster 307.

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Engel CE et al. ACTRIMS Forum 2019, Poster 307.
Engel CE et al. ACTRIMS Forum 2019, Poster 307.

Key clinical point: Patients with multiple sclerosis report a wide range of concerns about family planning and pregnancy.

Major finding: Of the 137 respondents who did not become pregnant following diagnosis, 22 (16%) indicated that their decision was driven by multiple sclerosis–related concerns, including MS worsening with pregnancy (64%).

Study details: A survey of 174 women with confirmed MS diagnosis who received care at the University of Virginia Medical Center.

Disclosures: The study was supported by the ziMS Foundation.

Citation: Engel CE et al. ACTRIMS Forum 2019, Poster 307.

Key clinical point: Patients with multiple sclerosis report a wide range of concerns about family planning and pregnancy.

Major finding: Of the 137 respondents who did not become pregnant following diagnosis, 22 (16%) indicated that their decision was driven by multiple sclerosis–related concerns, including MS worsening with pregnancy (64%).

Study details: A survey of 174 women with confirmed MS diagnosis who received care at the University of Virginia Medical Center.

Disclosures: The study was supported by the ziMS Foundation.

Citation: Engel CE et al. ACTRIMS Forum 2019, Poster 307.

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