Publications by authors named "Anneke Van Der Walt"

Sex and sex hormones are thought to influence multiple sclerosis (MS) through effects on inflammation, myelination and neurodegeneration, and exogenous hormones have been explored for their therapeutic potential. However, our understanding of how sex hormones influence MS disease processes and outcomes remains incomplete. Furthermore, our current knowledge is derived primarily from studies that focus exclusively on cisgender populations with exclusion of gender-diverse people.

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Background: Effectiveness of disease-modifying treatment (DMT) in people affected by primary progressive multiple sclerosis (PPMS) is limited. Whether specific subgroups may benefit more from DMT in a real-world setting remains unclear. Our aim was to investigate the potential effect of DMT on disability worsening among patients with PPMS stratified by different disability trajectories.

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  • The study investigated the prevalence of two types of disability progression in patients with aquaporin-4 antibody-positive neuromyelitis optica spectrum disorder (AQP4-IgG NMOSD): Progression Independent of Relapse Activity (PIRA) and Relapse-Associated Worsening (RAW).
  • It included 181 patients from the MSBase registry, mostly females with an average age of 38.1 years, monitored for an average of 4.5 years, where only 2.2% experienced PIRA and 7.2% experienced RAW.
  • The findings suggest PIRA is rare in AQP4-IgG NMOSD cases, but the study had limitations, such as using
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Background: Few studies on multiple sclerosis (MS) have explored the variability of percentage brain volume change (PBVC) measurements obtained from different clinical MRIs. In a retrospective multicentre cohort study, we quantified the variability of annualised PBVC in clinical MRIs.

Methods: Clinical MRIs of relapse-onset MS patients were assessed by icobrain.

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Background: Remote objective tests may supplement in-clinic examination to better inform treatment decisions. Previous cross-sectional studies presented objective speech metrics as potential markers of Multiple Sclerosis (MS) disease progression.

Objective: To examine the short-term stability and long-term sensitivity of speech metrics to MS progression.

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Healthcare breakthroughs are extending the lives of multiple sclerosis (MS) patients and cancer survivors, creating a growing cohort of individuals navigating a dual diagnosis. Determining the relationship between MS and cancer risk remains challenging, with inconclusive findings confounded by age, risk exposures, comorbidities, genetics and the ongoing introduction of new MS disease-modifying therapies (DMTs) across study periods.This research places significant emphasis on cancer survival, with less attention given to the impact on MS outcomes.

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  • This study investigates the reproducibility of fMRI findings related to motor speech function by analyzing data from a word repetition task performed by 14 healthy controls across two time points.
  • Significant brain activation was noted in areas like the right cerebellum and sensorimotor cortices, with moderate reproducibility in the cerebellum but less consistency in other regions.
  • The results suggest key regions involved in motor speech but indicate that further research is necessary to establish fMRI as a dependable measure of brain activity changes.
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Introduction: Newcastle, Australia, has been serially studied for MS epidemiology since 1961, showing consistently increasing prevalence estimates and incidence rates, including to our 2011 study.

Objectives: To assess the 2011-2021 epidemiology of MS in Newcastle and to compare with previous measures.

Methods: Demographic and clinical data were extracted from medical records of MS cases residing in Newcastle, as identified by public and private clinicians.

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  • * Machine learning models were applied to predict confirmed disability progression after two years, achieving a ROC-AUC score of 0.71, indicating moderate accuracy, while historical disability was found to be a stronger predictor than treatment or relapse history.
  • * The research followed strict guidelines and made its coding accessible for others to facilitate future benchmarking in predicting disability progression in MS patients.
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  • - Cladribine (Mavenclad®) is an oral treatment for relapsing remitting multiple sclerosis (RRMS), but its effects on the immune system were previously unclear.
  • - A Phase IV study with 41 RRMS patients showed that cladribine significantly reduced the count of certain monocytes and altered levels of cytokines, notably increasing CCL2 at week 1 post-treatment.
  • - The study found that cladribine also affects the P2X7 receptor's activity, highlighting a new action mechanism that suggests further research into its potential use against other forms of MS and neurodegenerative diseases.
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Up to half of all people with multiple sclerosis experience communication difficulties due to dysarthria, a disorder that impacts the motor aspects of speech production. Dysarthria in multiple sclerosis is linked to cerebellar dysfunction, disease severity and lesion load, but the neuroanatomical substrates of these symptoms remain unclear. In this study, 52 participants with multiple sclerosis and 14 age- and sex-matched healthy controls underwent structural and diffusion MRI, clinical assessment of disease severity and cerebellar dysfunction and a battery of motor speech tasks.

