2012 MS Bro Updated
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Transcript of 2012 MS Bro Updated
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Joseph P. Van Der Meulen Symposium in Clinical Neuroscience
Multiple Sclerosis:Current Treatmentsand Future Promise
Saturday, May 12, 2012
Louis B. Mayer AuditoriumUSC Health Sciences Campus
Los Angeles, California
presented by
Office of Continuing Medical Educationand the Department of Neurology
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JOSEPH P. VAN DER MEULEN, M.D.The annual Joseph P. Van Der Meulen Symposium in Clinical Neuroscience honorsDr. Van Der Meulen, former Chairman of the Department of Neurology at theUniversity of Southern California, for his contributions to the development of c linicaand basic neuroscience. Dr. Van Der Meulen continues at USC as Professor oNeurology and Vice President for Health Affairs, Emeritus.
Dr. Van Der Meulen was born in Boston, Massachusetts and educated at the PubliLatin School and Boston College before receiving his M.D. from Boston UniversityHe completed an internal medicine internship at Bellevue Hospital (Cornell Service
in New York and received his neurology training at the Harvard Neurological Unit othe Boston City Hospital under Dr. Derek Denny-Brown. He subsequently spent twoyears at the Karolinska Institute studying neurophysiology with Professor RagnaGranit, a Nobel Laureate. After serving on the faculty at Harvard and Case-W esterReserve, Dr. Van Der Meulen joined the Department of Neurology at USC in 1971serving as Chairman until 1979. He served as Vice President for Health Affairs (19772005), and Director of the Independent Health Professions (1991-2005).
During his tenure as Chairman of Neurology, he restructured the department andinitiated the development of neuroscience. He served as Dean of the School o
Medicine in 1985 and 1986 and as Interim Dean from 1995-1997. In addition to his organizational and administrative contributionshe has continued to teach and practice clinical neurology. His continuing activities on behalf of the medical community, the USCfamily, and the development of clinical and basic neurosciences make him a leader in education, health care, and research in theUnited States.
NEEDS ASSESSMENT AND COURSE DESCRIPTIONMultiple Sclerosis (MS) is a complex neurological disease that has been diagnosed in approxim ately 400,000 individuals in thUnited States, with worldwide estimates of 1.2 million, and rising. It is the most common cause of nontraumatic disability iyoung adults and is typically diagnosed between the ages of 20-40 although diagnoses at younger and older ages are nouncom mon. Economic costs of this disease are estimated at $10 billion annually. Although the cause of MS is unknown, it ibelieved that an autoimmune attack on m yelin in the central nervous system is triggered by environmental factors in geneticalsusceptible individuals. Clinically, MS can take one of several form s, from a relatively mild relapsing-remitting form, to rapid1
progressive disease. Symptoms, disease course, and treatment response are variable and at this point largely unpredictablepresenting challenges to recognition and managemen t. Research in the area of biomark ers is beginning to shed light on somof these areas. Multiple clinical trials have shown that early diagnosis and treatment of M S can delay disability. To this end2 3
the diagnostic criteria have been modified to incorporate MR I data which facilitate accurate diagnosis as early as possible. New4
insights into epidemiology, genetics, pathogenesis and treatmen t have been emerging at a rapid pace. New state-of-the art MRtechniques have facilitated earlier diagnosis and have contributed to a better understanding of inflammatory andneurodegenerative characteristics of the disease. Genetic, epidemiologic a nd imm unologic studies have provided new5
information about risk factors for developing MS, susceptibility to different forms of MS, and may also assist in predictin
response to currently approved disease modifying drugs. New research efforts have provided information about the rol6,7,8,9of race and ethnicity in disease presentation and activity, and have revealed special characteristics of MS in children. MS10,11
is unique among m any neurological diseases in that many disease m odifying drugs are available that are capable of controllininflamm ation and delaying neurodegenerative disease progression. Prom ising new disease mod ifying drugs are currently beingtested in clinical trials which have resulted in FDA applications, and several new strategies to promote neural repair an12
regeneration are being explored, including those that use or target stem cells. Given the rapid pace of discovery and th13
changing armamentarium for treatment it is essential for neurologists and other caretakers to be well informed in order totranslate these advances to best clinical practice.
