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Multiple Sclerosis

Multiple Sclerosis Lecture Series: Current Concepts

Learning Objectives
1. Summarize the positive impact of early treatment in multiple sclerosis
2. Utilize pharmacologic and non-pharmacologic therapies to maximize neurological reserve
0.5 Credit CME
Stanford Medicine
Published Online: May 16, 2023 Video 33 min 42 sec
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Internet Enduring Material sponsored by Stanford University School of Medicine. Presented by the Stanford University School of Medicine Department of Neurology and Center for Continuing Medical Education.

What are the early treatment possibilities for Multiple Sclerosis? In the third lecture of the MS Lecture Series, learn about MS phenotypes, the importance of early intervention, and maximizing neurological reserve in patients. Treatments for Multiple Sclerosis continue to evolve, so watch this video to learn the latest concepts and best practices for treating MS patients quickly after diagnosis.

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Video Information

All Rights Reserved. The content of this activity is protected by U.S. and International copyright laws. Reproduction and distribution of its content without written permission of its creator(s) is prohibited.

Accreditation

In support of improving patient care, Stanford Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Financial Support Disclosure Statement: Stanford Medicine adheres to the Standards for Integrity and Independence in Accredited Continuing Education.

There are no relevant financial relationships with ACCME-defined ineligible companies for anyone who was in control of the content of this activity, except those listed in the table below. All of the relevant financial relationships listed for these individuals have been mitigated.

Lucas B. Kipp, MD

Stanford hospital & Clinics

Course Director, Faculty

Grant or research support-Roche/Genetech/ Grant or research support biogen Idec.

Ruth Adewuya, MD, CHCP

Managing Director, Center for Continuing Medical Education

Stanford University School of Medicine

Planner

Nothing to disclose

Marilyn Mejia, BA

Education Design Coordinator

Stanford University

Planner

Nothing to disclose.

Jamie McDonald, MD

Stanford Health Care

Reviewer

Nothing to disclose

Commercial Support Disclosure Statement: This educational activity is supported in part by an educational grant from Novartis Pharmaceuticals Corporation.

References:
1.
Bermel  RA, Bakshi  R.  The measurement and clinical relevance of brain atrophy in multiple sclerosis.  Lancet Neurol. 2006;5(2):158–170. doi:10.1016/S1474-4422(06)70349-0Google Scholar
2.
Cohen  JA, Barkhof  F, Comi  G,  et al.  Oral fingolimod or intramuscular interferon for relapsing multiple sclerosis.  N Engl J Med. 2010;362(5):402–415. doi:10.1056/NEJMoa0907839Google Scholar
3.
Comi  G, Radaelli  M, Soelberg Sørensen  P.  Evolving concepts in the treatment of relapsing multiple sclerosis.  Lancet. 2017;389(10076):1347–1356. doi:10.1016/S0140-6736(16)32388-1Google Scholar
4.
Criste  Gerson, , Trapp  Bruce, and Dutta  Ranjan. “Chapter 5 - Axonal Loss in Multiple Sclerosis: Causes and Mechanisms.” In Handbook of Clinical Neurology, edited by Douglas S. Goodin, 122:101–13.  Multiple Sclerosis and Related Disorders. Elsevier, 2014. https://doi.org/10.1016/B978-0-444-52001-2.00005-4.
5.
De Stefano  N, Stromillo  ML, Giorgio  A,  et al.  Establishing pathological cut-offs of brain atrophy rates in multiple sclerosis.  J Neurol Neurosurg Psychiatry. 2016;87(1):93–99. doi:10.1136/jnnp-2014-309903Google Scholar
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D'hooghe  MB, Nagels  G, Bissay  V, De Keyser  J.  Modifiable factors influencing relapses and disability in multiple sclerosis.  Mult Scler. 2010;16(7):773–785. doi:10.1177/1352458510367721Google Scholar
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Fisniku  LK, Brex  PA, Altmann  DR,  et al.  Disability and T2 MRI lesions: a 20-year follow-up of patients with relapse onset of multiple sclerosis.  Brain. 2008;131(Pt 3):808–817. doi:10.1093/brain/awm329Google Scholar
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Freedman  MS., Comi  G, De Stefano  N,  et al.  Moving toward Earlier Treatment of Multiple Sclerosis: Findings from a Decade of Clinical Trials and Implications for Clinical Practice.  Multiple Sclerosis and Related Disorders. 2014;3(2): 147–55. doi: 10.1016/j.msard.2013.07.001Google Scholar
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Giovannoni  G, Butzkueven  H, Dhib-Jalbut  S,  et al.  Brain health: time matters in multiple sclerosis.  Mult Scler Relat Disord. 2016;9 Suppl 1:S5–S48. doi:10.1016/j.msard.2016.07.003Google Scholar
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He  A, Merkel  B, Brown  JWL,  et al.  Timing of high-efficacy therapy for multiple sclerosis: a retrospective observational cohort study.  Lancet Neurol. 2020;19(4):307–316. doi:10.1016/S1474-4422(20)30067-3Google Scholar
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Heine  M, Verschuren  O, Hoogervorst  EL,  et al.  Does aerobic training alleviate fatigue and improve societal participation in patients with multiple sclerosis? A randomized controlled trial.  Mult Scler. 2017;23(11):1517–1526. doi:10.1177/1352458517696596Google Scholar
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Petersen  ER. Effect of Smoking, a NAT1 Genetic Variant and HLA Genes on Disease. MULTILEARNING Group, Inc. Accessed June 3, 2022.
13.
Kappus  N, Weinstock-Guttman  B, Hagemeier  J,  et al.  Cardiovascular risk factors are associated with increased lesion burden and brain atrophy in multiple sclerosis.  J Neurol Neurosurg Psychiatry. 2016;87(2):181–187. doi:10.1136/jnnp-2014-310051Google Scholar
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Katz Sand  I, Krieger  S, Farrell  C, Miller  AE.  Diagnostic uncertainty during the transition to secondary progressive multiple sclerosis.  Mult Scler. 2014;20(12):1654–1657. doi:10.1177/1352458514521517Google Scholar
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Kavaliunas  A, Manouchehrinia  A, Stawiarz  L,  et al.  Importance of early treatment initiation in the clinical course of multiple sclerosis.  Multiple Sclerosis Journal. 2017;23(9):1233–1240. doi:10.1177/1352458516675039Google Scholar
16.
Krieger  SC, Cook  K, De Nino  S, Fletcher  M.  The topographical model of multiple sclerosis: A dynamic visualization of disease course.  Neurol Neuroimmunol Neuroinflamm. 2016;3(5):e279. Published 2016 Sep 7 . doi:10.1212/NXI.0000000000000279Google Scholar

Accreditation
In support of improving patient care, Stanford Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Credit Designation
Stanford Medicine designates this Enduring Material for a maximum of 0.50 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

     
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