Calibrating COVID-19: The Interplay of Disease Modifying Therapy and Vaccination in Patients with Multiple Sclerosis
The emergence of COVID-19 has created an unprecedented medical emergency that both raises new questions and presents updated information each day. This issue is even more pressing for patients with conditions such as multiple sclerosis (MS) who have altered immune systems from both chronic illness and disease modifying therapies (DMTs). While the advent of vaccines has revived hope for a return to normal life, vaccination is not always straightforward for those on or planning to start immunosuppressive therapies such as MS DMT. In this activity, Drs. Claire Riley and Robert Bermel discuss guidance outlined by the National Multiple Sclerosis Society (NMSS) and approaches to implementing these considerations in routine practice.
The target audience for this CME initiative includes general neurologists, neurodegenerative disease specialists, and advanced practice professionals involved involved in the diagnosis and long-term management of patients with MS.
- Review historical data on the interaction of DMT with multiple vaccine types in order to assess the applicability of these observations to the COVID-19 pandemic.
- Identify how receipt of a COVID-19 vaccination may influence the initiation of MS DMT to determine whether the start and/or dosing of each agent requires adjustment.
- Examine how distinct mechanisms of active MS DMT may influence the ability to receive a COVID-19 vaccine, and determine whether any agents require a washout period prior to its administration.
Robert Bermel, MD
Director and Staff Neurologist,
Mellen Center for Multiple Sclerosis
Dr. Robert Bermel is a Staff Neurologist in the Neurological Institute's Mellen Center for MS at Cleveland Clinic. He received a medical degree with thesis honors from the State University of New York at Buffalo, where his interest in MS began while training under Dr. Lawrence Jacobs. Dr. Bermel completed a neurology residency and served as Chief Resident at Cleveland Clinic. There he was also funded as a NMSS postdoctoral fellow in clinical neuroimmunology and advanced imaging. He is widely recognized for his contributions to neurological research, particularly in MS and imaging techniques. He is also actively involved at the forefront of pharmacological and technological advancement in MS and has been a frequent presenter of such advances at national and international meetings.
Claire Riley, MD
Medical Director, Multiple Sclerosis Center
Karen L. K. Miller Assistant Professor of Neurology
New York, New York
Dr. Claire Riley is an Assistant Professor of Neurology and Medical Director of the MS Center at Columbia University. She earned her medical degree from Columbia University College of Physicians and Surgeons followed by an internship in internal medicine and residency in neurology at Columbia University Irving Medical Center. In addition, she completed a clinical fellowship in the Columbia University MS Center in 2010. Dr. Riley is board certified in neurology by the American Board of Psychiatry and Neurology and plays an active role as an investigator in multiple MS clinical trials.
Adnan Subei, DO - Moderator
Multiple Sclerosis Program
Memorial Healthcare System Neuroscience Institute
Dr Adnan Subei is a board-certified neurologist and medical director for the MS program at Memorial Healthcare System Neuroscience Institute. He earned his doctorate in osteopathic medicine at Lake Erie College of Osteopathic Medicine followed by a neuro-visual disorders (clinical neuro-ophthalmology) fellowship, internship, and neurology residency all at Michigan State University. Dr Subei completed an additional fellowship in neuro-immunology with emphasis on neuro-ophthalmology at the Cleveland Clinic Mellen Center for MS Treatment and Research. Has been awarded multiple fellowship grants from the American Academy of Neurology and the National MS Society (NMSS) and continues an active interest in research.
This activity is jointly provided by Postgraduate Institute for Medicine and Efficient LLC.
In support of improving patient care, this activity has been planned and implemented by the Postgraduate Institute for Medicine (PIM) and Efficient LLC. PIM 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.
PIM designates this enduring material for a maximum of 0.50 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Disclosure of Conflict of Interest
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.
Dr. Bermel reported the following financial relationships:
- Patent holder: Multiple Sclerosis Performance Test
- Consulting fees: Biogen, EMD Serono, Genentech/Roche, Genzyme/Sanofi, Novartis, Viela Bio
- Contracted research: Biogen, Genentech/Roche, Novartis
Dr. Riley reported the following financial relationships:
- Consulting Fees: Bristol-Myers Squibb, Genentech
Dr. Subei reported no relevant financial relationships.
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.
This activity is supported by educational grants from Bristol-Myers Squibb, Genentech, and Sanofi.
- 0.50 AMA PRA Category 1 Credit™