ReferencesCourtney AM, et al. Multiple Sclerosis. Med Clin North Am. 2009;93(2):451-476.1
Hecker M, Paap BK, Goertsches RH, Kandulski O, Fatum C, et al. (2011) Reassessment of Blood Gene Expression Markers for the Prognosis of Relapsing-Remitting2
Multiple Sclerosis. PLoS ONE 6(12): e29648. doi:10.1371/journal.pone.0029648.e.g. Champions Study Group. Neurology. 2006;66:678-684.3
Polman CH, et al. Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol. 2011;69(2):292-302.4
Ali EN, Buckle GJ. Neuroimaging in multiple sclerosis. Neurol Clin. 2009;27(1):203-219.5
International Multiple Sclerosis Genetics Consortium & the Wellcome Trust Case Control Consortium. Genetic risk and a primary role for cell-mediated immune mechanisms6
in multiple sclerosis. Nature. 2011;476: 214-219.Edwards L, et al. Central Inflammation versus peripheral regulation in Multiple Sclerosis. J Neurol. 2011; 258(8):1518-27.7
Axtell R, Chander R, Steinman l. (2012) Clinic Rev Allerg Immunol DOI 10.1007/s12016-011-8296-5.8
Freedman et al. Recognizing and treating suboptimally controlled multiple sclerosis: steps toward regaining command. Curr Med Res Opin. 2009;25(10):2459-2470.9
Yeh EA, et al. Pediatric multiple sclerosis. Nat Rev Neurol. 2009;5(11):621-631.10
Chitnis T, et al. Pediatric Multiple Sclerosis, Neurol Clin. 2011;29:481505.11
Stuve O, et al. Translational research in neurology and neuroscience 2010.Arch Neurol. 2010;67(11):1307-1315.12Uccelli A, et al. Mesenchymal stem cells for the treatment of multiple sclerosis and other neurological diseases. Lancet Neurology. 2011;10(7):649-656.13
This course will address current therapy after outlining essentials of pathophysiology and diagnosis. Managem ent issues sucas treatment choice and assessm ent of efficacy will be outlined. Promising future treatments for both prevention of new lesioand restoration of existing damaged tissue will be presented.
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COURSE OBJECTIVES
At the conc lus ion of this program, the participant should be ab le to:
Implement the most current diagnostic criteria in order to facilitate early recognition of MS
Explain current concepts in the pathophysiology and how this relates to treatment of MS
Evaluate the complex genetics of MS and what they tell us about MS pathogenesis
Cite and assess current and future treatment modalities, including risk profiles and mechanisms of action
Evaluate the contributions of epidemiology and ethnicity in MS management
Apply MRI data in the diagnosis and prognosis of the individual patient
Assess treatment eff icacy Define the status of neuroregenerative medicine in MS
SCHEDULE
7:15 a.m. Registration and Continental Breakfast
8:00 a.m. Welcome and Introductory Remarks
Margaret Burnett, MD and Leslie P. Weiner, MD
8:15 a.m. Multiple Sclerosis Overview / Pathophysiology
Lawrence Steinman, MD
9:15 a.m. MRI in Diagnosis and Prognosis
Nancy L. Sicotte, MD
10:15 a.m . Break
10:30 a.m. Epidemiology of Multiple Sclerosis
Annette M. Langer-Gould, MD, PhD, MS
11:15 a.m. The Genetics of Multiple Sclerosis and
Ethnic Influences in the DiseaseLilyana Amezcua, MD
12:00 noon Panel Discussion
Drs. Amezcua, Langer-Gould, Sicotte,
and Steinman
12:15 p.m. Lunch
1:15 p.m. Pediatric Multiple Sclerosis: What It Tell
Us about Multiple Sclerosis and How
Management D iffers From the Adult
Patient
Emmanuelle L. Waubant, MD, PhD
2:15 p.m. Current Therapies for Multiple Scleros
and Possible Algorithms for Their Use
Regina Berkovich, MD, PhD
2:45 p.m. New and Emerging Therapies for
Multiple Sclerosis
Margaret Burnett, MD
3:15 p.m. Break
3:30 p.m. Neuromyelitis Optica: New Ideas on an
Old Disease
Mark J. Morrow, MD
4:15 p.m. Neuroprotection, Neuroregen eration a
Stem CellsLeslie P. Weiner, MD
5:00 p.m. Panel Discussion
Drs. Berkovich, Burnett, Morrow, and Wein
5:15 p.m . Adjourn
Desirable Physician Attributes: In alignment with the CME mission of the Keck School of Medicine, programs are planned in the conteof desirable physician attributes as designated by the ACGME/ABMS and the Institute of Medicine: 1) Patient Care and Patient CentereCare, 2) Medical Knowledge, 3) Practice-based Learning, 4) Interpersonal and Communication Skills, 5) Professionalism, 6) Systems-basePractice, 7) Work in Interdisciplinary Teams, 8) Apply Quality Improvement, 9) Utilize Informatics, and 10) Employ Evidence-based practicThis program and the objectives have been developed in the context of attributes 1, 2, 3, 5, and 10.
CME CREDITThe Keck School of Med icine of the University of Southern California is accredited by the Accreditation Council for Continuin
Medical Education (ACCME) to sponsor continuing medical education for physicians.
The Keck Schoo l of Medicine of the University of Southern California designates this live activity for a maximum o f 7.5AM
PRA Category 1 Credits. Physicians should claim only the credit comm ensurate with the extent of their participation in th
activity.
The California State Board of Registered Nursing accepts courses approved forAMA PRA Category 1 C redits as m eetin
the continuing education requirements for license renewal.
ACKNOWLEDGMENTWe g ratefully acknow ledge an educational grant in support of the program from
Elan Pharmaceuticals, Inc.
