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To better handle the influx of inquiries due to the COVID-19 pandemic, American Family Care (AFC) recently announced a partnership with Botco.ai to integrate artificial intelligence (AI) into AFC’s chat channels. 

Botco.ai's intelligent chat provides patients with immediate and relevant answers regarding COVID-19 testing and clinic wait times, in addition to resources for potential franchise owners.

COVID-19 is proving that people want answers immediately, and rightfully so,” says Sean Hart, vice president of Franchise Sales and Development at American Family Care. “Before the pandemic, chat was just a way to extend the efficiency of our team, but now Botco.ai is helping us address both the sales and patient side, doing the work of multiple people for us.”

AFC engaged Botco.ai to streamline its chat functionality to help instantly address COVID-19 inquiries and also respond to those interested in buying an AFC franchise. The franchise noticed it was receiving several COVID-19 inquiries through its sales chat, and it needed an efficient solution to answer questions about coronavirus test results, disease concerns, scheduling, and mask use without slowing down the sales process.

Botco.ai is enabling AFC to proactively start the patient and franchisee engagement process, answer all questions, and schedule a call or appointment with a relevant member of the AFC team. The chat allows AFC to significantly increase its customer and patient engagement without hiring additional team members.

“We knew we could make the American Family Care team feel like they hired an entirely new division to manage its COVID-19 inquiries,” says Rebecca Clyde, CEO and co-founder of Botco.ai. “Patients need quick and easy access to COVID-related information, and we’re helping AFC provide that service without compromising its sales efforts. COVID-19 testing and tracing is one of the most important services a clinic can provide, and we’re with AFC every step of the way.”

Articles

Botco.ai’s AI-powered intelligent chat solution automatically addresses questions regarding COVID-19, scheduling visits, franchising and more.

American Family Care Adopts AI Chat Solution to Answer Patient Questions on COVID 

A large body of research suggests that vitamin D deficiency may play a causative role in the development of multiple sclerosis.

In a review paper recently published by the 

 Yeh Wei Zhen of Monash University in Melbourne, Australia, and colleagues provided a detailed overview of the possible connection and the immunoregulatory effects and therapeutic potential of vitamin D in multiple sclerosis. Here is some of what they said:

There is a latitudinal gradient to MS prevalence and incidence whereby the greater the distance from the equator, the greater the prevalence and incidence. Exposure to ultraviolet B light and vitamin D levels

, which include B and T lymphocytes, vitamin D pushes differentiation toward regulatory B and T cells, which, in turn, ramps anti-inflammatory cytokine production such as IL-10 and TGF-beta and dials down pro-inflammatory cytokines. Inflammatory processes are involved in the demyelination process that characterizes multiple sclerosis.

A nested case-control study of more than 7 million U.S. military personnel founded that among whites, every 50 nmol/L increase in serum 25 (OH)D3 was associated a 41% decrease in subsequent MS diagnosis. Among blacks, a smaller decrease of 34% was detected.

A prospective study of Finnish women found that a 50 nmol/L higher level of serum 25 (OH)D

 during the first trimester of pregnancy reduced later MS risk by 39%.

Findings from the Nurses’ Health Study and its companion study, Nurses’ Health Study II, have shown an association between total vitamin D intake and the risk of developing multiple sclerosis later on.

Several studies have shown that low serum vitamin D levels are associated with a higher risk of developing full-fledged multiple sclerosis among those with a first demyelinating attack, sometimes called 

. For example, an Italian study found those in lowest 10th percentile of vitamin D among a group of 100 people with clinically isolated syndrome were most likely to convert to clinically definite multiple sclerosis.

A number of genes that are associated with a higher risk of developing multiple sclerosis are modulated by vitamin D. The researchers mention several genes in this context, including the HLA-DRB1 gene, which has a variant, DRB1*15:01, which they say is the strongest genetic risk factor for MS.

Several studies have shown a connection between vitamin D supplementation and increases in anti-inflammatory cytokines IL-10 and TGF-beta, but the supplementation story is a mixed bag with different studies coming up with different results.

Similarly, the results are mixed from studies that have looked at the effects of vitamin D supplementation on multiple sclerosis among those who already have the disease. For example, one placebo-controlled study found evidence of an improvement in MS lesions among those randomized to daily 14,007 IU of vitamin D, but the study’s primary outcomes of relapses, disability progression, or new lesions were not met. Two meta-analyses published in 2018 concluded that there was no significant benefit from vitamin D supplementation.

“Mixed results” is also the verdict from handful of studies that have tested whether vitamin D supplementation would lessen the chance of people converting from clinically isolated syndrome to multiple sclerosis.

Researchers reviewed the evidence of the association between vitamin D and multiple sclerosis.

