Reshaping the Paradigm: Implications of Recent Clinical Advances in the Diagnosis and Treatment of Neuromyelitis Optica Spectrum Disorder (NMOSD) -- An ACTRIMS-ECTRIMS Virtual Satellite
This activity is intended for neurologists, nurse practitioners, physician assistants, pharmacists, and other providers involved in the care of patients with NMOSD.
• Describe the role of anti-AQP4 antibodies in the pathogenesis of NMOSD and develop appropriate testing algorithms to assess individuals suspected of harboring it.
• Recognize the updated diagnostic criteria for NMOSD and utilize this information to assist in making an accurate and timely diagnosis for individuals with seropositive or seronegative presentations of the disease.
• Describe the biologic rationale for, differential mechanisms of action of and Phase 3 research data evaluating recently approved agents designed for relapse prevention to determine their current and/or potential clinical utility.
The program is divided into three case-based learning modules. Each case is designed to illuminate 2-3 key issues which is used to create an integrative didactic. Each faculty member leads his own case designed to capture the following major themes:
Module 1: New Insights into the Pathophysiology of NMOSD – Dr. Weinshenker
- Role of AQP4-IgG in triggering the complement cascade in NMOSD; resulting inflammation and formation of the membrane attack complex
- Proposed role of the cytokine interleukin-6 (IL-6) in NMOSD-associated inflammation and related long-term disability
- Relative expression of CD19 versus CD20 during B-cell development and on mature plasma cells; rationale for the development of CD19-directed therapies in NMOSD
- Opportunities for targeted drug development based on these and other proposed pathways
Module 2: Updated Diagnostic and Radiologic Criteria for NMOSD – Dr. de Seze
- Updated (2015) international diagnostic criteria for NMOSD in patients with and without AQP4 antibodies
- Atypical clinical features of NMOSD
- Potential mimics of NMO that need to be considered in the differential diagnosis
Module 3: New Agents for the Long-term Management of the Patient with NMOSD – Dr. Greenberg
- Rationale for the use of relapse prevention via maintenance immunosuppressant therapy; clinical and/or biologic factors affecting the application of this strategy
- Design, entry criteria and primary and secondary outcomes from the pivotal Phase 3 trials of eculizumab (PREVENT), inebilizumab (N-Momentum) and satralizumab (SAkuraStar and SAkuraSky)
- Dosing, administration requirements, side effect profiles, patient selection and other practical considerations with the use of eculizumab, inebilizumab and satralizumab
Modules during the symposium were followed by an audience Q&A to address any additional questions related to the activity material. The archived Q&A is included in this enduring program.
Professor of Neurology and Consultant
Benjamin M Greenberg, MD, MHS
Vice Chair of Translational Research and Strategic Initiatives
Professor, Department of Neurology
University of Texas Southwestern Medical Center
Dr Benjamin Greenberg is a Professor and the Cain Denius Scholar in Mobility Disorders in the Department of Neurology and Neurotherapeutics at UT Southwestern Medical Center. He is an internationally recognized expert in treating rare autoimmune disorders of the central nervous system with a specialization in transverse myelitis, NMOSD, and MS. He currently serves as the Vice Chair of Translational Research and Strategic Initiatives for the Department of Neurology and Neurotherapeutics at UT Southwestern and is Director of several programs dedicated to demyelinating diseases in both adults and children. His research efforts have helped to transform biorepository development, and his collaborations have identified multiple novel biomarkers with the potential to advance differentiation of neurologic disorders.
Professor of Neurology
Neuroimmunology Department Head
Strasbourg University Hospital
Commercial Support Acknowledgement
Disclosure of Financial Relationships
- Consultant: Alexion, Chugai, Roche, Mitsubishi Tanabe, VielaBio
- Royalties/Inventions: Hospices Civil de Lyon, MVZ Labor PD Dr. Volkmann und Kollegen GbR, Oxford University, RSR Ltd.
Dr. Greenberg discloses the following:
- Grant support: CLENE Nanomedicine, The Guthy Jackson Charitable Foundation, NIH, NMSS, PCORI, SRNA
- Consultant: Abcam, Alexion, Axon Advisors, EMD Serono, Greenwich Bio, Novartis, Roche, Rubin Anders, Viela Bio
- Board Member (unpaid): Seigel Rare Neuroimmune Association
Dr de Seze discloses the following:
- Board Honorarium: Alexion, Biogen, Cellgen, Novartis, Roche, Sanofi Genzyme
Disclosure of Unlabeled Use
CMSC and Efficient LLC require faculty to disclose to the attendees when products or procedures being discussed are off-label, unlabeled, experimental, and/or investigational (not FDA approved); and any limitations on the information that is presented, such as data that are preliminary or that represent ongoing research, interim analyses, and/or unsupported opinion. Faculty in this activity may discuss information about pharmaceutical agents that is outside of US Food and Drug Administration approved labeling. This information is intended solely for continuing education and is not intended to promote off-label use of these medications. If you have questions, contact the medical affairs department of the manufacturer for the most recent prescribing information.
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- 1.00 AAPA Category I CME
- 1.00 ACPE Pharmacy
- 1.00 AMA PRA Category 1 Credit™
- 1.00 ANCC
- 1.00 Attendance