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Real-world data (RWD) can be defined as all data generated during routine clinical care. This includes electronic health records, disease-specific registries, imaging databanks, and data linkage to administrative databases. In the field of neuro-ophthalmology, the intersection of RWD and clinical practice offers unprecedented opportunities to understand and treat rare diseases.

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  • Non-specific immunosuppressants (NSIS) are still widely used for treating multiple sclerosis (MS) despite safety concerns, particularly in resource-limited areas.
  • The study analyzed MSBase registry data to compare treatment outcomes of adults with relapsing-remitting MS (RRMS) using dimethyl fumarate (DMF) versus NSIS between January 2014 and April 2022.
  • Results showed that while annualized relapse rates were similar, DMF led to longer times before treatment discontinuation and confirmed disability progression, supporting its use over NSIS for RRMS patients.
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  • The study aimed to find an effective oral corticosteroid regimen for myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) that extends the time to first relapse and reduces overall steroid exposure.
  • In a retrospective study of 109 patients, higher doses of oral prednisone, particularly 12.5 mg/day or more for at least 3 months, significantly delayed the time to first relapse, with notable reductions in relapse risk.
  • The findings suggest that a daily dose of 12.5 mg of prednisone for adults (or 0.16 mg/kg for children) at disease onset is optimal, showing no serious adverse effects in patients treated at this level.
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Background: In Australia, tixagevimab/cilgavimab 150 mg/150 mg was a government-funded pre-exposure prophylaxis for COVID-19 people with multiple sclerosis (pwMS) and other neuroimmunological conditions (pwNIc) treated with anti-CD20 antibodies or sphingosine-1-phosphate receptor modulators were eligible.

Objective: To analyse the roll-out, uptake and real-world efficacy of tixagevimab/cilgavimab in the prevention and severity of COVID-19. To assess compliance with uptake depending on the location of delivery.

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Background: Aging-related processes contribute to neurodegeneration and disability in multiple sclerosis (MS). Biomarkers of biological aging such as leukocyte telomere length (LTL) could help personalise prognosis. Pregnancy has been shown to be protective against disability accumulation in women with MS, though it is unclear if this effect relates to aging mechanisms or LTL.

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Background: It remains unclear whether routine cerebrospinal fluid (CSF) parameters can serve as predictors of multiple sclerosis (MS) disease course.

Methods: This large-scale cohort study included persons with MS with CSF data documented in the MSBase registry. CSF parameters to predict time to reach confirmed Expanded Disability Status Scale (EDSS) scores 4, 6 and 7 and annualised relapse rate in the first 2 years after diagnosis (ARR2) were assessed using (cox) regression analysis.

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Background: The Big Multiple Sclerosis Data (BMSD) network ( https://bigmsdata.org ) was initiated in 2014 and includes the national multiple sclerosis (MS) registries of the Czech Republic, Denmark, France, Italy, and Sweden as well as the international MSBase registry. BMSD has addressed the ethical, legal, technical, and governance-related challenges for data sharing and so far, published three scientific papers on pooled datasets as proof of concept for its collaborative design.

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Background: Evidence from network meta-analyses (NMAs) and real-world propensity score (PS) analyses suggest monoclonal antibodies (mAbs) offer a therapeutic advantage over currently available oral therapies and, therefore, warrant consideration as a distinct group of high-efficacy disease-modifying therapies (DMTs) for patients with relapsing multiple sclerosis (RMS). This is counter to the current perception of these therapies by some stakeholders, including payers.

Objectives: A multifaceted indirect treatment comparison (ITC) approach was undertaken to clarify the relative efficacy of mAbs and oral therapies.

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