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6. High socioeconomic impact on prescription behavior despite unrestricted access to disease-modifying therapies in people with multiple sclerosis.

Author

Samadzadeh, S., Havla, J., Lepka, K., Brinks, R., Meuth, S. G., Klotz, L., and Albrecht, P.

Subjects
DRUG bioavailability, DRUG accessibility, MEDICAL care, DRUG prescribing, GROSS domestic product
Abstract

Background: Economic and health care restraints strongly impact on drug prescription for chronic diseases. We aimed to identify potential factors for prescription behavior in chronic disease. Multiple sclerosis was chosen as a model disease due to its chronic character, incidence, and high socioeconomic impact. Methods: Germany was used as a model country as the health-care system is devoid of economic and drug availability restraints. German statutory health insurance data were analyzed retrospectively. The impact of number of university hospitals and neurologists as well as the gross domestic product (GDP) as potential factors on prescriptions of platform and high-efficacy disease-modifying therapies (DMTs) was analyzed. Results: Prescription of platform DMTs increased over time in almost all federal states with varying degree of increase. Univariate regression analysis showed that the prescription volume of platform DMTs positively correlated with the number of university hospitals and neurologists, as well as the GDP per federal state. Stepwise forward regression analysis including all potential factors indicated a statistically significant model for platform DMT (R² = 0.55; 95%-CI [0.28, 0.82]; p=0.001) revealing GDP as the main contributor. This was confirmed in the independent analysis. Conclusion: This study illustrates that even without overt drug prescription inequity, access to medication is not evenly distributed and depends on economic strength and regional medical care density. [ABSTRACT FROM AUTHOR]

Published
2024
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8. S1-Leitlinie: Lumbalpunktion und Liquordiagnostik: Zusammenfassung der Leitlinie der Deutschen Gesellschaft für Neurologie

Author

Tumani, H., Petereit, H. F., Gerritzen, A., Groß, C. C., Huss, A., Isenmann, S., Jesse, S., Khalil, M., Lewerenz, J., Leypoldt, F., Melzer, N., Meuth, S. G., Otto, M., Ruprecht, K., Sindern, E., Spreer, A., Stangel, M., Strik, H., Uhr, M., Vogelgsang, J., Wandinger, K.-P., Weber, T., Wick, M., Wildemann, B., Wiltfang, J., Woitalla, D., Zerr, I., and Zimmermann, T.

Published
2019
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13. S1 guidelines “lumbar puncture and cerebrospinal fluid analysis” (abridged and translated version)

Author

Tumani, H., Petereit, H. F., Gerritzen, A., Gross, C. C., Huss, A., Isenmann, S., Jesse, S., Khalil, M., Lewczuk, P., Lewerenz, J., Leypoldt, F., Melzer, N., Meuth, S. G., Otto, M., Ruprecht, K., Sindern, E., Spreer, A., Stangel, M., Strik, H., Uhr, M., Vogelgsang, J., Wandinger, K.-P., Weber, T., Wick, M., Wildemann, B., Wiltfang, J., Woitalla, D., Zerr, I., and Zimmermann, T.

Published
2020
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18. Monitoring von Blutparametern unter verlaufsmodifizierender MS-Therapie: Substanzspezifische Relevanz und aktuelle Handlungsempfehlungen

Author

Klotz, L., Berthele, A., Brück, W., Chan, A., Flachenecker, P., Gold, R., Haghikia, A., Hellwig, K., Hemmer, B., Hohlfeld, R., Korn, T., Kümpfel, T., Lang, M., Limmroth, V., Linker, R. A., Meier, U., Meuth, S. G., Paul, F., Salmen, A., Stangel, M., Tackenberg, B., Tumani, H., Warnke, C., Weber, M. S., Ziemssen, T., Zipp, F., and Wiendl, H.

Published
2016
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33. Specific T-cell activation in peripheral blood and cerebrospinal fluid in central disorders of hypersomnolence

Author

Lippert, Julian, Young, P., Gross, C., Meuth, S. G., Drager, B., Schirmacher, A., and Heidbreder, A.

