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Continuation of Natalizumab Treatment Reduces Risk of MS Relapses During Pregnancy

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Continuation of Natalizumab Treatment Reduces Risk of MS Relapses During Pregnancy

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.

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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.

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Cannabis-Using MS Patients Improve Cognition With 28 Days of Abstinence

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Cannabis-Using MS Patients Improve Cognition With 28 Days of Abstinence

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.

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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.

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Baseline Neurofilament Light Levels Track With Brain Volume Loss in MS

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Baseline Neurofilament Light Levels Track With Brain Volume Loss in MS

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.

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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.

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Baseline Neurofilament Light Levels Track With Brain Volume Loss in MS
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Even With No Disease Activity, Recurrence Risk Near 50% When Stopping DMTs for MS

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Even With No Disease Activity, Recurrence Risk Near 50% When Stopping DMTs for MS

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.

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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.

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Even With No Disease Activity, Recurrence Risk Near 50% When Stopping DMTs for MS
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Newer Drugs Provide Superior Disease Activity Control in Pediatric MS

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Newer Drugs Provide Superior Disease Activity Control in Pediatric MS

Key clinical point: Newer oral and intravenous drugs for multiple schlerosis provide significantly better disease activity control than the older injectables as initial disease-modifying therapy in children.

Major finding: The number needed to treat with a newer disease-modifying drug rather than an injectable agent to prevent one relapse was 3.7.

Study details: A prospective, multicenter, observational cohort study including 741 pediatric patients with MS followed while on their first-time disease-modifying therapy.

Disclosures: The study was sponsored by the Multiple Sclerosis Society. Dr. Kysko reported having no financial conflicts in regard to the study.

Citation: Krysko KM. ECTRIMS 2019, abstract 249.

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Key clinical point: Newer oral and intravenous drugs for multiple schlerosis provide significantly better disease activity control than the older injectables as initial disease-modifying therapy in children.

Major finding: The number needed to treat with a newer disease-modifying drug rather than an injectable agent to prevent one relapse was 3.7.

Study details: A prospective, multicenter, observational cohort study including 741 pediatric patients with MS followed while on their first-time disease-modifying therapy.

Disclosures: The study was sponsored by the Multiple Sclerosis Society. Dr. Kysko reported having no financial conflicts in regard to the study.

Citation: Krysko KM. ECTRIMS 2019, abstract 249.

Key clinical point: Newer oral and intravenous drugs for multiple schlerosis provide significantly better disease activity control than the older injectables as initial disease-modifying therapy in children.

Major finding: The number needed to treat with a newer disease-modifying drug rather than an injectable agent to prevent one relapse was 3.7.

Study details: A prospective, multicenter, observational cohort study including 741 pediatric patients with MS followed while on their first-time disease-modifying therapy.

Disclosures: The study was sponsored by the Multiple Sclerosis Society. Dr. Kysko reported having no financial conflicts in regard to the study.

Citation: Krysko KM. ECTRIMS 2019, abstract 249.

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Continuous Treatment Reduces Risk of Confirmed Disability Progression in MS

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Continuous Treatment Reduces Risk of Confirmed Disability Progression in MS

Key clinical point: Treatment with DMT for more than 10 years reduces the risk of confirmed disability progression in MS.

Major finding: Continuous treatment with DMT reduced the risk of 24-month confirmed disability progression by 35%.

Study details: A retrospective analysis of data for 15,602 patients with relapsing-remitting MS.

Disclosures: Two of the researchers are employees of Biogen International, which supported the research. Several investigators received compensation or funding from various pharmaceutical companies.

Citation: Laffaldano P et al. ECTRIMS 2019. Abstract 94.

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Key clinical point: Treatment with DMT for more than 10 years reduces the risk of confirmed disability progression in MS.

Major finding: Continuous treatment with DMT reduced the risk of 24-month confirmed disability progression by 35%.

Study details: A retrospective analysis of data for 15,602 patients with relapsing-remitting MS.

Disclosures: Two of the researchers are employees of Biogen International, which supported the research. Several investigators received compensation or funding from various pharmaceutical companies.

Citation: Laffaldano P et al. ECTRIMS 2019. Abstract 94.

Key clinical point: Treatment with DMT for more than 10 years reduces the risk of confirmed disability progression in MS.

Major finding: Continuous treatment with DMT reduced the risk of 24-month confirmed disability progression by 35%.

Study details: A retrospective analysis of data for 15,602 patients with relapsing-remitting MS.

Disclosures: Two of the researchers are employees of Biogen International, which supported the research. Several investigators received compensation or funding from various pharmaceutical companies.

