Learning Objectives

After viewing this case study, the participant should be able to:

• Discuss considerations for switching DMT therapies
• Review management strategies when switching therapy
   

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Target Audience

This program has been designed to meet the educational needs of neurologists and other physicians specializing in the treatment of MS patients, as well as MS clinical specialist nurses and nurse practitioners practicing in MS comprehensive care centers, free standing MS centers, private and group practices, MS academic and research programs, rehabilitation centers, VA MS COE programs, pediatric MS COE programs, and long-term care facilities.

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Requirements for Successful Completion

To successfully complete this activity for CE credit, the participant will:
1.   Take the pretest
2.   Review the content in the presentation
3.   Complete the posttest with a score of at least 3 correct answers
4.   Fill out a brief evaluation

Upon completion of the requirements 1 – 4, a CE certificate will be available for download.

Release & Expiration Dates
November 18, 2013 until November 18, 2014

Faculty Disclosure Information
It is the policy of the University of North Texas, Health Science Center (UNT HSC) at Fort Worth, Office of Professional and Continuing Education (PACE) and Letters & Sciences to ensure balance, independence, and scientific rigor in all of their educational activities. Any significant financial interest or any other relationship that a presenter or discussant may have with the manufacturer(s) of any commercial product(s) or device(s), financial management organizations or knowledge/research brokerage firms must be disclosed to the participants.

The faculty has disclosed the following:

Bruce A. Cohen, MD
Professor of Neurology
Director, Comprehensive Multiple Sclerosis Program
Department of Neurology
Northwestern University Feinberg School of Medicine
Chicago, IL

Disclosure Information

• Has served as a consultant for Acorda Therapeutics, Astellas Pharma, Biogen Idec, EMD Serono, Genzyme/Sanofi Aventis, Teva Neuroscience
• Has received research support from Biogen Idec, Novartis, Roche
• Holds stock in Abbott Laboratories, CVS-Caremark
• Will be discussing the off-label uses of immune suppressive agents, emerging treatments for MS, and unapproved treatments for PML

David A. Hafler, MD, MSc
Gilbert H. Glaser Professor of Neurology
Professor of Immunobiology
Chair, Department of Neurology Yale School of Medicine
New Haven, CT

Disclosure Information

• Has served as a consultant for Genzyme/Sanofi Aventis, McKinsey & Co., NKT Therapeutics, Novartis Pharmaceuticals, Sage Therapeutics
• Has served as a scientific advisory board member for Allozyne, Inc., Biogen Idec, Teva Neuroscience, Pfizer
• Has served as a speaker for Bayer Yakuhin, Ltd.
• Will be discussing emerging therapies under investigation for MS including alemtuzumab (anti-CD52), rituximab
  (anti-CD 20), antibodies against IL-2 (anti-CD25)

Albert Lo, MD, PhD, CPH
Associate Professor, Departments of Neurology and Community Health
Brown University
Associate Director, Center of Excellence for Regenerative & Restorative Medicine
Providence VA Medical Center
Providence, RI

Disclosure Information

• Has received honorarium from Acorda Therapeutics
• Has received research support from Acorda Therapeutics
• Will not be discussing off-label uses

Aaron Miller, MD
Director, Clinical Affairs
Corinne Goldsmith Dickinson Center for Multiple Sclerosis
Mt. Sinai School of Medicine, New York, NY
Co-Director, Multiple Sclerosis Care Center
Maimonides Medical Center
Brooklyn, NY

Disclosure Information

• Has served as a consultant for Acorda Therapeutics, Biogen Idec, EMD Serono, GlaxoSmithKline, Novartis Pharmaceuticals, Nuron Biotech, Ono Pharmaceutical Co., Sanofi Aventis, Teva Neuroscience
• Has received research support from Acorda Therapeutics, Biogen Idec, Genentech, Genzyme, Novartis Pharmaceuticals, Osmotica, Questcor, Roche, Sanofi Aventis
• Will be discussing off-label uses of amantadine and modafinil for fatigue; gabapentin, pregabelin, and duloxetine for pain

Claire S. Riley, MD
Director, Neurological Institute of New York
Columbia University Multiple Sclerosis & Research Center
New York, NY

Disclosure Information

• Has served as a consultant for Biogen Idec, EMD Serono, Genzyme, Novartis Pharmaceuticals, Teva Neuroscience
• Will be discussing off-label uses of modafinil for fatigue; alternate dosing strategies for glatiramer acetate

