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Novel Therapeutics in Multiple Sclerosis Management: Clinical Applications Thomas Leist, MD,a Samuel F. Hunter, MD, PhD,b Daniel Kantor, MD,c Clyde Markowitz, MDd a
Associate Professor, Director, Comprehensive Multiple Sclerosis Center, Thomas Jefferson University, Philadelphia, PA; bPresident, Advanced Neurosciences Institute, President, NeuroNexus Center for Neurology Education and Research, Nashville, TN; cPresident, Florida Society of Neurology, Medical Director, Neurologique, Ponte Vedra, FL; dAssociate Professor of Neurology, Director, Multiple Sclerosis, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
ABSTRACT Multiple sclerosis (MS) affects an estimated 300,000 individuals in the United States. No cure exists and although there is a lack of consensus on management, strategies to modify disease course are available. These strategies involve initiating disease-modifying therapies that have been found to slow disease progression and prevent disability symptoms, thereby improving function for MS patients. The overall goal of early disease management is to intervene prior to irreversible neuronal destruction in order to delay disability progression and improve quality of life. Maintaining a lower level of disability for a longer period of time postpones and ultimately attempts to prevent reaching a level of immobility and irreversible disability. However, due to the complex nature of disease and its unique, individual patient course, no patient can be treated alike and no patient responds to therapy similarly. Therefore, MS research is continuous in its evolution of therapeutic development, focusing on neuroprotective effects and agents with distinctive mechanisms of action allowing for unique safety and efficacy profiles. Investigations include novel oral agents and monoclonal antibodies. Many of the approved agents also are continually being investigated in order to evaluate comparative data, the most appropriate means of implementing subsequent therapy upon failure, responsiveness to therapeutic agent when switched, and long-term safety and efficacy. This multimedia webcast educational activity will cover the current state of MS science, current therapies in MS, emerging treatments in clinical trials for MS as well as differences between physicians in diagnosis and management of MS and their evolving practices. Ó 2014 Published by Elsevier Inc. The American Journal of Medicine (2014) 127, S2 This CME Multimedia Activity also is available through the Website of The American Journal of Medicine (www.amjmed.com). Click on the CME Multimedia Activity button in the navigation bar for full access. Statement of author disclosure: Please see the Author Disclosures section at the end of this article.
The American Journal of Medicine, Vol 127, No 1, January 2014 Funding: This activity is supported by an educational grant from Teva Pharmaceuticals, Ltd. Authorship: All authors had access to all data in preparation of this multimedia activity.
ACKNOWLEDGMENT This multimedia activity was peer reviewed by The American Journal of Medicine and is cosponsored by the Elsevier Office of Continuing Medical Education and AcademicCME.
AUTHOR DISCLOSURES It is the policy of the Elsevier Office of Continuing Medical Education (EOCME) that all faculty, instructors, and planners disclose real or apparent conflicts of interest relating to the topics of this educational activity. The faculty reported the following financial relationships or relationships to products or devices they or their spouse/ life partner have with commercial interests related to the content of this CME activity: Thomas Leist, MD is a consultant/advisor for Bayer Healthcare, Biogen IDEC, Inc., Genzyme Corporation, sanofi aventis, EMD Serono Inc, Teva Pharmaceutical Industries Ltd; and is on the speaker’s bureau for Teva Pharmaceutical Industries Ltd. Samuel F. Hunter, MD, PhD is a consultant/advisor for Bayer Healthcare, Biogen IDEC, Inc., Genzyme Corporation, sanofi aventis, Teva Pharmaceutical Industries Ltd.; and has received grant/research support from Biogen IDEC, Inc., Genzyme Corporation, sanofi aventis, Synthon Pharmaceuticals Inc., Teva Pharmaceutical Industries Ltd.; and is on the speaker’s bureau for Bayer Healthcare, Biogen IDEC, Inc., Teva Pharmaceutical Industries Ltd. Daniel Kantor, MD is a consultant/advisor for Biogen IDEC, Inc., Genzyme Corporation, Novartis Pharmaceuticals Corporation, Teva Pharmaceutical Industries Ltd.; has received grant/research support from Biogen IDEC, Inc., Genzyme Corporation, Novartis Pharmaceuticals Corporation, Roche Pharmaceuitclas, Teva Pharmaceutical Industries Ltd.; and is on the speaker’s bureau for Biogen IDEC, Inc., Genzyme Corporation, Novartis Pharmaceuticals Corporation, Teva Pharmaceutical Industries Ltd. Clyde Markowitz, MD is a consultant/advisor for Acorda Therapeutics Inc, Bayer Healthcare, Biogen IDEC, Inc., EMD Serono Inc., Novartis Pharmaceuticals Corporation, sanofi aventis, Teva Pharmaceutical Industries Ltd.; has received grant/research support from Bayer Healthcare, Biogen IDEC, Inc., EMD Serono Inc, Novartis Pharmaceuticals Corporation, Ono Pharmaceutical Ltd, Roche Pharmaceuticals, sanofi aventis, Teva Pharmaceutical Industries Ltd. Planners, Managers, Reviewers: Timothy Hayes, MD, PhD, Margaret Taylor, Gena Dolson, MS, Esther Polgar, Sandy Breslow, Jill McNair, and Karen Overstreet, EdD, RPh, FACEHP, CCMEP hereby state that they or their spouse/life partner do not have any financial relationships to products or devices with any commercials interest related to the content of this activity of any amount during the past 12 months.