Citation: Laffaldano P et al. ECTRIMS 2019. Abstract 94.

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Which Interventions Can Treat Cognitive Fatigue?

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Which Interventions Can Treat Cognitive Fatigue?

Key clinical point: Only one intervention – transcranial direct current stimulation (tDCS) – has been found to counteract cognitive fatigability in a trial with objective outcome measures.

Major finding: Compared with sham stimulation, anodal tDCS increased P300 amplitude and reduced fatigue-related decrements in reaction time in a preliminary study.

Study details: A systematic review of intervention studies that objectively measured cognitive fatigability in adults with neurologic disorders.

Disclosures: The authors had no disclosures.

Citation: Lindsay-Brown A et al. CMSC 2019, Abstract NNN10.

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Key clinical point: Only one intervention – transcranial direct current stimulation (tDCS) – has been found to counteract cognitive fatigability in a trial with objective outcome measures.

Major finding: Compared with sham stimulation, anodal tDCS increased P300 amplitude and reduced fatigue-related decrements in reaction time in a preliminary study.

Study details: A systematic review of intervention studies that objectively measured cognitive fatigability in adults with neurologic disorders.

Disclosures: The authors had no disclosures.

Citation: Lindsay-Brown A et al. CMSC 2019, Abstract NNN10.

Key clinical point: Only one intervention – transcranial direct current stimulation (tDCS) – has been found to counteract cognitive fatigability in a trial with objective outcome measures.

Major finding: Compared with sham stimulation, anodal tDCS increased P300 amplitude and reduced fatigue-related decrements in reaction time in a preliminary study.

Study details: A systematic review of intervention studies that objectively measured cognitive fatigability in adults with neurologic disorders.

Disclosures: The authors had no disclosures.

Citation: Lindsay-Brown A et al. CMSC 2019, Abstract NNN10.

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Out-of-Pocket Costs for MS Drugs Rose Significantly

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Out-of-Pocket Costs for MS Drugs Rose Significantly

Key clinical point: Prices of self-administered disease-modifying therapies for multiple sclerosis increased significantly from 2006 to 2016.

Major finding: Patients’ out-of-pocket costs increased by a factor of 7.2 during this period.

Study details: A cohort study of Medicare claims data from 2006 to 2016.

Disclosures: The Myers Family Foundation and the National Heart, Lung, and Blood Institute funded this research. Several authors are employees of health insurance companies such as the UPMC Health Plan Insurance Services Division and Humana. One author received personal fees from Pfizer that were unrelated to this study.

Citation: San-Juan-Rodriguez A et al. JAMA Neurol. 2019 Aug 26. doi: 10.1001/jamaneurol.2019.2711; Hartung DM and Bourdette D. JAMA Neurol. 2019 Aug 26. doi: 10.1001/jamaneurol.2019.2445.

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Key clinical point: Prices of self-administered disease-modifying therapies for multiple sclerosis increased significantly from 2006 to 2016.

Major finding: Patients’ out-of-pocket costs increased by a factor of 7.2 during this period.

Study details: A cohort study of Medicare claims data from 2006 to 2016.

Disclosures: The Myers Family Foundation and the National Heart, Lung, and Blood Institute funded this research. Several authors are employees of health insurance companies such as the UPMC Health Plan Insurance Services Division and Humana. One author received personal fees from Pfizer that were unrelated to this study.

Citation: San-Juan-Rodriguez A et al. JAMA Neurol. 2019 Aug 26. doi: 10.1001/jamaneurol.2019.2711; Hartung DM and Bourdette D. JAMA Neurol. 2019 Aug 26. doi: 10.1001/jamaneurol.2019.2445.

Key clinical point: Prices of self-administered disease-modifying therapies for multiple sclerosis increased significantly from 2006 to 2016.

Major finding: Patients’ out-of-pocket costs increased by a factor of 7.2 during this period.

Study details: A cohort study of Medicare claims data from 2006 to 2016.

Disclosures: The Myers Family Foundation and the National Heart, Lung, and Blood Institute funded this research. Several authors are employees of health insurance companies such as the UPMC Health Plan Insurance Services Division and Humana. One author received personal fees from Pfizer that were unrelated to this study.

Citation: San-Juan-Rodriguez A et al. JAMA Neurol. 2019 Aug 26. doi: 10.1001/jamaneurol.2019.2711; Hartung DM and Bourdette D. JAMA Neurol. 2019 Aug 26. doi: 10.1001/jamaneurol.2019.2445.

