Influence of physicians' risk perception on switching treatments between high- efficacy and non-high-efficacy disease‑modifying therapies in multiple sclerosis.

Background: The decision of initiating treatment for multiple sclerosis (MS) with a high-efficacy DMT (HE DMT) or non-high-efficacy DMT (non-HE DMT) is influenced by several factors, including risk perception of patients and physicians.

Objective: Investigate the influence of physicians' risk perception on decision-making when switching treatments for MS and the reasons for switching.

Methods: Data were drawn from the Adelphi Real-World MS Disease-Specific Program (a retrospective survey) and analysis included people with RMS identified between 2017- 2021.

Need of guidance in disabling and chronic migraine identification in the primary care setting, results from the european MyLife anamnesis survey.

Background: Migraine affects 80.8 million people in Western Europe and is the first cause of disability among people between ages 15 and 49 worldwide. Despite being a highly prevalent and disabling condition, migraine remains under-diagnosed and poorly managed.

Current clinical practice in disabling and chronic migraine in the primary care setting: results from the European My-LIFE anamnesis survey.

Background: Migraine is a prevalent and disabling headache disorder that affects more than 1.04 billion individuals world-wide. It can result in reduction in quality of life, increased disability, and high socio-economic burden.

Living with secondary progressive multiple sclerosis in Europe: perspectives of multiple stakeholders.

The transition from relapsing-remitting multiple sclerosis to secondary progressive multiple sclerosis (SPMS) remains a clinical challenge owing to the heterogeneous course of the disease, indistinct disease progression and lack of availability of validated biomarkers and diagnostic tools. This article summarizes the outcomes from an international expert group meeting conducted to validate the preliminary research findings gathered through interviews with primary healthcare stakeholders and pharmaceutical representatives, and to understand the current and future patient journey of SPMS across seven European countries. We highlight the uncertainty in SPMS diagnosis and management and, consequently, the need for uniform assessment guidelines, enhanced awareness and a collaborative effort between the stakeholders associated with SPMS patient care and the pharmaceutical industry.

Usability, Acceptability, and Usefulness of an mHealth App for Diagnosing and Monitoring Patients With Breakthrough Cancer Pain.

Background: Breakthrough pain is a major problem and a source of distress in patients with cancer. We hypothesized that health care professionals may benefit from a real-time mobile app to assist in the diagnosis and monitoring of breakthrough cancer pain (BTcP).

Objective: This study aimed to test the usability, acceptability, and usefulness in real-world practice of the mobile App INES·DIO developed for the management of patients with BTcP.

A consensus initiative for the assessment of patients newly diagnosed with multiple sclerosis in Spain: the eXamina Project.

Aim: To create a national consensus checklist to assess newly diagnosed multiple sclerosis patients when considering treatment initiation in Spain.

Materials & Methods: The Delphi consensus method was used. A scientific committee drafted items/domains, 52 experts evaluated their inclusion in the project checklist and 47 experts assessed checklist use in clinical practice.

Fatigue Improvement after Switching Multiple Sclerosis Treatment from Interferon-β to Glatiramer Acetate in Clinical Practice.

Background/aims: The immunomodulatory effect of glatiramer acetate may help in reducing multiple sclerosis (MS)-related fatigue; however, evidence to prove this notion especially after switching from another immunomodulatory therapy is limited. We assessed the 6-month effect of glatiramer acetate on MS-related fatigue in patients switching from interferon-β (IFN-β) in clinical practice.

Methods: This was an observational study including 54 patients with relapsing-remitting MS that showed moderate/severe fatigue primarily caused by MS before switching from IFN-β to glatiramer acetate and received glatiramer acetate for ≥6 months in daily practice.

Effect on quality of life of switching to combined oral contraception based on natural estrogen: an observational, multicentre, prospective phase IV study (ZOCAL Study).

Objectives: This observational, multicentre, prospective phase IV study examined change in health-related quality of life (QOL) from baseline to 6 months in women initiating combined oral contraception (COC) based on natural estrogen.

Methods: Eligible women attending a baseline and 6-month gynaecology appointment belonged to one of three groups: group 1 used barrier contraception (condoms) and elected to continue this method; group 2 used condoms and elected to switch to COC based on natural estrogen; group 3 used COC based on ethinylestradiol and elected to switch to COC based on natural estrogen. The Spanish Society of Contraception (SEC)-QOL scale assessed health-related QOL.

Identification of factors involved in medication compliance: incorrect inhaler technique of asthma treatment leads to poor compliance.