Carrie L. Sammarco, DrNP, FNP-C, MSCN
Nurse Practitioner
Comprehensive Multiple Sclerosis Clinical Care Center
NYU Langone Medical Center

Disclosure Information

• Has served as an advisory board member for Biogen Idec, Teva Neuroscience, Berlex Laboratories
• Has served as a consultant for Biogen Idec, EMD Serono, Novartis Pharmaceuticals, Pfizer, Teva Neuroscience
• Will not be discussing off-label uses

Howard L. Weiner, MD
Director, Multiple Sclerosis Program
Center for Neurologic Diseases
Brigham & Women’s Hospital
Boston, MA

Disclosure Information

• Has served as a consultant for Genentech, Gerson Lehrman Group, Inc., Teva Pharmaceuticals
• Has served as a scientific advisory board member for Biogen Idec, EMD Serono, NasVax Ltd.
• Will not be discussing off-label uses

The Planning Committee members have disclosed the following:

David Hafler, MD, MSc

• Has served as a consultant for Genzyme/Sanofi Aventis, McKinsey & Co., NKT Therapeutics, Novartis Pharmaceuticals, Sage Therapeutics
• Has served as a scientific advisory board member for Allozyne, Inc., Biogen Idec, Teva Neuroscience, Pfizer
• Has served as a speaker for Bayer Yakuhin, Ltd.

Jim Lin, BScPhm, MBA
•   Has no relationships to disclose

Carrie L. Sammarco, DrNP, FNP-C, MSCN
•   Has served as an advisory board member for Biogen Idec, Teva Neuroscience, Berlex Laboratories
•   Has served as a consultant for Biogen Idec, EMD Serono, Novatis Pharmaceuticals, Pfizer, Teva Neuroscience
 

Arnold H. Seto, PharmD
•   Has no relationships to disclose
 

In accordance with the policies of Letters & Sciences and the University of North Texas, Health Science Center (UNT HSC) at Fort Worth, Office of Professional and Continuing Education (PACE), and the standards of ACCME and ANCC to identify and resolve any potential conflicts of interest, assure fair balance, independence, and objectivity, and instill scientific rigor in all CME/CNE activities, all presentations and case studies, with any potential for conflicts of interest, have been reviewed by 2 external reviewers. These external reviewers, who have no potential conflicts of interest and nothing to disclose, have determined that no bias exists in the presentations and cases. These external reviewers are:

Michele Nichols, PharmD
Consultant, Private Practice
Raritan, NJ

Allen A. Yudovich, MD
Henry Ford Medical Center
Detroit, MI

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Accreditation

Continuing Medical Education

This program has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the University of North Texas Health Science Center at Fort Worth, Office of Professional and Continuing Education and Letters & Sciences.
 

Accreditation Statements

The University of North Texas Health Science Center at Fort Worth, Office of Professional and Continuing Education is accredited by the ACCME to provide continuing medical education for physicians.

The University of North Texas Health Science Center at Fort Worth, Office of Professional and Continuing Education is accredited by the American Osteopathic Association to award continuing medical education to physicians.
 

Credit Designation

The University of North Texas Health Science Center at Fort Worth, Office of Professional and Continuing Education designates this activity for a maximum of 0.25 AMA PRA Category 1 Credit(s)™.

The University of North Texas Health Science Center has requested that the AOA Council on Continuing Medical Education approve this program for 0.25 hour of AOA Category 1B CME credits. Approval is currently pending.

Physicians should claim only the credit commensurate with the extent of their participation in the activity.
 

Continuing Nursing Education & Credit Designation

Letters & Sciences is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

This activity has been designated for 0.25 contact hour.

To obtain the full number of contact hours, the participant must review the entire activity and complete the evaluation forms.
 

Nonendorsements of Products

The participant is advised that the educational content contained herein was developed by and reflects the opinions of the presenters and discussants, and does not necessarily reflect the opinions or recommendations of the educational providers or the commercial supporter. Accredited status does not imply endorsement by Letters & Sciences or the American Nurses Credentialing Center’s Commission on Accreditation of any commercial product discussed/displayed in conjunction with the educational program.
 

Commercial Support

This program is supported by an unrestricted educational grant from EMD Serono. EMD Serono, Inc. is an affiliate of Merck KGaA, Darmstadt, Germany.