Links Between Vitamin D Deficiency and Multiple Sclerosis

Cosentyx (secukinumab) has a high persistence rate among patients with psoriatic arthritis (PsA) who are familiar with biologic medications, according to a real-world study of patients treated in outpatient rheumatology clinics in Greece. The findings 

The biologic, a recombinant human monoclonal antibody that targets interleukin-17A, was approved for the treatment of PsA in Europe in 2015, and in the United States in 2016.

Investigators wanted to know whether patients with PsA would stick with Cosentyx if they had already tried another biologic; this measure, called persistence, is important to payers because many do not want to start patients on costlier branded medications if the patient abandons use and receives little or no benefit.

The study involved 75 patients who had previously been treated with another biologic. Almost two-thirds (64%) had received anti-tumor necrosis factor (TNF) drugs, such as Humira (adalimumab); 7% had received the anti-IL12/23 Stelara (ustekinumab), and 29% had tried both. During the study, half the patients receiving Cosentyx also received non-biologics (53%), and a third (35%) received glucocorticoids.

About three-quarters of the patients were women (76%), with a mean age of 54 years. They had lived with PsA for 6.7 years, with a median treatment time of 11.1 months on Cosentyx. Patients had follow-up visits every three to six months from March 2016 to December 2018.

At the start of the study, the patients had the following symptoms:

22% had enthesitis, involving inflammation where the tendon meets the bone

12% had dactylitis, a swollen, painful inflammation of the fingers

Treatment with Cosentyx brought statistically significant improvements in all these symptoms, as measured both by disease activity indexes and functionality scores. Dactylitis resolved for the patients who reported it, and enthesitis resolved for more than half (56%) who had this at baseline.

At the end of the study’s follow-up period, peripheral arthritis scores improved, as did patients’ function scores, which were assessed by questionnaire. All patients with dactylitis at baseline saw the symptom resolve, as did 56% of patients with enthesitis at baseline.

In their paper, the authors say a “novel finding” of the study is the data for patients treated with Cosentyx who had previously received both anti-TNF agents and anti-IL12/23 agents.


Referred to by the authors as “drug survival,” the rate at the last follow-up visit was 64%, with an estimated median drug survival of 26.8 months. The estimated 1 and 2 years drug survival was 66% and 56%, respectively, the authors wrote.

“In our study, the overall [Cosentyx] survival of patients exposed to both classes was not different from those exposed to anti-TNFs alone (68% vs. 67%),” they said.

The authors say their evidence lends support the idea that Cosentyx can help patients for whom other treatments have failed. “Our findings suggest that (Cosentyx) is an efficacious and well-tolerated biologic agent in this multi-resistant, difficult to treat patient group,” they said.

A recent study found 64% of patients with psoriatic arthritis who had tried at least one biologic stayed with Cosentyx for the entire study period.

Real-World Data: Psoriatic Arthritis Patients Stay on Cosentyx After Other Options Fail

Spinal muscular atrophy (SMA) is a rare inherited genetic disorder that affects motor neurons. Until recently, outside of patients, their families and clinicians who treated the disease, relatively few people have heard about of SMA.

But that changed with the approval of Spinraza (nusinersen) in 2016 and Zolgensma (onasemnogene abeparvovec-xioi) in 2019 and their price tags.

Zolgensma, a one-time gene therapy treatment, is priced at $2.1 million and shows up on various lists as being the most expensive drug in the world. Spinraza is priced at $750,000 for the first year and $375,000 for treatment in subsequent years. Cumulatively, it may be even more expensive than Zolgensma, depending on how many years a person is treated.

On Friday, the FDA approved a third SMA drug that may kick off a new era of price competition among SMA drugs.

 (risdiplam) will be priced so the highest annual cost will be $340,000, a Genentech 

 Genentech is marketing the drug in the U.S. and its parent company, Roche, is marketing it elsewhere. In a press release on Friday, Genentech highlighted the fact that it Evrysdi is liquid medicine that can be administered at home by mouth or feeding tube. As the name suggests, it is a daily medication.

Even if the price is lower than Spinraza and Zolgensma, analysts believe that Evrysdi will be a blockbuster with sales of $2 billion, according to 

The press release also noted that one of the two trials (called Sunfish) upon which FDA approval was based is the first and only placebo-controlled trial to include adults with SMA Types 2 and 3 (SMA is grouped into five types).

Evrysdi will delivered be to people’s homes by Accredo, the specialty pharmacy owned by Express Scripts.

“Given the majority of people with SMA in the U.S. remain untreated, we believe that Evrysdi, with its favorable clinical profile and oral administration, may offer meaningful benefits for many living with this rare neurological disease,” said Levi Garraway, M.D., Ph.D., the chief medical officer and head of global product development for Genentech.

Author | MHE Staff

Articles

American Family Care Adopts AI Chat Solution to Answer Patient Questions on COVID

Links Between Vitamin D Deficiency and Multiple Sclerosis

Real-World Data: Psoriatic Arthritis Patients Stay on Cosentyx After Other Options Fail

FDA Approves Evrysdi, Third Drug for Spinal Muscular Atrophy