Objective: To identify the impact of delivery device of inhaled corticosteroids and long-acting β2-agonist (ICS/LABA) on asthma medication compliance, and investigate other factors associated with compliance.

Materials And Methods: We conducted a retrospective and multicenter study based on a review of medical registries of asthmatic patients treated with ICS/LABA combinations (n=2,213) whose medical devices were either dry powder inhalers (DPIs, such as Accuhaler(®), Turbuhaler(®), and NEXThaler(®)) or pressurized metered-dose inhalers (pMDI). Medication compliance included persistence outcomes through 18 months and medication possession ratios.

The importance of inhaler devices: the choice of inhaler device may lead to suboptimal adherence in COPD patients.

Objective: This study aims to identify factors associated with poor adherence to COPD treatment in patients receiving a fixed-dose combination (FDC) of inhaled corticosteroids and long-acting β2-agonist (ICS/LABA), focusing on the importance of inhaler devices.

Methods: We conducted a retrospective and multicenter study based on a review of medical registries between 2007 and 2012 of COPD patients (n=1,263) treated with ICS/LABA FDC, whose medical devices were either dry powder inhalers (DPIs) or pressurized metered-dose inhalers (pMDI). Medication adherence included persistence outcomes through 18 months and medication possession ratios.

Cost analysis of glatiramer acetate versus interferon-β for relapsing-remitting multiple sclerosis in patients with spasticity: the Escala study.

Objective: The Escala Study evidenced that the administration of glatiramer acetate for relapsing-remitting multiple sclerosis improved the spasticity of patients previously treated with interferon-β. However, whether such an improvement was translated into cost savings remained unclear. We therefore conducted a cost analysis of glatiramer acetate versus interferon-β in these patients with multiple sclerosis and spasticity.

A patient care program for adjusting the autoinjector needle depth according to subcutaneous tissue thickness in patients with multiple sclerosis receiving subcutaneous injections of glatiramer acetate.

Background: The perceived pain on injection site caused by subcutaneous (SC) self-injection may negatively affect acceptance and adherence to treatment in patients with multiple sclerosis (MS). Pain on injection may be caused by inaccurate injection technique, inadequate needle length adjustment, or repeated use of the same injection body area. However, information is lacking concerning the optimal needle depth to minimize the injection pain.

Benefit of endermology on indurations and panniculitis/lipoatrophy during relapsing-remitting multiple sclerosis long-term treatment with glatiramer acetate.

Introduction: Use of endermology (Endermologie®), which consists of a deep mechanical massage, in patients with multiple sclerosis receiving glatiramer acetate suggested improvements in injection-site indurations and panniculitis/lipoatrophy in our previous pilot experience. We aimed to assess the effect of endermology in a larger population of patients with multiple sclerosis receiving glatiramer acetate in clinical practice.

Methods: This was the extension phase of our pilot experience, carried out in patients with relapsing-remitting multiple sclerosis (RRMS) and indurations and/or panniculitis/lipoatrophy associated with long-term glatiramer acetate administration.

Cost-effectiveness of glatiramer acetate and interferon beta-1a for relapsing-remitting multiple sclerosis, based on the CombiRx study.

Background: To assess the cost-effectiveness of the Disease Modifying Treatments (DMT), Glatiramer Acetate (GA) and Interferon beta-1a (IFN) in monotherapy alone and in combination for the prevention of relapses among Spanish patients aged between 18-60 years old with established Relapsing-Remitting Multiple Sclerosis (RRMS).

Methods: A Markov model was developed to represent the transition of a cohort of patients over a 10 year period using the perspective of the Spanish National Health Service (NHS). The model considered five different health states with 1-year cycles including without relapse, patients with suspect, non-protocol defined and protocol defined exacerbations, as well as a category information lost.

Budget impact analysis of the fentanyl buccal tablet for treatment of breakthrough cancer pain.

Background: The purpose of this study was to assess the economic impact of the fentanyl buccal tablet for the management of breakthrough cancer pain (BTcP) in Spain.

Methods: A 4-year budget impact model was developed for the period 2012-2015 for patients with BTcP from the perspective of the Spanish National Health System. BTcP products included in this model were rapid-onset opioids containing fentanyl (buccal, sublingual, or nasal transmucosal).

Cost analysis of glatiramer acetate vs. fingolimod for the treatment of patients with relapsing-remitting multiple sclerosis in Spain.

Background: Fingolimod is an innovative drug with a significant budget impact in the treatment of MS in Spain. The aim of this study was to calculate the direct cost comparison of glatiramer acetate and fingolimod for the treatment of patients with relapsing-remitting multiple sclerosis (RRMS) in Spain.

