Novartis (Australia)

ObjectivesTo characterize the use of ofatumumab (OFA), a fully human self-administered anti-CD20 monoclonal antibody, in a real-world setting in Australia by assessing the profile of relapsing multiple sclerosis (RMS) patients initiating OFA through an evaluation of patient demographics, background MS disease characteristics and prior therapy history as recorded in MSBase.MethodsThis is a retrospective secondary use of MSBase Registry data study, describing the baseline characteristics of RMS patients in Australia initiated on OFA treatment, including demographics, disease duration, expanded disability status scale (EDSS), treatment history with disease-modifying therapies (DMTs) prior to commencing OFA and proportion of naïve patients initiating ofatumumab relative to patients having received a prior DMT.ResultsAs of 1st January 2024, MSBase has included 320 eligible patients initiated on OFA, with 22.2% treatment naïve, 30.9% switching from ocrelizumab, 14.7% switching from natalizumab, 3.1% from alemtuzumab and 27.7% from oral DMTs. The reasons for switching DMT to OFA included scheduled stop (13.1%), evidence of disease activity (9.1%), convenience (6.9%), side effects/intolerance (6.2%), JCV antibody positive (2.8%), pregnancy planned/confirmed (2.5%) and not reported (37.2%). The median age of patients initiating OFA was 42.67 [36.65, 51.98] years, with a median disease duration of 9.19 [3.61, 17.11] years and median EDSS of 2 [1.5, 3.5].ConclusionThe real-world data from this secondary use of data MSBase registry analysis provides a valuable snapshot of the Australian experience of relapsing MS patients initiated on OFA, with 22% of patients treated as first line therapy.

AimsAt present, there is no robust information on the prevalence and incidence of heart failure (HF) in the general Australian community. The present study of primary care data sought to estimate the prevalence and incidence of HF in the community and to describe the demographic and clinical profile of Australians with HF.Methods and resultsWe undertook a retrospective cohort study based on analysis of anonymized medical records of adult patients cared for at 43 Australian general practices between 1 July 2013 and 30 June 2018. Data were extracted from coded and uncoded fields in electronic medical records. The prevalence and annual incidence of HF were calculated, along with 95% confidence intervals, using the ‘active’ population of people who were regular attenders at the practices. Age‐standardized estimates were also derived using the 2017 Australian population as reference. The mean age of the population with HF was 69.8 years, 50.6% were female, and mean body mass index was 31.2 kg/m2. The age‐standardized prevalence was 2.199% [95% confidence interval (CI): 2.168–2.23%], and the age‐standardized annual incidence was 0.348% (95% CI: 0.342–0.354%). These estimates accord with almost 420 000 people living with HF in Australia in 2017, and >66 000 new cases of HF occurring that year. Only 18.9% of patients with definite HF had this formally captured as a ‘diagnosis’ in their medical record. HF was more frequent among those of lower socio‐economic status.ConclusionsHF is common in Australia. The majority of HF patients do not have this diagnosis optimally noted in their primary care medical records.

BackgroundAge has been independently associated with higher rates of treatment discontinuation in multiple sclerosis.ObjectiveThe current study examines the impact of age on persistence for all reimbursed DMTs for RRMS in Australia.MethodsThe Pharmaceutical Benefits Scheme (PBS) 10% sample supplied by the Department of Human Services was used in this study. Eligible patients must have received a script for a reimbursed DMT for RRMS between September 2011 and February 2016. Patients were classified into five age-groups (ages 18–30; 31–40; 41–50; 51–60; 61+) and defined as persistent if their DMT script was filled within 4 months. Persistence was derived using the Kaplan-Meier method and hazard ratios (HR) to represent the relative rate of drop-off of different age groups.ResultsPatients aged 18–30 (n=250) had a 44% increased risk of discontinuation (HR 1.44 (95%CI: 1.22–1.72) compared to the ‘all ages’ cohort (n=1,866); no significant difference was observed for any other age group (HRs between 1.08 and 0.92). Patients in this 18–30 age-group had a significantly higher risk of discontinuation on injectable therapy (glatiramer acetate, interferon beta-1a, interferon beta-1b) compared to those on non-injectable therapy (dimethyl fumarate, fingolimod, natalizumab, teriflunomide) (HR 2.42 (95% CI: 1.63–3.61).ConclusionsPatients aged 18–30 were the least persistent age group in this study. Patients aged 18–30 were less persistent on injectable than non-injectable DMTs.

The rotating radiofrequency coil (RRFC) has been developed recently as an alternative approach to multi-channel phased-array coils. The single-element RRFC avoids inter-channel coupling and allows a larger coil element with better B1 field penetration when compared with an array counterpart. However, dedicated image reconstruction algorithms require accurate estimation of temporally varying coil sensitivities to remove artefacts caused by coil rotation. Various methods have been developed to estimate unknown sensitivity profiles from a few experimentally measured sensitivity maps, but these methods become problematic when the RRFC is used as a transceiver coil. In this work, a novel and practical radial encoding method is introduced for the RRFC to facilitate image reconstruction without the measurement or estimation of rotation-dependent sensitivity profiles. Theoretical analyses suggest that the rotation-dependent sensitivities of the RRFC can be used to create a uniform profile with careful choice of sampling positions and imaging parameters. To test this new imaging method, dedicated electronics were designed and built to control the RRFC speed and hence positions in synchrony with imaging parameters. High-quality phantom and animal images acquired on a 9.4 T pre-clinical scanner demonstrate the feasibility and potential of this new RRFC method.

Our primary purpose was to assess the clinical (predictive) validity of central retinal thickness (CRT) and best corrected visual acuity (BCVA) at 1 week and 1 month after starting treatment with ranibizumab for central retinal vein occlusion. The authors also assessed detectability of response to treatment. The authors used data from 325 participants in the CRUISE study, which included measurement of time-domain CRT and BCVA at baseline, 1 week, 1 month, and 6 months postrandomization. Analysis of covariance models were fitted to assess clinical validity, and distributions of change were constructed to assess detectability of response. There was no evidence that 1-week CRT, and very strong evidence that 1-week BCVA were associated with baseline-adjusted BCVA at 6 months (P = 0.17 and P < 0.001, respectively). There was strong evidence that both 1-month CRT and 1-month BCVA were associated with baseline-adjusted 6-month BCVA (P = 0.005 and P < 0.001, respectively), but simultaneous adjustment found evidence of independent association only for BCVA (P = 0.71 and P < 0.001 for CRT and BCVA, respectively). Detectability of response tended to be higher for CRT than BCVA at 1 week and 1 month but by 6 months these were equivalent for CRT and BCVA. In this study, BCVA monitoring of treated central retinal vein occlusion patients seemed more informative than time-domain optical coherence tomography monitoring.