Background: Previous real-world comparative research of MS disease modifying therapies (DMTs) in the overall population has suggested dimethyl fumarate (DMF) to be comparable to fingolimod (FTY) and more efficacious than teriflunomide (TERI) in reducing relapses. However, there is limited comparative evidence in patients switching from platform DMTs in the US. The objective of the study was to compare the annualized relapse rate (ARR) and risk of relapse in MS patients who have switched from a platform therapy to DMF, FTY, or TERI. Methods: MS patients (18-65 years old) initiating an oral DMT from June 2013 to March 2015 were identified from the Truven MarketScan ® Commercial Claims Database. The index date was the date of first oral DMT fill. Patients were required to have: continuous enrollment in the database for 12 months pre-index date and ≥3 months post-index date; ≥1 MS diagnosis over the pre-index period; discontinuation of a platform DMT with no evidence of oral or infusion DMTs over the pre-index period; and adherence to the index drug for ≥90 days. DMF patients were propensity-score matched (PSM) 3:1 to FTY and to TERI based on age, gender, region, a claims-based MS severity measure, ARR, and number of hospitalizations over the pre-index period. Patients were censored when they dropped out of the database or at the end of the study period (March 31, 2016). Post-index relapses were annualized. Results: The database included 20,311 oral DMT users. After applying the study criteria, the PSM yielded 1602:534 switch patients for the DMF-FTY matched cohort. DMF-FTY patients were well-matched on all covariates: age (mean = 44 for both), gender (28% vs. 26% male, respectively), MS severity measure (0.99 vs. 1.08), and baseline ARR (0.40 vs. 0.44). PSM yielded 833:279 switch patients for the DMF-TERI match. DMF-TERI patients were well-matched on all covariates: age (mean = 50), gender (24% vs. 25% male), MS severity measure (0.86 vs. 0.99), and baseline ARR (0.23 vs. 0.30). The standardized differences confirmed balance across all covariates for matched cohorts. The matched DMF-FTY cohorts had comparable post-index ARR (Rate Ratio [RR] = 1.07 [95% Cl: 0.861, 1.328]) and risk of relapse (Hazard Ratio [HR ]= 0.996 [95% CI: 0.803, 1.236]). Post-index ARR was significantly lower with DMF in comparison to TERI (RR = 0.667 [0.486, 0.914]). The risk of relapse was also significantly lower when switching to DMF than TERI (HR = 0.679 [0.503, 0.917]). Conclusion:In this analysis, the effectiveness profiles for those oral DMT users specifically switching from platform therapies are consistent with findings from previous research conducted among all oral DMT users, regardless of prior therapy.

The flash-lag effect is a robust visual illusion in which a flash appears to spatially lag a continuously moving stimulus, even though both stimuli are actually precisely aligned. Some research has been done to test how visual information has been integrated over time. The position integration model suggests motion integration is a form of interpolation of past positions, and predicts that we cannot perceive the reversal point at its actual position on the trajectory of a moving object which reverses abruptly. In current research, we demonstrate that subjects could perceive the reversal point accurately while the psychometric function measured by a flash does not pass through the actual turning point. These results do not support the position integration model. We propose that the flash-lag effect is more likely to be a temporal illusion.

