Networks in Neurology: New Agents and Strategies for Multiple Sclerosis (Credit Expired)


Multiple sclerosis (MS) is the leading cause of non-traumatic disability in adults over the age of 50 and has become a prominent focus of evolving research. In just the past two decades, a greater understanding of the pathogenesis of MS has led to a litany of new FDA approved therapies. In fact, there are now 18 disease modifying therapies (DMTs) representing nine therapeutic classes approved for use in the US with multiple late-stage medications poised to join them. This activity features an in-depth interview with renowned MS specialist, Dr Robert Naismith, regarding the reasoning behind and potential clinical role of several recently approved and rising DMTs for patients with MS. Dr Naismith, as well as 4 other MS experts, were also surveyed regarding their own views on these agents and their utility in clinical practice. These results are reviewed throughout the program to help guide discussion and provide real-world context to each new development in MS.

Target Audience

This activity is intended for neurologists and advanced practice professionals involved in the care of patients with MS.

Learning Objectives

  1. Appraise the mechanistic diversity amongst and biologic rationale for the development of recently approved and late-stage investigational DMTs to inform current and future treatment planning for patients with various presentations of MS.
  2. Compare the relative safety and efficacy of available and investigational S1P-receptor modulators to determine the appropriate roles of these agents in MS clinical practice.
  3. Review the mechanism of action and outcomes data supporting the FDA approval of diroximel fumarate to determine how, if at all, this agent should be incorporated into existing patient management.
  4. Identify the similarities and differences between available and investigational anti-CD20 antibodies in MS to assess their current and/or potential roles in patient management.
  5. Review the unique mechanism of action of and outcomes data with cladribine to identify appropriate candidates for its use.
  6. Evaluate published research with and ongoing Phase 3 evaluation of rising BTK inhibitors to discern the potential future role of these agents in the long-term care of patients with MS.
Course summary
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   Robert Naismith, MD (Chair)
   Professor, Neurology
   Director, John L. Trotter Multiple Sclerosis Center
   Director, Multiple Sclerosis Clinical Trials Program
   Washington University School of Medicine
   St. Louis, Missouri

   Adnan Subei, DO (Moderator)

   Medical Director, Multiple Sclerosis Program
   Memorial Healthcare System
   Neuroscience Institute
   Hollywood, Florida


Surveyed Experts:

   Riley Bove, MD
   Assistant Professor of Neurology
   Director of Digital Innovation, UCSF MS and Neuroinflammation Center
   UCSF Weill Institute for Neurosciences
   San Francisco, CA

   Carrie Hersh, DO, MSc, FAAN
   Assistant Professor of Neurology
   Director, Multiple Sclerosis Health & Wellness Program
   Cleveland Clinic Mellen Program for Multiple Sclerosis
   Lou Ruvo Center for Brain Health
   Las Vegas, NV

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

   Darin Okuda, MD
   Professor of Neurology
   Director, Neuroinnovation Program
   Director, Multiple Sclerosis & Neuroimmunology Imaging Program
   UT Southwestern Medical Center
   Dallas, TX



Credit for this program has expired. The accreditation information below is based on the activity release date.

This activity is jointly provided by Postgraduate Institute for Medicine and Efficient LLC. 

Accreditation Statement

In support of improving patient care, this activity has been planned and implemented by the Postgraduate Institute for Medicine (PIM) and Efficient LLC. Postgraduate Institute for Medicine 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

PIM designates this enduring material for a maximum of 1.75 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Conflict of Interest Disclosure Policy


PIM requires instructors, planners, managers, and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest (COI) they may have as related to the content of this activity. All identified COI are thoroughly vetted and resolved according to PIM policy. PIM is committed to providing its learners with high quality activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest.

Planners' and Managers' Disclosure

PIM planners and managers have nothing to disclose. Efficient LLC planners and managers have nothing to disclose.

Faculty Disclosures

Dr Naismith reports the following financial relationships:

  • Consulting Fees (e.g. advisory boards): Biogen, Celgene, Genentech, Genzyme, Lundbeck, NervGen, Third Rock Ventures, Viela Bio.

Dr Subei has no relevant financial relationships to report.

Dr Longbrake reports the following financial relationships:

  • Consulting Fees: Genentech

Dr Okuda reports the following financial relationships:

  • Consulting Fees: Celgene, EMD Serono, Viela Bio
  • Contracted Research: Biogen

Dr Hersh reports the following financial relatipnships:

  • Consulting Fees: Novartis, Biogen, EMD-Serono, Genzyme, Genentech, Bristol-Myers Squibb
  • Fees for Non-CME/CE Services: Novartis, Biogen, EMD-Serono, Genzyme, Genentech, Bristol-Myers Squibb

Dr Bove reports the following financial relationships:

  • Consulting Fees: Alexion, Biogen, Sanofi Genzyme, Roche Genentech, Novartis
  • Contracted Research: Biogen, Roche Genentech

Disclosure of Unlabeled Use

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.


Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. 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 and/or dangers in use, review of any applicable manufacturer's product information, and comparison with recommendations of other authorities.

Commercial Support

This activity is supported by educational grants from Biogen, Bristol-Myers Squibb, EMD Serono, and Sanofi.


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