Subjects
610 Medicine & health
Abstract

An autoimmune-mediated process in the pathophysiology of narcolepsy type 1 (NT1) is highly suspicious, if this pathomechanism is transferable to other types of central disorders of hypersomnolence (CDH), is still controversial. The association of NT1 with HLA-class-II system implicates a T-cell-mediated autoimmunity, in which helper CD4+ T-cells and cytotoxic CD8+ T-cells may be pathogenic.This study aimed to identify specific immune profiles in peripheral blood (PB) and cerebrospinal fluid (CSF) in different types of CDH.Forty-three patients with polysomnographically confirmed CDH (24 idiopathic hypersomnia (IH), 12 NT1, 7 NT2) were compared to 24 healthy controls (HC). PB and CSF were analysed with multiparameter flow cytometry to distinguish between subclasses of peripheral and intrathecal immune cells and specific surface markers of T-cells.The overall proportion of helper CD4+ T-cells and cytotoxic CD8+ T-cells in PB and CSF did not differ between the patients and HC. Activated HLA-DR+ CD4+T-cells and HLA-DR+ CD8+T-cells in PB and CSF both in NT1, NT2 and IH were significant increased compared to HC. A significant correlation of HLA-DR+ CD4+ - and HLA-DR+ CD8+ T-cells with higher amounts of excessive daytime sleepiness was found in the NT1- and IH groups, indicating an association of activated T-cells in the CNS with increased of sleepiness.These findings provide further evidence of a T-cell-mediated autoimmunity not only in NT1, but in NT2 and IH as well. Moreover, the identification of activated cytotoxic CD8+ T-cells further supports the evidence of T cell-mediated neuronal damage, which has previously been suggested in NT1.

Published
2019
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35. Immunophenotyping of cerebrospinal fluid cells in ischaemic stroke

Author

Schulte‐Mecklenbeck, A., primary, Kleffner, I., additional, Beuker, C., additional, Wirth, T., additional, Hartwig, M., additional, Schmidt‐Pogoda, A., additional, Klotz, L., additional, Hansen, W., additional, Wiendl, H., additional, Meuth, S. G., additional, Gross, C. C., additional, and Minnerup, J., additional

Published
2019
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37. Absence of Epstein-Barr virus seronegativity in a large cohort of patients with early multiple sclerosis

Author

Abrahamyan, S., Eberspaecher, B., Ambrosius, B., Hessler, N., Antony, G., Koenig, I. R., Hoshi, M. -M., Aly, L., Luessi, F., Groppa, S., Klotz, L., Meuth, S. G., Tackenberg, B., Stoppe, M., Bergh, F. Then, Tumani, H., Kuempfel, T., Stangel, M., Heesen, C., Wildemann, B., Paul, F., Bayas, A., Warnke, C., Weber, F., Linker, R. A., Ziemann, U., Zettl, U. K., Zipp, F., Wiendl, H., Hemmer, B., Gold, R., Salmen, A., Ruprecht, K., Abrahamyan, S., Eberspaecher, B., Ambrosius, B., Hessler, N., Antony, G., Koenig, I. R., Hoshi, M. -M., Aly, L., Luessi, F., Groppa, S., Klotz, L., Meuth, S. G., Tackenberg, B., Stoppe, M., Bergh, F. Then, Tumani, H., Kuempfel, T., Stangel, M., Heesen, C., Wildemann, B., Paul, F., Bayas, A., Warnke, C., Weber, F., Linker, R. A., Ziemann, U., Zettl, U. K., Zipp, F., Wiendl, H., Hemmer, B., Gold, R., Salmen, A., and Ruprecht, K.

Published
2018

38. Changes of disease characteristics and disease-modifying treatment within one year in the National German MS cohort

Author

Ambrosius, B., Hessler, N., Antony, G., Konig, I. R., Hoshi, M-M., Aly, L., Luessi, F., Groppa, S., Klotz, L., Meuth, S. G., Tackenberg, B., Stoppe, M., Bergh, F. Then, Tumani, H., Kuempfel, T., Stangel, M., Heesen, C., Wildemann, B., Paul, F., Bayas, A., Warnke, C., Weber, F., Linker, R. A., Ziemann, U., Zettl, U. K., Zipp, F., Wiendl, H., Hemmer, B., Gold, R., Salmen, A., Ambrosius, B., Hessler, N., Antony, G., Konig, I. R., Hoshi, M-M., Aly, L., Luessi, F., Groppa, S., Klotz, L., Meuth, S. G., Tackenberg, B., Stoppe, M., Bergh, F. Then, Tumani, H., Kuempfel, T., Stangel, M., Heesen, C., Wildemann, B., Paul, F., Bayas, A., Warnke, C., Weber, F., Linker, R. A., Ziemann, U., Zettl, U. K., Zipp, F., Wiendl, H., Hemmer, B., Gold, R., and Salmen, A.