Background: Hemophilia-A is a chronic inherited bleeding disorder that results from deficiencies in factor VIII. Prophylactic replacement of coagulation factor VIII (FVIII) is the standard of care. However, about 20-30% of patients with severe hemophilia A may develop neutralizing antibodies (inhibitors) against the coagulation factor VIII. The Immune Tolerance Induction (ITI) method, consist in the regular infusion of variable FVIII doses to induce FVIII antigen-specific tolerance. It has proven the most effective inhibitor eradication treatment in patients with high-titer inhibitors. Current published studies reported wide range of findings on the factor usage and cost of treatment. The objective of this study is to describe the consumption, duration, and cost of ITI treatment in US healthcare settings. Methods: This retrospective analysis used MarketScan, an US health insurance claim database from January 2010 to September 2015. Eligible patients were: male hemophilia-A inhibitor patients who received ITI treatment. ITI treatment was identified as patients who tested Bethesda/Nijmegen assays between 30 days prior to an ITI index date and the end of study period; and used high dose of factor therapy (>3 times of the median IU factors dispensed for patients in the same age group for more than 5 consecutive months, allowing one month gap). Conclusion of ITI treatment was defined as when the amount of IU dispensed has fallen under 1.5 times of the median amount dispensed, or remaining in ITI treatment at the end of study period. Patients, who used by-pass agents to treat bleeding without undergoing ITI, were excluded. The total cost of ITI treatment was focused only on the cost of factor therapy. The treatment duration, cost, and IU consumption were further stratified by age groups and specific factor therapies. Results: Of the 2,302 hemophilia-A patients, 231 inhibitor patients were identified. A total of 72 patients used high dose short-acting factors for ITI treatment. No patient receiving long-acting factor was captured in the inhibitor population. Table 1 lists the patient counts, duration and cost of ITI treatment by age groups. Higher percentages of younger patient groups developed inhibitor compared with older age groups. About 14% of hemophilia-A patients aged 7 and under had ITI treatment. The older groups (aged 16 and older) had higher total costs as they required higher IU of factor therapy. The average duration of ITI treatment was 18.7 months, and the average total cost was $1,463,668 per patient regardless of the type of short acting factor therapy used. Conclusions: This US health insurance claim database study reflects that the current utilization of short acting factor for ITI treatment is associated with high cost burden. Products that decrease or eliminate inhibitor formation should be developed. Disclosures Su: Novartis Pharmaceuticals Corporation: Employment; Biogen: Employment, Equity Ownership. Zhou:Biogen: Employment, Equity Ownership. Buckley:Biogen: Employment, Equity Ownership. Rising:Biogen: Employment, Equity Ownership. Hou:Biogen: Employment, Equity Ownership. Jain:Biogen: Employment, Equity Ownership.

OBJECTIVES: To characterize the functional, emotional and social impact of migraine in Portugal. METHODS: A worldwide, cross-sectional, online survey was conducted including migraine patients recruited via online panels and patient organizations from September 2017-February 2018. Study participants were adults reporting 4 or more monthly migraine days over the 3 months previous to survey with a pre-determined quota of 90% participants having received previous preventive migraine treatment. Results from the Portuguese sample are reported. RESULTS: A total of 143 migraine patients were included, 79.7% women and mean age of 37.3 years (SD 12.6; range 18-72). About 79.0% of participants mentioned feeling very or extremely limited in completing daily activities during the migraine attack. Indeed, 71.3% participants rely on support of family/friends to perform daily activities (average 11.8 hours in previous 3 months; SD 18.9; range 1-90). 39.2% of participants have often/always "no energy to complete daily living tasks or feel fatigued". Most common negative feelings perceived by participants were lack of others' understanding about their pain (53.9%), feeling helpless (42.7%) and depressed (40.0%). Nevertheless, 37.1% mentioned having learned to cope with the disease. Most patients (62.9%) claimed that migraine has changed their relationships with relatives/friends/partner and 81.1% of participants also mentioned that migraine has affected their social life and activities (48.3% cannot take part in usual activities/hobbies, 47.4% stopped social events). In the previous month, 80.4% of participants had to cancel plans due to migraine. As an overall consequence, 39.9% of patients mentioned being very/extremely fearful regarding next migraine attack. CONCLUSIONS: This study confirms that migraine is associated with functional impairment requiring support from others and a clear emotional and social impact in patients' lives.

A university-focused alliance portfolio is a manifestation of industry–university–research cooperation and has become an important path to realize original innovation in science and technology. Unlike traditional technological innovation, original innovation particularly emphasizes new ideas and research areas never covered before. This paper integrates resource-based theory, alliance portfolio theory, and innovation theory, and aims to scientifically establish an evaluation index system of original innovation performance from the three dimensions of initiate research, technology breakthrough, and research breakthrough. The work explores how a university can select partners to realize collaborative innovation in the context of inter-organizational scientific research cooperation with multiple innovation subjects for nationwide research institutes and universities in mainland China. The empirical results show that resource complementarity has a significant positive effect on innovation performance. Three typical universities in the “2011 project” are selected as post-interview cases for enriching empirical evidence. This study contributes to original innovation literature by introducing the concept of resource complementarity in a university-focused alliance portfolio, and further provides implications for original and science-driven innovation studies and suggests directions for university and research institutes.