Methods: A cost analysis model was developed to compare glatiramer acetate and fingolimod, based on a 1-year time horizon.

Contribution of endermology to improving indurations and panniculitis/lipoatrophy at glatiramer acetate injection site.

Introduction: Endermology is a mechanical massage therapy that enables fat mobilization and body contouring. The authors' aim was to assess the effect of endermology on indurations and panniculitis/lipoatrophy associated with subcutaneous administration of glatiramer acetate in patients with multiple sclerosis (MS).

Methods: This was a multicenter pilot experience carried out in patients with MS treated with glatiramer acetate who showed indurations and/ or panniculitis/lipoatrophy at the injection site.

Benefit-risk analysis of glatiramer acetate for relapsing-remitting and clinically isolated syndrome multiple sclerosis.

Background: Glatiramer acetate (GA) and interferon beta-1 are licensed for treating patients with multiple sclerosis (MS). However, they have slightly different indications, side effect profiles, and tolerability.

Objective: The purpose of this study was to assess the benefit-risk (BR) profile of GA in relapse-remitting MS (RRMS) and clinical isolated syndrome (CIS).

Cost-effectiveness analysis of disease modifiying drugs (interferons and glatiramer acetate) as first line treatments in remitting-relapsing multiple sclerosis patients.

Unlabelled: Abstract Objective: The aim of this study was to assess cost-effectiveness of the different Disease Modifying Drugs (DMD) used as first-line treatments (interferons IM IFNβ-1a, SC IFNβ-1a, SC IFNβ-1b, and glatiramer acetate, GA) in Remitting-Relapsing Multiple Sclerosis (RRMS) in Spain.

Methods: A Markov model was developed to simulate the progression of a cohort of patients with RRMS, during a period of 10 years. Seven health states, defined by the Expanded Disability Status Scale (EDSS), were considered in the model.

Clinical utility of maraviroc.

Maraviroc belongs to the family of chemokine (C-C motif) receptor 5 (CCR5) antagonists that prevent the entry of human immunodeficiency virus (HIV) into host CD4+ T cells by blocking the CCR5 co-receptor R5. Maraviroc is currently the only CC5R co-receptor inhibitor that has been approved for clinical use in HIV-1-infected patients carrying the CCR5 tropism who are antiretroviral-naïve or have experienced therapeutic failure following traditional antiretroviral therapies. This article is a review of the main characteristics of maraviroc and the latest data regarding its clinical application.

Cost-effectiveness of optimized background therapy plus maraviroc for previously treated patients with R5 HIV-1 infection from the perspective of the Spanish health care system.

Objective: The aim of this work was to evaluate the cost-effectiveness, from the perspective of the Spanish health care system, of optimized background therapy (OBT) plus maraviroc 300 mg BID versus OBT plus placebo in previously treated patients with R5 HIV-1 infection.

Methods: A lifetime cohort model was developed, based on 24- and 48-week pooled results from the Maraviroc Versus Optimized Therapy in Viremic Antiretroviral Treatment-Experienced Patients (MOTIVATE) studies 1 and 2, to reflect the Spanish health care system's perspective. Treatment duration was based on clinical trial follow-up from MOTIVATE 1 and 2.

Cost-effectiveness analysis of emtricitabine/tenofovir versus lamivudine/zidovudine, in combination with efavirenz, in antiretroviral-naive, HIV-1-infected patients.

Objective: The aim of this study was to compare the cost per unit of effectiveness (successful treatment episode) of 2 highly active antiretroviral therapy combinations-emtricitabine/tenofovir DF + efavirenz (TVD + EFV) and lamivudine/zidovudine + efavirenz (COMB + EFV)-in antiretroviral-naive, HIV-1-infected patients from the perspective of costs to society.

Methods: This cost-effectiveness analysis was modeled using a decision tree that considered the therapeutic response (successful treatment episode, ie, HIV-1 RNA <400 copies/mL using data obtained directly from a clinical trial) and the switch to rescue therapy in nonresponders. The time horizon was 24 months of treatment.

[Cost of nucleoside analogue reverse transcriptase inhibitor-related toxicity in HIV-1-infected patients].

Objective: To estimate the impact of toxicity related to nucleoside analogue reverse transcriptase inhibitors (NRTI) on the total cost of medical care in HIV-1-infected patients.

Methods: . A pharmacoeconomic model was developed from the data obtained by a prospective, observational, multicenter study performed in Spain (Recover).