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  • SAGE Publications  (3)
  • Bowen, James D  (3)
  • 1
    Online Resource
    Online Resource
    SAGE Publications ; 2018
    In:  Multiple Sclerosis Journal - Experimental, Translational and Clinical Vol. 4, No. 4 ( 2018-10), p. 205521731881903-
    In: Multiple Sclerosis Journal - Experimental, Translational and Clinical, SAGE Publications, Vol. 4, No. 4 ( 2018-10), p. 205521731881903-
    Abstract: Administrative-claims data enable comparative effectiveness assessment using large numbers of patients treated in real-world settings. Objective To evaluate real-world relapses, healthcare costs and resource use in patients with MS newly initiating subcutaneous interferon beta-1a (sc IFNβ-1a) v. oral disease-modifying drugs (DMDs: dimethyl fumarate, fingolimod, teriflunomide). Methods Patients from an administrative claims database (1 Jan 2012–31 Dec 2015) were selected if they: were 18–63 years old; had an MS diagnosis; had newly initiated sc IFNβ-1a, dimethyl fumarate, fingolimod, or teriflunomide (first claim = index); had no evidence of DMD 12-months pre-index; and had 12-month eligibility pre- and post-index. Relapse was defined as an MS-related inpatient stay, emergency room visit, or outpatient visit with a corticosteroid prescription ± 7 days. Outcomes were evaluated using logistic regression and generalized linear models. Results A total of 4475 patients met inclusion criteria: 21.9% sc IFNβ-1a, 51.0% dimethyl fumarate, 19.7% fingolimod, 7.4% teriflunomide. Teriflunomide patients had 1.357 (95% CI 1.000, 1.831; p = 0.0477) greater odds of 1-year relapse than sc IFNβ-1a patients. Estimated mean all-cause 1-year costs were higher after fingolimod (US$72,376) v. sc IFNβ-1a initiation (US$65,408; p  〈  0.0001). Non-DMD costs were not significantly different. Conclusion Patients initiating sc IFNβ-1a had better relapse outcomes v. teriflunomide, and lower all-cause costs v. fingolimod.
    Type of Medium: Online Resource
    ISSN: 2055-2173 , 2055-2173
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2018
    detail.hit.zdb_id: 2841884-0
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  • 2
    In: Multiple Sclerosis Journal, SAGE Publications, Vol. 22, No. 10 ( 2016-09), p. 1349-1358
    Abstract: Patient-Reported Expanded Disability Status Scale (PREDSS) tools are an attractive alternative to the Expanded Disability Status Scale (EDSS) during long term or geographically challenging studies, or in pressured clinical service environments. Objectives: Because the studies reporting these tools have used different metrics to compare the PREDSS and EDSS, we undertook an individual patient data level analysis of all available tools. Methods: Spearman’s rho and the Bland–Altman method were used to assess correlation and agreement respectively. Results: A systematic search for validated PREDSS tools covering the full EDSS range identified eight such tools. Individual patient data were available for five PREDSS tools. Excellent correlation was observed between EDSS and PREDSS with all tools. A higher level of agreement was observed with increasing levels of disability. In all tools, the 95% limits of agreement were greater than the minimum EDSS difference considered to be clinically significant. However, the intra-class coefficient was greater than that reported for EDSS raters of mixed seniority. The visual functional system was identified as the most significant predictor of the PREDSS–EDSS difference. Conclusion: This analysis will (1) enable researchers and service providers to make an informed choice of PREDSS tool, depending on their individual requirements, and (2) facilitate improvement of current PREDSS tools.
    Type of Medium: Online Resource
    ISSN: 1352-4585 , 1477-0970
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2016
    detail.hit.zdb_id: 2008225-3
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  • 3
    Online Resource
    Online Resource
    SAGE Publications ; 2017
    In:  Multiple Sclerosis Journal - Experimental, Translational and Clinical Vol. 3, No. 4 ( 2017-12), p. 205521731774309-
    In: Multiple Sclerosis Journal - Experimental, Translational and Clinical, SAGE Publications, Vol. 3, No. 4 ( 2017-12), p. 205521731774309-
    Abstract: The objective of this paper is to assess, in individuals with clinically stable multiple sclerosis (MS), the safety, tolerability, pharmacokinetics (PK) and exploratory pharmacodynamics of the monoclonal recombinant human antibody IgM22 (rHIgM22). Methods Seventy-two adults with stable MS were enrolled in a double-blind, randomized, placebo-controlled, single ascending-dose, Phase 1 trial examining rHIgM22 from 0.025 to 2.0 mg/kg. Assessments included MRI, MR spectroscopy, plasma PK, and changes in clinical status, laboratory values and adverse events for three months. The final cohort had additional clinical, ophthalmologic, CSF collection and exploratory biomarker evaluations. Participants were monitored for six months. Results rHIgM22 was well tolerated with no clinically significant safety signals. Noncompartmental PK modeling demonstrated linear dose-proportionality both of C max and AUC 0–Last . The steady-state apparent volume of distribution of approximately 58 ml/kg suggested primarily vascular compartmentalization. CSF:plasma rHIgM22 concentration increased from 0.003% on Day 2 for both 1.0 and 2.0 mg/kg to 0.056% and 0.586% for 1.0 and 2.0 mg/kg, respectively, on Day 29. No statistically significant treatment-related changes were observed in exploratory pharmacodynamic outcome measures included for the 21 participants of the extension cohort. Conclusions Single doses of rHIgM22 were well tolerated and exhibited linear PK, and antibody was detected in the CSF.
    Type of Medium: Online Resource
    ISSN: 2055-2173 , 2055-2173
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2017
    detail.hit.zdb_id: 2841884-0
    Location Call Number Limitation Availability
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