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COURSE FACULTY
COURSE DIRECTORKeck School of Medicine of USC
Margaret Burnett, MDAssistant Professor o f Neurology and NeuropathologyDirector, LAC+USC Multiple Sclerosis Clinic
GUEST FACULTY
Annette M. Langer-Gould, MD, PhD, MSResearch Scientist, NeurologyDepartment of Research and EvaluationKaiser Permanente Southern CaliforniaAssociate Clinical Professor of NeurologyKeck School of Medicine of USC
Mark J. Morrow, MDChairman, Department of NeurologyNeurology Residency Program DirectorHarbor-UCLA Medical CenterTorrance, CaliforniaClinical Professor of Neurology
David Geffen School of Medicine at UCLALos Angeles, California
Nancy L. Sicotte, MDDirector, Multiple Sclerosis ProgramDepartment of NeurologyCedars-Sinai Medical CenterAssociate Professor of NeurologyDavid Geffen School of Medicine at UCLALos Angeles, California
Lawrence Steinman, MDGeorge A. Zimmerman Professor of Neurological
Sciences, Neurology, Genetics and PediatricsStanford University School of MedicineStanford, California
Emmanuelle L. Waubant, MD, PhDAssociate Professor of Neurology
University of California, San Francisco,School of Medicine
San Francisco, California
FACULTY AT THE KECK SCHOOL OF MEDICINUniversity of Southern California
Lilyana Amezcua, MDAssistant Professor of NeurologyDivision Co-chief, MS Comprehensive Care Center
Regina Berkovich, MD, PhDAssistant Professor of Neurology
Leslie P. Weiner, MDProfessor of Neurology, Molecular Microbiology
and ImmunologyRichard Angus Grant, Sr., Chair in NeurologyLeslie P. Weiner Chair in Neurology
FACULTY DISCLOSURECurrent guidelines state that participants in continuing medical education activities should be aware of any affiliation or financial interethat could affect the speakers presentation(s). The Accreditation Council for Continuing Medical Education policy mandates that the CMprovider adequately manage identified potential conflicts of interest prior to the educational activity. Faculty members have completedisclosure forms and potential conflicts of interest have been reviewed and resolved. All disclosures will be listed in the course syllabus
Enjoy beautiful Los Angeles......
Photo credits: Cover, Keck Medical Center - Jose Aparicio; Los Angeles Beach - Joe Schlabotnik; Disney Concert Hall - Alan Turkus;
Downtown Los Angeles - Jose Aparicio. Used with permission.
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COURSE INFORMATION
Course Date: Saturday, May 12, 2012
Tuition: $50 if registered and paid by noon PST on 5/11/12; $65 if registering or paying on site.Tuition is non-refundable. Pre-registration closes at noon on Friday, May 11, 2012.
Location: Louis B. Mayer Auditorium, Keith Administration Building, USC Health Sciences Campus,1975 Zonal Avenue, Los Angeles, California 90033.
Registration, Continental Breakfast and Exhibits: 7:15 a.m. to 8:00 a.m., Louis B. Mayer Auditorium Lobby
Parking and lunch are provided. Parking instructions and a map to the Health Sciences Campus will beemailed to registrants before the course.
Information: For additional information, call 323-442-2555 or 800-USC-1119. FAX application to 888-665-865(toll free). E-mail for CME course information: [email protected] Web site: www.usc.edu/cmeTo register on line, go to http://bit.ly/GSOMXU
Registration confirmation and parking information will be emailed. Please provide email address when registering
Special Needs: Advance notice of any special needs by May 1 will help us serve you better.
COURSE APPLICATIONMultiple Sclerosis: Current Treatment and Future Promise (#2705) May 12, 201
Tuition:$50 if registered and paid by noon PST on 5/11/12; $65 if registering or paying on site.
Please print:
Name:____________________________________________________________________________________________(Last) (First) (Degree: MD, DO, RN, etc.)
Medical License Number:________________________________Email*:_______________________________________
Daytime phone: (_______) ______________________________ Fax: (_________) ______________________________
Mailing address:____________________________________________________________________________________
City:________________________________________ State:________________ Zip + 4:________________________
Specialty:_________________________________________________________________________________________
Please mark one:
Check payable to USC enclosed
I wish to pay by credit card VISA OR MASTERCARD ONLY
Card Number:______________________________________________Expiration Date:___________________________
Am ount: $______________ Au thorized signa ture:______________________________________________________
Please mail to Office of Continuing Medical Education, Keck School of Medicine of USC, 1975 Zonal Avenue, KAM317, Los Angeles, CA 90033-1039. To make course reservations, call 323-442-2555 or 800-USC-1119.Registrations may be faxed to 888-665-8650 (toll free). To register on line, go to http://bit.ly/GSOMXU
Courses are subject to cancellation. Please check with the CME office for course availability if you register within three
weeks of the starting date. USC will not refund travel costs for canceled courses.
* Registration confirmation and parking information will be emailed. Please provide email address when
registering!
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MultipleSclerosis:
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TheJo
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LouisB.
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