Novel Therapeutics in Multiple Sclerosis Management: Clinical Applications Thomas Leist, MD,a Samuel F. Hunter, MD, PhD,b Daniel Kantor, MD,c Clyde Markowitz, MDd a
Associate Professor, Director, Comprehensive Multiple Sclerosis Center, Thomas Jefferson University, Philadelphia, PA; bPresident, Advanced Neurosciences Institute, President, NeuroNexus Center for Neurology Education and Research, Nashville, TN; cPresident, Florida Society of Neurology, Medical Director, Neurologique, Ponte Vedra, FL; dAssociate Professor of Neurology, Director, Multiple Sclerosis, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
ABSTRACT Multiple sclerosis (MS) affects an estimated 300,000 individuals in the United States. No cure exists and although there is a lack of consensus on management, strategies to modify disease course are available. These strategies involve initiating disease-modifying therapies that have been found to slow disease progression and prevent disability symptoms, thereby improving function for MS patients. The overall goal of early disease management is to intervene prior to irreversible neuronal destruction in order to delay disability progression and improve quality of life. Maintaining a lower level of disability for a longer period of time postpones and ultimately attempts to prevent reaching a level of immobility and irreversible disability. However, due to the complex nature of disease and its unique, individual patient course, no patient can be treated alike and no patient responds to therapy similarly. Therefore, MS research is continuous in its evolution of therapeutic development, focusing on neuroprotective effects and agents with distinctive mechanisms of action allowing for unique safety and efficacy profiles. Investigations include novel oral agents and monoclonal antibodies. Many of the approved agents also are continually being investigated in order to evaluate comparative data, the most appropriate means of implementing subsequent therapy upon failure, responsiveness to therapeutic agent when switched, and long-term safety and efficacy. This multimedia webcast educational activity will cover the current state of MS science, current therapies in MS, emerging treatments in clinical trials for MS as well as differences between physicians in diagnosis and management of MS and their evolving practices. Ó 2014 Published by Elsevier Inc. The American Journal of Medicine (2014) 127, S2 This CME Multimedia Activity also is available through the Website of The American Journal of Medicine (www.amjmed.com). Click on the CME Multimedia Activity button in the navigation bar for full access. Statement of author disclosure: Please see the Author Disclosures section at the end of this article.
The American Journal of Medicine, Vol 127, No 1, January 2014 Funding: This activity is supported by an educational grant from Teva Pharmaceuticals, Ltd. Authorship: All authors had access to all data in preparation of this multimedia activity.
ACKNOWLEDGMENT This multimedia activity was peer reviewed by The American Journal of Medicine and is cosponsored by the Elsevier Office of Continuing Medical Education and AcademicCME.
AUTHOR DISCLOSURES It is the policy of the Elsevier Office of Continuing Medical Education (EOCME) that all faculty, instructors, and planners disclose real or apparent conflicts of interest relating to the topics of this educational activity. The faculty reported the following financial relationships or relationships to products or devices they or their spouse/ life partner have with commercial interests related to the content of this CME activity: Thomas Leist, MD is a consultant/advisor for Bayer Healthcare, Biogen IDEC, Inc., Genzyme Corporation, sanofi aventis, EMD Serono Inc, Teva Pharmaceutical Industries Ltd; and is on the speaker’s bureau for Teva Pharmaceutical Industries Ltd. Samuel F. Hunter, MD, PhD is a consultant/advisor for Bayer Healthcare, Biogen IDEC, Inc., Genzyme Corporation, sanofi aventis, Teva Pharmaceutical Industries Ltd.; and has received grant/research support from Biogen IDEC, Inc., Genzyme Corporation, sanofi aventis, Synthon Pharmaceuticals Inc., Teva Pharmaceutical Industries Ltd.; and is on the speaker’s bureau for Bayer Healthcare, Biogen IDEC, Inc., Teva Pharmaceutical Industries Ltd. Daniel Kantor, MD is a consultant/advisor for Biogen IDEC, Inc., Genzyme Corporation, Novartis Pharmaceuticals Corporation, Teva Pharmaceutical Industries Ltd.; has received grant/research support from Biogen IDEC, Inc., Genzyme Corporation, Novartis Pharmaceuticals Corporation, Roche Pharmaceuitclas, Teva Pharmaceutical Industries Ltd.; and is on the speaker’s bureau for Biogen IDEC, Inc., Genzyme Corporation, Novartis Pharmaceuticals Corporation, Teva Pharmaceutical Industries Ltd. Clyde Markowitz, MD is a consultant/advisor for Acorda Therapeutics Inc, Bayer Healthcare, Biogen IDEC, Inc., EMD Serono Inc., Novartis Pharmaceuticals Corporation, sanofi aventis, Teva Pharmaceutical Industries Ltd.; has received grant/research support from Bayer Healthcare, Biogen IDEC, Inc., EMD Serono Inc, Novartis Pharmaceuticals Corporation, Ono Pharmaceutical Ltd, Roche Pharmaceuticals, sanofi aventis, Teva Pharmaceutical Industries Ltd. Planners, Managers, Reviewers: Timothy Hayes, MD, PhD, Margaret Taylor, Gena Dolson, MS, Esther Polgar, Sandy Breslow, Jill McNair, and Karen Overstreet, EdD, RPh, FACEHP, CCMEP hereby state that they or their spouse/life partner do not have any financial relationships to products or devices with any commercials interest related to the content of this activity of any amount during the past 12 months.
