NeurologyLive Staff

This week Neurology News Network covered a trio of abstracts from the ACTRIMS Forum 2021, which included the use of electronic smart pill bottle caps to improve disease-modifying therapy adherence, a study using subcutaneous cladribine personalized dosing, and the effects of MS fatigue in a long-term program. 

Welcome to this special edition of Neurology News Network. I’m Marco Meglio. Please excuse our appearance this week as a majority of the US workforce, including the 

team, moves to working remote as we come together to help reduce the spread of the novel coronavirus. This episode was dedicated to the recent cover of the ACTRIMS Forum.

A reminder system using electronic smart caps from a 

pill bottle paired with remote smartphone

 app technology produced greater rates of adherence for people with multiple sclerosis, but still suggested that developing strategies to improve adherence to oral disease-modifying therapies (DMTs) remains a need within MS care. Overall, the average perfect adherence over the 90-day study period for all participants was 65%. Average perfect adherence was statistically significantly higher in the reminders arm (68%) compared to the monitoring only arm (61.4%). Notably, there was no difference observed in perfect adherence by once versus twice daily dosing. Of 5959 total scheduled doses in the monitoring only arm, 4% were taken early, 61.4% on time, 5.6% late, 4.7% in excess, and 24.4% not at all. Of 7135 doses in the reminders arm, 3.4% were taken early, 68% on time, 3.7% late, 12.2% in excess, and 12.8% not at all.

subcutaneous cladribine personalized dosing

 (CPD) was well-tolerated in patients with relapsing multiple sclerosis, with efficacy in line with oral cladribine trial data. The researchers offered CPD to people with MS regardless of disease course. Treatment schedule consisted of 10 mg on 3 consecutive days in week 1 (4 days in people over 90 kg), another 0-3 doses in week 5 based on total lymphocyte count in week 4. A second cycle of CPD was administered 11 months later. CPD was generally well-tolerated. Over the follow-up period, 1 myocardial infarction, 1 breast cancer, 1 pulmonary embolism, and 3 severe allergic skin reactions without long-term sequelae occurred. Death occurred in 2 severely disabled patients with MS, 1 from influenza and 1 from encephalitis. Lymphopenia of at least grade 3 occurred in 7%.

, showed that patients with multiple sclerosis (MS) who entered a 

long-term fatigue program remained unchanged

 after a 5- to 6-year period, raising questions about whether fatigue is progressive within this patient population.Senior author Cinda L. Hugos, MS, PT, associate professor of neurology, Oregon Health & Science University, and colleagues compared 38 participants who completed either the Fatigue: Take Control or the MS: Take Control fatigue self-management programs. Upon completion, t-tests revealed no significant differences in Modified Fatigue Impact Scale (MFIS) scores within or between groups at the 5- to 6-year follow-up compared with any other time point. Additionally, chi-square tests showed that regardless of group, there was no significant difference in the proportion of those who completed any of the potential behavior changes.

For more direct access to expert insight, head to NeurologyLive.com. This has been Neurology News Network. Thanks for watching.

Videos

Neurology News Network for the week ending March 6, 2021. 

Electronic Pill Bottle Improves DMT Adherence, Subcutaneous Cladribine Personalized Dosing Well-Tolerated, MS Fatigue Unchanged Long-Term

's Friday 5! Every week, the staff compiles 5 highlights of 

's widespread coverage in neurology, ranging from newsworthy study findings and FDA action to expert interviews and peer-to-peer panel discussions.

 Cure Connections series, Philippa Cheetham, MBChB, MRCS, MD, FRCS; Jessica Ailani, MD, FAHS; and Jill Dehlin, RN, discuss the factors that differentiate migraine attacks from headaches and the impact of migraine attacks on patients’ lives.

 The Economic Burden of SMA Prior to Treatment Approvals: Lisa Belter, MPH

The director of research analytics at Cure SMA discussed her recent research conducted in tandem with Novartis Gene Therapies on the economic burden and costs patients with spinal muscular atrophy and their caregivers face.

: Dylan Rice, on Improving Adherence to MS DMTs

The clinical research coordinator at Massachusetts General Hospital discussed his presentation from 

 on electronic pill bottle monitoring to promote MS medication adherence.

 Risdiplam Efficacious in Infants with Spinal Muscular Atrophy Type 1

Recently announced positive data from part 1 of the FIREFISH study (NCT02913482) evaluating risdiplam (Evrysdi; PTC Therapeutics) in SMA type 1—just one of many such ongoing studies—were announced by PTC Therapeutics.

The Kenneth P. Johnson Memorial Lecture and the Clinical Course of MS: Benjamin Segal, MD

The chair of the Department of Neurology and the director of the Neuroscience Research Institute at The Ohio State University discussed his keynote lecture at ACTRIMS Forum 2021.

We kindly ask you to share 5 minutes of your time with us, in order to help us better craft our content to meet your needs and interests.

Articles

Take 5 minutes to catch up on NeurologyLive's highlights from the week ending March 5, 2021.

