Additional file 2: of Subjective patient-reported versus objective adherence to subcutaneous interferon β-1a in multiple sclerosis using RebiSmart®: the CORE study

Series of six figures comparing adherence with age, EDSS score, neurologists’ estimations of adherence, ease of administration, patient’s perceived relevance of storage and being well informed about RebiSmart® features. (PDF 43 kb

Additional file 1: of Subjective patient-reported versus objective adherence to subcutaneous interferon β-1a in multiple sclerosis using RebiSmart®: the CORE study

Neurologist and patient questionnaires. Neurologist questionnaire (Appendix I) used to collect patient demographics and medical history at month 0 and patient questionnaire (Appendix II) used to record subjective adherence at M0 and after a 6-month observational period. (PDF 73 kb

Effectiveness and safety of Rituximab in multiple sclerosis: an observational study from Southern Switzerland

<div><p>Background</p><p>Despite positive results from phase II and observational studies, Rituximab (RTX) is not currently approved for multiple sclerosis (MS) treatment and can only be used off-label.</p><p>Objective</p><p>To characterize MS patients treated with RTX and investigate its effectiveness and safety in a clinical practice setting.</p><p>Methods</p><p>Observational analysis of data collected from MS patients at the Neurocenter of Southern Switzerland. Relapses, EDSS worsening, MRI lesion accrual and "evidence of disease activity” (EDA) status were described by Cox regression. RTX and natalizumab treated patients were matched by propensity scores.</p><p>Results</p><p>Out of 453 MS patients, 82 were treated with RTX, 43 (52.4%) relapsing-remitting (RRMS) and 39 (47.6%) progressive MS (median age = 48 [40–54] years, females n = 60 [73.2%], EDSS = 4.0 [2.5–6.0], median follow-up = 1.5 [1.0–2.5] years). Three relapses occurred and 59 (75.6%) patients had not EDA at follow-up end. Time to EDA was similar in RTX and natalizumab treated RRMS patients (HR = 1.64, 95%CI = 0.46–5.85, p = 0.44). Twenty-four patients presented non infusion related adverse events (infections), requiring RTX discontinuation in 6 individuals.</p><p>Conclusion</p><p>These results provide further evidence for RTX being effective in MS treatment, to a similar extent to natalizumab in RRMS. Clinicians must be vigilant for the potential occurrence of infections.</p></div

Proportion of RRMS patients with not evidence of disease activity (NEDA) under treatment with RTX (red) and NTZ (blue) over 30 months follow up.

<p>Proportion of RRMS patients with not evidence of disease activity (NEDA) under treatment with RTX (red) and NTZ (blue) over 30 months follow up.</p

Effectiveness and safety of Rituximab in multiple sclerosis: an observational study from Southern Switzerland - Fig 3

<p>Total leucocyte (a), CD4+ T cell (b), CD8+ T cell (c) and CD19+ B cell (d) peripheral blood counts for each individual from baseline up to the 36^th month of follow-up during RTX treatment. Horizontal lines indicate median and IQR cell concentration at baseline (i.e. before first RTX infusion).</p

Cluster comparison.

IntroductionThe availability of consumer-facing health technologies for chronic disease management is skyrocketing, yet most are limited by low adoption rates. Improving adoption requires a better understanding of a target population’s previous exposure to technology. We propose a low-resource approach of capturing and clustering technology exposure, as a mean to better understand patients and target health technologies.MethodsUsing Multiple Sclerosis (MS) as a case study, we applied exploratory multivariate factorial analyses to survey data from the Swiss MS Registry. We calculated individual-level factor scorings, aiming to investigate possible technology adoption clusters with similar digital behavior patterns. The resulting clusters were transformed using radar and then compared across sociodemographic and health status characteristics.ResultsOur analysis included data from 990 respondents, resulting in three clusters, which we defined as the (1) average users, (2) health-interested users, and (3) low frequency users. The average user uses consumer-facing technology regularly, mainly for daily, regular activities and less so for health-related purposes. The health-interested user also uses technology regularly, for daily activities as well as health-related purposes. The low-frequency user uses technology infrequently.ConclusionsOnly about 10% of our sample has been regularly using (adopting) consumer-facing technology for MS and health-related purposes. That might indicate that many of the current consumer-facing technologies for MS are only attractive to a small proportion of patients. The relatively low-resource exploratory analyses proposed here may allow for a better characterization of prospective user populations and ultimately, future patient-facing technologies that will be targeted to a broader audience.</div

Baseline characteristics at first RTX infusion in all MS, RRMS and PMS patients.

<p>Baseline characteristics at first RTX infusion in all MS, RRMS and PMS patients.</p

Effectiveness and safety of Rituximab in multiple sclerosis: an observational study from Southern Switzerland - Fig 1

<p>Proportion of patients free of relapses (a), free of EDSS worsening (b), free of NT2 lesions (c) and with not evidence of disease activity (NEDA) (d) during 36 months of follow up in RRMS (green) and PMS patients (red) under treatment with RTX.</p

Univariate and multivariate cox regression models testing associations between baseline characteristics and risk of EDA during RTX treatment.

<p>Univariate and multivariate cox regression models testing associations between baseline characteristics and risk of EDA during RTX treatment.</p

Study flow chart.

IntroductionThe availability of consumer-facing health technologies for chronic disease management is skyrocketing, yet most are limited by low adoption rates. Improving adoption requires a better understanding of a target population’s previous exposure to technology. We propose a low-resource approach of capturing and clustering technology exposure, as a mean to better understand patients and target health technologies.MethodsUsing Multiple Sclerosis (MS) as a case study, we applied exploratory multivariate factorial analyses to survey data from the Swiss MS Registry. We calculated individual-level factor scorings, aiming to investigate possible technology adoption clusters with similar digital behavior patterns. The resulting clusters were transformed using radar and then compared across sociodemographic and health status characteristics.ResultsOur analysis included data from 990 respondents, resulting in three clusters, which we defined as the (1) average users, (2) health-interested users, and (3) low frequency users. The average user uses consumer-facing technology regularly, mainly for daily, regular activities and less so for health-related purposes. The health-interested user also uses technology regularly, for daily activities as well as health-related purposes. The low-frequency user uses technology infrequently.ConclusionsOnly about 10% of our sample has been regularly using (adopting) consumer-facing technology for MS and health-related purposes. That might indicate that many of the current consumer-facing technologies for MS are only attractive to a small proportion of patients. The relatively low-resource exploratory analyses proposed here may allow for a better characterization of prospective user populations and ultimately, future patient-facing technologies that will be targeted to a broader audience.</div