&lt;p&gt;Efficacy, safety, and quality-of-life of treatments for acute relapses of multiple sclerosis: results from a literature review of randomized controlled trials&lt;/p&gt;

Costello, Jessica; Njue, Annete; Lyall, Matthew; Heyes, Anne; Mahler, Nancy; Philbin, Michael; Nazareth, Tara

doi:10.2147/dnnd.s208815

Cited by 9 publications

(11 citation statements)

References 40 publications

(101 reference statements)

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“…RCI has been shown to be effective and well tolerated in accelerating the resolution of acute exacerbations in MS in several studies. 7 , 9 RCI can be self-administered, thus being convenient for the patient. In contrast, both PMP and IVIg are usually more intensive treatments administered in the hospital setting for acutely limited patients.…”

Section: Discussionmentioning

confidence: 99%

“…Second-line or alternative treatment options for the management of MS relapse include repository corticotropin injection (RCI; Acthar ® Gel (Mallinckrodt Pharmaceuticals, Inc., Bedminster, NJ, USA)), plasmapheresis (PMP), and intravenous immunoglobulin (IVIg) therapy. 7 RCI is a naturally sourced complex mixture of adrenocorticotropic hormone analogs and other pituitary peptides. 8 RCI is the only therapy indicated for the treatment of acute exacerbations of MS in adults by the US Food and Drug Administration.…”

Section: Introductionmentioning

confidence: 99%

“…8 Further, RCI has demonstrated effectiveness in accelerating the resolution of acute exacerbations of MS in controlled clinical trials. 7 , 9 PMP is recommended as a second-line treatment for patients with steroid-resistant exacerbations in relapsing forms of MS by the American Academy of Neurology. 10 , 11 However, the effectiveness of PMP in the treatment of MS remains inconclusive.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Cost per response analysis of repository corticotropin injection versus other alternative treatments for acute exacerbations of multiple sclerosis

Wan¹,

Chopra²,

Niewoehner³

et al. 2020

DIC

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Cost per response analysis of repository corticotropin injection versus other alternative treatments for acute exacerbations of multiple sclerosis

Wan¹,

Chopra²,

Niewoehner³

et al. 2020

DIC

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“…Plasmapheresis is a medical procedure that has been recommended for steroid-resistant acute MS relapses by the American Academy of Neurology and the American Society for Apheresis. Intravenous immunoglobulin (IVIG) is an administered treatment comprised of pooled immunoglobulin G (IgG) prepared from the fractionation of human plasma and is also used in the treatment of MS relapse despite not having an FDA indication for such use (47).…”

Section: Management Of Msmentioning

confidence: 99%

Perspectives on urological care in multiple sclerosis patients

Moussa

Chakra

Papatsoris

et al. 2021

IRDR

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Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system. Lower urinary tract dysfunction due to MS includes a dysfunction of the storage phase or dysfunction of the voiding phase or a detrusor-sphincter dyssynergia. Baseline evaluation includes a voiding chart, an ultrasound scan of the urinary tract, urine culture, and an urodynamic study. For storage symptoms, antimuscarinics are the first-line treatment, and clean intermittent catheterization (CIC) is indicated if there is concomitant incomplete bladder emptying. Intradetrusor injections with botulinum toxin A (BTX-A), are recommended for refractory cases. Urinary diversion is rarely indicated. For patients with voiding symptoms, CIC and alpha-blockers are usually offered. Sexual dysfunction in patients with MS is multifactorial. Phosphodiesterase type 5 inhibitors are first-line therapies for MS-associated erectile dysfunction in both male and female patients. This review summarizes the epidemiology, pathogenesis, risk factors, genetic, clinical manifestations, diagnostic tests, and management of MS. Lastly, the urologic outcomes and therapies are reviewed.

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“…Despite the clinical and economic evidence supporting the efficacy, safety, and benefits of RCI treatment for acute MS relapse [ 23 ], many patients suffering from MS relapse are denied access to RCI treatment by third-party payers in the U.S. This study aims to understand the demographic and clinical characteristics of MS relapse patients approved for RCI treatment compared to MS relapse patients denied access to RCI treatment by third-party payers, as well as to compare measurable clinical outcomes and healthcare resource utilization (HCRU) for MS relapse patients whose prescription claims for RCI are either approved or denied.…”

Section: Introductionmentioning

confidence: 99%

Consequences of Insurance Denials Among U.S. Patients Prescribed Repository Corticotropin Injection for Acute Exacerbations of Multiple Sclerosis

et al. 2020

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Introduction Repository corticotropin injection (RCI; Acthar ® Gel) is indicated for the treatment of acute exacerbations of multiple sclerosis (MS) in adults. Despite the well-documented clinical and economic benefits of RCI, many patients are denied use of the therapy by third-party payers. This study aims to understand the demographic and clinical characteristics of MS relapse patients who received a prescription for RCI from their physicians and then were either approved or denied treatment by their insurers. The study compares measurable clinical outcomes and healthcare resource utilization (HCRU) between approved and denied cohorts. Methods A retrospective analysis of adults experiencing MS relapse from January 2015 to December 2018 was conducted using a de-identified open-source claims database [Symphony Health Integrated Dataverse ® (IDV)]. Patients were identified using ICD codes for MS and considered to have relapsing/remitting type according to established claims-based methodology. Clinical characteristics and HCRU were analyzed during the year preceding (“baseline”) and the year following (“follow-up”) each patient’s index date, defined as the date of a patient’s first approved RCI claim (for patients with ≥ 1 approved claim) or first denied RCI claim (for patients with only denied claims). Baseline characteristics were reported with unadjusted differences and p values indicating the significance of characteristics between the two cohorts. For outcomes, match-adjusted results were reported using propensity matching to account for underlying differences between cohorts. Results The study sample included 1902 MS relapse patients with at least one claim for RCI. At baseline, approved patients were slightly older compared to denied patients (mean age 48.0 vs. 47.2), had higher rates of hemiplegia/paraplegia (6.7% vs. 3.3%), greater mobility impairment (17% vs. 11.5%), more exacerbation episodes (66.2% vs. 59.9%), and a higher number of physical therapy/rehab claims (23.5 vs. 14.0), respectively. Outcomes among the matched sample show an increased use of corticosteroids for patients denied access to RCI compared to approved patients (51.1% vs. 42.4%), more exacerbation episodes (36.6% vs. 28.2%), and an increased number of physical therapy/rehab claims (11.5% vs. 9.9%), respectively. Conclusion The results of this study may aid providers and payers in evaluating scenarios where RCI may be beneficial and improve quality of care for patients experiencing MS relapse.

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<p>Efficacy, safety, and quality-of-life of treatments for acute relapses of multiple sclerosis: results from a literature review of randomized controlled trials</p>

Cited by 9 publications

References 40 publications

Cost per response analysis of repository corticotropin injection versus other alternative treatments for acute exacerbations of multiple sclerosis

Cost per response analysis of repository corticotropin injection versus other alternative treatments for acute exacerbations of multiple sclerosis

Perspectives on urological care in multiple sclerosis patients

Consequences of Insurance Denials Among U.S. Patients Prescribed Repository Corticotropin Injection for Acute Exacerbations of Multiple Sclerosis

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