NeurologyLive Friday 5 — March 5, 2021

 staff prepares this preview of what to expect from our coverage. This week on 

, there are a number of hot topics that we will be posting throughout the week. As always, our weekly coverage extends beyond just these topics, so make sure to check out the rest of the site!

 team is still conducting coverage of the Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum 2021 this week, including a number of news items publishing today. The meeting kicked off virtually last week, and our coverage will extend into the next few weeks. You can expect to see coverage of some of the top clinical presentations, as well as interviews with the experts about the ongoing conversations and themes in multiple sclerosis care.

To check out the latest ACTRIMS 2021 coverage, 

 Cure Connections series, "The Migraine Patient Journey: Episodic Migraine and CGRP Inhibitors," has been made available. This group conversation is moderated by Philippa Cheetham, MBChB, MRCS, MD, FRCS, and includes Jessica Ailani, MD, a headache specialist at MedStar Georgetown, and Jill Dehlin, RN, a patient advocate. The conversation offers patient and clinician insight regarding the challenges associated with migraine and best approaches to preventing and managing attacks with lifestyle intervention and newer therapies.

To catch up on our available Cure Connections series, 

 series, dedicated to conversations with leaders in the neurology community, will go live this Wednesday, March 3. This rendition features Dylan Rice, a clinical research coordinator at Massachusetts General Hospital. Rice stopped by to discuss his poster presented at the recently concluded ACTRIMS 2021 Forum, which involved using an electronic smart cap system to track and boost levels of adherence in patients with multiple sclerosis who take daily disease-modifying therapies.

A conversation with William Noah, MD, director and founder of the Sleep Centers of Middle Tennessee, will air during 

 channel this Thursday, March 4, 2021. Noah discussed how integrating positive airway pressure therapy into sleep care benefitted patients’ understanding of the benefits of the therapy, and how receiving care from integrated sleep practices streamlines and simplifies communications between doctors and patients.

To check out what's on the Medical World News channel now, 

 "Mind Moments" podcast went live on Friday last week. The episode features Jennifer Martin, PhD, a member of the American Academy of Sleep Medicine's (AASM) board of directors and professor of medicine at UCLA. She discusses the benefits of cognitive-behavioral therapy for insomnia, its efficacy compared to pharmacological treatments, and the recent AASM guidance on its use.

To subscribe on your favorite podcast player, 

We kindly ask you to share 5 minutes of your time with us, in order to help us better craft our content to meet your needs and interests. 

Here's what is coming soon to NeurologyLive.

This Week on NeurologyLive — March 1, 2020

team, moves to working remote as we come together to help reduce the spread of the novel coronavirus.

secondary data analysis from the EXPAND study

 showed that patients with secondary progressive multiple sclerosis treated with siponimod experienced a significant benefit on the Symbol Digit Modalities Test, suggesting that the oral S1P receptor modulator can improve cognitive processing speed. The between-group difference for the siponimod vs placebo groups in mean change from baseline in SDMT scores was 1.08 at 12 months, and 1.23 at month 18, and 2.30 at month 24. The data also showed a lower risk of having a decrease of 4 or more points and a higher risk of having an increase of 4 or more points on the SDMT for siponimod-treated patients. First author Ralph HB Benedict, PhD, professor of neurology, Jacobs School of Medicine & Biomedical Sciences, University at Buffalo, and colleagues wrote that the data offer Class II evidence for the benefits of siponimod treatment. They noted that the data are at “a magnitude of change accepted as clinically meaningful.”

Results from a retrospective cohort study found that patients with migraine who received opioid medications at their emergency department visits were 

associated with increased future health resource utilization

, highlighting the need for optimizing migraine management in emergency settings. A total of 788 patient cases pulled from the Baylor Scott & White Health record between December 2013 and April 2017 were included in the study. During the 6-month follow-up period, compared to patients with migraine who were non-recipients at their index ED visits, opioid recipients had significantly more all-cause and migraine-related opioid prescriptions.

Data from a recent study suggest that the 

, decreased ischemic stroke admissions, and reduced performance on stroke quality of care.Researchers found that telestroke consultations were reduced by 1.32% per week and IS patient admissions decreased from 13.3 patients per week prior to March 1, 2020 to 10.3 patients per week afterward. Patient presentation and care delivery time metrics were unchanged, but rates of adherence to dysphagia screening, early antithrombotic initiation, and early venous thrombo-embolism were reduced. The researchers found decreasing telestroke consultations over the 6-month study period, but no differences in the mean number of consultations prior to (33.7 per week) and after March 2020 (29.8 per week) or the mean number of stroke cases per week prior to March (23.9) and after (21.2). All stroke admissions decreased from 16.7 patients per week prior to March to 12.9 patients per week after March.

Neurology News Network for the week ending February 27, 2021. 

NeurologyLive Staff

Articles

Electronic Pill Bottle Improves DMT Adherence, Subcutaneous Cladribine Personalized Dosing Well-Tolerated, MS Fatigue Unchanged Long-Term

NeurologyLive Friday 5 — March 5, 2021

This Week on NeurologyLive — March 1, 2020

Siponimod Improves Cognitive Processing Speed, Opioid Use for Migraine in Emergency Departments, Reduced Stroke Admissions During Pandemic