Published
2018

42. Disease-modifying therapy in multiple sclerosis and chronic inflammatory demyelinating polyradiculoneuropathy: common and divergent current and future strategies

Author

Melzer, N and Meuth, S G

Subjects
Receptors, Lysosphingolipid, Multiple Sclerosis, Polyradiculoneuropathy, Chronic Inflammatory Demyelinating, Integrin alpha4, Cell Migration Inhibition, Antibodies, Monoclonal, Humans, Immunologic Factors, Immunotherapy, Lymphocytes, Review Articles
Abstract

Multiple sclerosis (MS) and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) represent chronic, autoimmune demyelinating disorders of the central and peripheral nervous system. Although both disorders share some fundamental pathogenic elements, treatments do not provide uniform effects across both disorders. We aim at providing an overview of current and future disease-modifying strategies in these disorders to demonstrate communalities and distinctions. Intravenous immunoglobulins (IVIG) have demonstrated short- and long-term beneficial effects in CIDP but are not effective in MS. Dimethyl fumarate (BG-12), teriflunomide and laquinimod are orally administered immunomodulatory drugs that are already approved or likely to be approved in the near future for the basic therapy of patients with relapsing-remitting MS (RRMS) due to positive results in Phase III clinical trials. However, clinical trials with these drugs in CIDP have not (yet) been initiated. Natalizumab and fingolimod are approved for the treatment of RRMS, and trials to evaluate their safety and efficacy in CIDP are now planned. Alemtuzumab, ocrelizumab and daclizumab respresent monoclonal antibodies in advanced stages of clinical development for their use in RRMS patients. Attempts to study the safety and efficacy of alemtuzumab and B cell-depleting anti-CD20 antibodies, i.e. rituximab, ocrelizumab or ofatumumab, in CIDP patients are currently under way. We provide an overview of the mechanism of action and clinical data available on disease-modifying immunotherapy options for MS and CIDP. Enhanced understanding of the relative effects of therapies in these two disorders may aid rational treatment selection and the development of innovative treatment approaches in the future.

Published
2014

44. Neues zur symptomatischen MS-Therapie: Teil 3 – Blasenfunktionsstörungen.

Author

Henze, T., Feneberg, W., Flachenecker, P., Seidel, D., Albrecht, H., Starck, M., and Meuth, S. G.

Abstract

Copyright of Der Nervenarzt is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Published
2018
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45. Neues zur symptomatischen MS-Therapie: Teil 4 – Störungen der Sexualfunktion und der Augenbewegungen.

Author

Henze, T., Feneberg, W., Flachenecker, P., Seidel, D., Albrecht, H., Starck, M., and Meuth, S. G.

Abstract

Copyright of Der Nervenarzt is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Published
2018
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46. A Study of the Geographic Accessibility of Outpatient Memory Clinics in Germany.

Author

Masanneck, L., Butryn, M., Nelke, C., Repple, J., Meier, U., Düzel, E., Meuth, S. G., and Pawlitzki, M.

Abstract

In the article, the authors present their study to identify the need for and accessibility of specialized structures for dementia treatment based on geographic analysis in Germany. Also cited are the support by the German Centre for Neurodegenerative Diseases (DZNE) for dementia research, and the medical specialties involved in the diagnosis and treatment of patients with memory impairments.

Published
2023
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48. Developmental endothelial locus-1 is a homeostatic factor in the central nervous system limiting neuroinflammation and demyelination

Author

Choi, E Y, primary, Lim, J-H, additional, Neuwirth, A, additional, Economopoulou, M, additional, Chatzigeorgiou, A, additional, Chung, K-J, additional, Bittner, S, additional, Lee, S-H, additional, Langer, H, additional, Samus, M, additional, Kim, H, additional, Cho, G-S, additional, Ziemssen, T, additional, Bdeir, K, additional, Chavakis, E, additional, Koh, J-Y, additional, Boon, L, additional, Hosur, K, additional, Bornstein, S R, additional, Meuth, S G, additional, Hajishengallis, G, additional, and Chavakis, T, additional

Published
2014
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49. L-Selectin is a possible biomarker for individual PML risk in natalizumab-treated MS patients

Author

Schwab, N., primary, Schneider-Hohendorf, T., additional, Posevitz, V., additional, Breuer, J., additional, Gobel, K., additional, Windhagen, S., additional, Brochet, B., additional, Vermersch, P., additional, Lebrun-Frenay, C., additional, Posevitz-Fejfar, A., additional, Capra, R., additional, Imberti, L., additional, Straeten, V., additional, Haas, J., additional, Wildemann, B., additional, Havla, J., additional, Kumpfel, T., additional, Meinl, I., additional, Niessen, K., additional, Goelz, S., additional, Kleinschnitz, C., additional, Warnke, C., additional, Buck, D., additional, Gold, R., additional, Kieseier, B. C., additional, Meuth, S. G., additional, Foley, J., additional, Chan, A., additional, Brassat, D., additional, and Wiendl, H., additional

Published
2013
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