The Impact of Upcoming Treatments in Huntington's Disease: Resource Capacity Limitations and Access to Care Implications.

BACKGROUND: The most advanced disease-modifying therapies (DMTs) in development for Huntington's disease (HD) require intrathecal (IT) administration, which may create or exacerbate bottlenecks in resource capacity. OBJECTIVE: To understand the readiness of healthcare systems for intrathecally administered HD DMTs in terms of resource capacity dynamics and implications for patients' access to treatment. METHODS: Forty HD centres across 12 countries were included. Qualitative and quantitative data on current capacity in HD centres and anticipated capacity needs following availability of a DMT were gathered via interviews with healthcare professionals (HCPs). Data modelling was used to estimate the current capacity gap in HD centres. RESULTS: From interviews with 218 HCPs, 25% of HD centres are estimated to have the three components required for IT administration (proceduralists, nurses and facilities). On average, 114 patients per centre per year are anticipated to receive intrathecally administered DMTs in the future. At current capacity, six of the sampled centres are estimated to be able to deliver DMTs to all the anticipated patients based on current resources. The estimated waiting time for IT administration at current capacity will average 60 months (5 years) by the second year after DMT availability. CONCLUSION: Additional resources are needed in HD centres for future DMTs to be accessible to all anticipated patients. Timely collaboration by the HD community will be needed to address capacity gaps. Healthcare policymakers and payers will need to address costs and navigate challenges arising from country- or region-specific healthcare delivery schemes.

The effects of methylphenidate on novel object exploration in weanling and periadolescent rats.

Methylphenidate (Ritalin) is used in the treatment of attention-deficit hyperactivity disorder. Surprisingly, little research has been conducted on the effects of methylphenidate during early development. Therefore, the present study was conducted to examine the effects of methylphenidate on object exploration in developing rats. Male and female weanling (21-day-old) and periadolescent (34-day-old) Sprague-Dawley rats were tested after acute or chronic treatment with methylphenidate. In weanling rats, chronic methylphenidate (5.0 mg/kg) increased locomotor activity and disrupted novel object exploration. In periadolescent rats, methylphenidate disrupted exploration of the novel object, but had no effect on locomotor activity at any dose tested. Periadolescent rats appear to be less sensitive to methylphenidate-induced changes in activity compared to weanling animals, whereas methylphenidate disrupted novel object exploration in both ages. Our results suggest that methylphenidate may alter recognition memory and/or reactivity to or preference for novelty.