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Out-of-Pocket Costs for MS Drugs Rose Significantly
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Switching From Interferon Beta-1a to Alemtuzumab Improves MS Outcomes

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Switching From Interferon Beta-1a to Alemtuzumab Improves MS Outcomes
REPORTING FROM CMSC 2019

Key clinical point: Clinical and imaging outcomes improve among patients with MS who switch from interferon beta-1a to alemtuzumab.

Major finding: The rate of freedom from relapse ranged from 83% to 90%, and disability scores were stable for 51% of patients.

Study details: An examination of data for 117 patients with MS who participated in extensions of the CARE-MS II trial.

Disclosures: Sanofi and Bayer HealthCare Pharmaceuticals supported this study. Dr. Ionete received research support from Biogen, Roche, and Sanofi. She reported receiving compensation for advisory board participation from Sanofi.

Citation: REPORTING FROM CMSC 2019

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REPORTING FROM CMSC 2019
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Key clinical point: Clinical and imaging outcomes improve among patients with MS who switch from interferon beta-1a to alemtuzumab.

Major finding: The rate of freedom from relapse ranged from 83% to 90%, and disability scores were stable for 51% of patients.

Study details: An examination of data for 117 patients with MS who participated in extensions of the CARE-MS II trial.

Disclosures: Sanofi and Bayer HealthCare Pharmaceuticals supported this study. Dr. Ionete received research support from Biogen, Roche, and Sanofi. She reported receiving compensation for advisory board participation from Sanofi.

Citation: REPORTING FROM CMSC 2019

Key clinical point: Clinical and imaging outcomes improve among patients with MS who switch from interferon beta-1a to alemtuzumab.

Major finding: The rate of freedom from relapse ranged from 83% to 90%, and disability scores were stable for 51% of patients.

Study details: An examination of data for 117 patients with MS who participated in extensions of the CARE-MS II trial.

Disclosures: Sanofi and Bayer HealthCare Pharmaceuticals supported this study. Dr. Ionete received research support from Biogen, Roche, and Sanofi. She reported receiving compensation for advisory board participation from Sanofi.

Citation: REPORTING FROM CMSC 2019

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Patients With MS Who Consider Marijuana Use More Likely to Engage in Risky Behaviors

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Patients With MS Who Consider Marijuana Use More Likely to Engage in Risky Behaviors
REPORTING FROM CMSC 2019

Key clinical point: Patients with multiple sclerosis who consider marijuana use are more likely to smoke and drink alcohol.

Major finding: Among multiple sclerosis patients who responded to a survey, 25.4% had used marijuana for their multiple sclerosis, 20.0% had discussed it with their doctors, and 16.1% were currently using some form of marijuana.

Study details: Questionnaire responses about health behaviors from 5,481 active participants in the North American Research Committee on Multiple Sclerosis.

Disclosures: The North American Research Committee on Multiple Sclerosis is funded in part by the Consortium of Multiple Sclerosis Centers and the Foundation of the CMSC. The present study had no funding support. Dr. Cofield reported receiving a consulting fee from the U.S. Department of Defense.

Citation: REPORTING FROM CMSC 2019

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Key clinical point: Patients with multiple sclerosis who consider marijuana use are more likely to smoke and drink alcohol.

Major finding: Among multiple sclerosis patients who responded to a survey, 25.4% had used marijuana for their multiple sclerosis, 20.0% had discussed it with their doctors, and 16.1% were currently using some form of marijuana.

Study details: Questionnaire responses about health behaviors from 5,481 active participants in the North American Research Committee on Multiple Sclerosis.

Disclosures: The North American Research Committee on Multiple Sclerosis is funded in part by the Consortium of Multiple Sclerosis Centers and the Foundation of the CMSC. The present study had no funding support. Dr. Cofield reported receiving a consulting fee from the U.S. Department of Defense.

Citation: REPORTING FROM CMSC 2019

Key clinical point: Patients with multiple sclerosis who consider marijuana use are more likely to smoke and drink alcohol.

Major finding: Among multiple sclerosis patients who responded to a survey, 25.4% had used marijuana for their multiple sclerosis, 20.0% had discussed it with their doctors, and 16.1% were currently using some form of marijuana.

Study details: Questionnaire responses about health behaviors from 5,481 active participants in the North American Research Committee on Multiple Sclerosis.

Disclosures: The North American Research Committee on Multiple Sclerosis is funded in part by the Consortium of Multiple Sclerosis Centers and the Foundation of the CMSC. The present study had no funding support. Dr. Cofield reported receiving a consulting fee from the U.S. Department of Defense.

Citation: REPORTING FROM CMSC 2019

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