Stigma Adds to Depressive Symptoms in Epilepsy, Parkinson Disease and Diabetes Show Increased Neuroaxonal Damage, ICER Publishes Report on ALS Treatments

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Welcome to this special edition of Neurology News Network. I’m Marco Meglio.

Using a cohort of adults with chronic epilepsy, findings showed that psychological factors such as perceived stress and felt stigma were the most significant correlates of depressive symptoms, followed by social and epilepsy-related factors.Epilepsy-related felt stigma refers to the shame of living with epilepsy and the fear of encountering actual episodes of social discrimination based solely on this condition. In this multicenter, cross-sectional study, 316 adults with epilepsy had depression assessed using the Beck Depression Inventory (BDI) and perceived stress evaluated using the 10-item Perceived Stress Scale (PSS-10). Felt stigma was determined using the 3-item Stigma Scale for Epilepsy (SSE), with individuals categorized as positive for felt stigma if they answered “yes” to at least 1 of the 3 items. Findings on both crude and adjusted models showed that interactions between SSE scores of at least 1 and PSS-10 scores significantly affected BDI scores (P <.05 each). Specifically, in an adjusted model, BDI scores were more strongly associated with PSS-10 scores in individuals with SSE scores of at least 1 than those with scores of 0.

Confirming previous reports, new post hoc data from a recently published study showed an association between Parkinson disease (PD), diabetes myelitis (DM), and more severe neuroaxonal damage.The analysis, which included 280 patients with PD, 29 of whom suffered from prevalent type 2 diabetes, found significant associations between neurofilament light (NfL) and patients’ diabetic. Using regression models, these associations persisted after adjustment for age, BMI, and vascular risk factors such as history of angina, myocardial infarction, stroke, and hypertension. The Tracking Parkinson’s study, first published online in July 2022, aimed to determine if blood biomarkers and genetic status are useful in addition to clinical measures for prognostic modelling in PD. Less than a few months later, the new analysis included a previously defined subgroup of the trial to explore the relationship between serum NfL and diabetes. The findings of the MARK-PD study, which first linked diabetes and high hemoglobin (HbA1c) to increased neuroaxonal damage and cognitive impairment in patients with PD, were a consideration for conducting this current study.

Recently, the Institute for Clinical and Economic Review (ICER) published its revised evidence report assessing the comparative clinical effectiveness and value of 2 treatments for amyotrophic lateral sclerosis (ALS): AMX0035 (Amylyx Pharmaceuticals), an investigational agent, and oral edaravone (Radicava; Mitsubishi Tanabe Pharma), which received FDA approval in May 2022.The report, reviewed by 4 experts within the field, indicated the incremental cost effectiveness of oral edaravone far exceeded typical cost-effectiveness threshold across multiple analyses and, if priced similarly to edaravone, the incremental cost effectiveness of AMX0035 would also far exceed typical thresholds. The health benefit price benchmark (HBPB) for oral edaravone is between $1400 and $3200 annually, and the HBPB for AMX0035 is $9100 to $30,600 annually.

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