Across the Spectrum: Transforming the Detection and Management of Disease State Transitions Across the Spectrum of Multiple Sclerosis

Program Description

Disease progression within individual disease states is a primary driver of therapeutic changes in multiple sclerosis (MS). Yet, as a disease that evolves and progresses for most patients, MS is increasingly recognized as a disease spectrum with transitional phases. These are not limited to the more familiar challenging concept of conversion from relapsing to secondary progressive disease but also from radiologically isolated syndrome to primary progressive MS.

There are no established cutoffs to define the points at which each type of transition may occur, but MS experts increasingly rely on several tools to help predict risk of progression and identify conversion. Unfortunately, clinicians are unlikely to be utilizing these same assessments. Even once progression and related conversions have been identified, clinicians admittedly lack familiarity with modern disease-modifying therapies (DMTs).

Target Audience

The target audience for this CME initiative includes neurodegenerative disease specialists, general neurologists, advanced practice neurology professionals, registered nurses, and other healthcare professionals involved in the diagnosis and long-term management of patients with MS.

Learning Objectives

Upon completion of the educational activity, participants should be able to:

  • Distinguish the advantages and drawbacks of available assessment tools in evaluating different MS transitions to select the most appropriate and practical metrics for identifying individual patient changes over the course of their disease
  • Appraise available evidence with individual DMTs across relapsing MS presentations to help delineate customizable treatment pathways for individuals experiencing or at risk of disease progression
  • Evaluate current research surrounding treatment of patients with inactive SPMS or PPMS to determine when and for whom DMT switching or discontinuation may be appropriate
Course summary
Available credit: 
  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 Attendance
Course opens: 
Course expires: 

   Erin Longbrake, MD, PhD (Moderator & Chair)
   Assistant Professor of Neurology
   Program Director, Neuroimmunology Fellowship
   Director, Clinical Research in Neuroimmunology
   Yale University
   New Haven, CT


   Robert Bermel, MD
   Director and Staff Neurologist,
   Mellen Center for Multiple Sclerosis
   Cleveland Clinic
   Cleveland, Ohio




   Jacqueline A. Nicholas, MD, MPH
   System Chief, Neuroimmunology & MS
   OhioHealth MS Center
   Columbus, OH


This activity is jointly provided by Medical Education Resources and Efficient LLC.


Accreditation Statement

In support of improving patient care, this activity has been planned and implemented by Medical Education Resources (MER) and Efficient LLC. MER 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.

Designation Statement

Medical Education Resources designates this enduring material for a maximum of 1.00 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
A Certificate of Participation will be given upon completion of the activity enabling participants to register their credit with the appropriate licensing boards or associations.

Disclosure of Relevant Financial Relationships

Medical Education Resources ensures balance, independence, objectivity, and scientific rigor in all our educational activities. In accordance with this policy, MER identifies relevant financial relationships with its instructors, content managers, and other individuals who are in a position to control the content of an activity. Reported relevant financial relationships are mitigated by MER to ensure that all scientific research referred to, reported, or used in an accredited continuing education activity conforms to the generally accepted standards of experimental design, data collection, and analysis. MER is committed to providing learners with high-quality accredited continuing education activities that promote improvements or quality in health care and not the business interest of an ineligible company.

Staff Disclosures

Efficient LLC and Medical Education Resources' planners and managers have no financial relationships to disclose.

Faculty Disclosure

Erin Longbrake, MD, PhD:

  • Consulting Fees: Biogen, Bristol Myers Squibb, EMD Serono, Genentech, Genzyme, Janssen, NGM Bio, TG Therapeutics
  • Grants/Research Support: Biogen, Genentech 

Robert Bermel, MD:

  • Patent holder: Multiple Sclerosis Performance Test
  • Consulting fees: Biogen, EMD Serono, Genentech/Roche, Genzyme/Sanofi, Novartis, Viela Bio
  • Contracted research: Biogen, Genentech/Roche, Novartis

Jacqueline A Nicholas, MD:

  • Consulting Fees: Alexion, Biogen, BMS, EMD Serono, Genentech, Greenwich Biosciences, Novartis, TG Therapeutics
  • Grants/Research Support: Biogen, Genentech, Novartis, University of Buffalo, PCORI
  • Speakers' Bureau: EMD Serono, Janssen

Disclosure of Unlabeled Use/Disclaimer

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications. The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.


The content and views presented in this educational activity are those of the authors and do not necessarily reflect those of Medical Education Resources, Efficient LLC, and/or AbbVie. The authors have disclosed if there is any discussion of published and/or investigational uses of agents that are not indicated by the FDA in their presentations. Before prescribing any medicine, primary references and full prescribing information should be consulted. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities. The information presented in this activity is not meant to serve as a guideline for patient management.

Commercial Support

This continuing education activity is supported by an educational grant from Genentech, a member of the Roche Group.

Method of Participation

There are no fees for participating in and receiving credit for this activity. During the period September 15, 2023 through September 15, 2024, participants must 1) read the learning objectives and faculty disclosures, 2) study the educational activity, 3) complete the posttest by recording the best answer to each question, and 4) complete the evaluation form.



Available Credit

  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 Attendance


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