MSL Leaders

Presented by The Johns Hopkins University School of Medicine
Supported through an educational grant from Biogen Idec and Elan
Pharmaceuticals Inc.

Program Overview
Multiple sclerosis (MS) is treated in a variety of clinical practice settings ranging from tertiary MS centers that specialize in managing MS patients to community-based neurologist’s offices. In the absence of clinical guidelines and with identified, critical gaps in available data, the approach to the management of the MS patient also varies widely, particularly amongst community-based neurologists. The goal of the initiative, A Multisite Think Tank on the Challenges of Multiple Sclerosis, is to explore the complex challenges facing community neurologists managing MS and other demyelinating disorders. During a series of live meetings held across the country in September 2007, expert neurologist faculty used a case-based, structured approach to guide attendees in an in-depth review of actual practice trends. This initiative examined the following 4 topics of high importance to community neurologists:

Clinically Isolated Syndrome: Evaluation, Risk-Stratification and Treatment Decisions
MS: Therapeutic Frontiers and Progressive Disease
Monitoring Disease Progression: Incorporating MRI and New Modalities in Clinical Decision-Making
Inadequate Responders: Identification and Treatment Modification

At this series of regional meetings, community-based neurologists shared their views of these areas of critical interest. In the recorded webcast Essential MS Insights Web Conferences based on the proceedings from the recent Multisite Think Tank on the Challenges of Multiple Sclerosis, a summary of the findings of the live meetings will be presented to the viewer, with a goal of disseminating the information gathered and further stimulating discussion of these important topics.

Topics to be discussed include the following:

Clinically Isolated Syndrome: Evaluation, Risk-Stratification and Treatment Decisions
MS: Therapeutic Frontiers and Progressive Disease
Monitoring Disease Progression: Incorporating MRI and New Modalities in Clinical Decision-Making
Inadequate Responders: Identification and Treatment Modification

Program Format
CME-certified professional education program; 1-hour online program
Estimated time to complete this educational activity: 1 hour

Intended Audience
This activity has been designed for neurologists and other healthcare professionals managing patients with multiple sclerosis (MS).
There are no prerequisites

Release and Expiration Dates
Release: February 15, 2008
Expiration: DECEMBER 31, 2008

Accreditation Statement
The Johns Hopkins University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Credit Designation Statement
The Johns Hopkins University School of Medicine designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit ™.

Responsibility Statement
The Johns Hopkins University School of Medicine takes responsibility for the content, quality and scientific integrity of this CME activity.

Learning objectives
At the conclusion of this activity, participants should be able to:

Outline the diagnostic steps in the diagnosis of clinically isolated syndrome, including analysis of spinal fluid, recording evoked potentials, and MRI findings
Describe the role of MRI monitoring as part of assessing disease progression, including analysis of clinical responses to incidental findings suggesting incipient MS in an asymptomatic patient
Outline the issues regarding available MS therapies including the goals of reducing disability progression and relapse rates, effect on MRI measures, and effects on cognitive dysfunction
Discuss the indications to switch or combine therapies in patients with progressing MS
Discuss how clinical research on the role of the immune system in the pathogenesis of MS may lead to the development of novel immunotherapies

Evaluation/ Post-test
Participants must document the amount of time spent and must receive a grade of 70% or above to receive a CME certificate. Certificates will be sent in 6-8 weeks.

Privacy Statement
The Office of Continuing Medical Education (CME) at the Johns Hopkins University School of Medicine is committed to protecting the privacy of its members and customers. The Johns Hopkins University School of Medicine CME maintains its Internet site as an information resource and service for physicians, other health professionals and the public. Continuing Medical Education at the Johns Hopkins University School of Medicine will keep your personal and credit information confidential when you participate in a CME Internet-based program. Your information will never be given to anyone outside of the Johns Hopkins University School of Medicine's CME program. Continuing Medical Education collects only the information necessary to provide you with the services that you request.

Faculty
Benjamin Greenberg, MD, MHS (Program chair)
Assistant Professor
Johns Hopkins School of Medicine
Department of Neurology
Co-Director Johns Hopkins Transverse Myelitis Center

Dr. Benjamin Greenberg received his master's degree in microbiology from The Johns Hopkins School of Public Health in Baltimore and his medical degree from Baylor College of Medicine in Houston. He then completed an internship in medicine at Rush Presbyterian-St. Luke's Medical Center in Chicago and subsequently returned to Johns Hopkins to complete his residency in neurology. He then completed a post-doctoral fellowship in Molecular Microbiology with Dr. Diane Griffin at the Johns Hopkins Bloomberg School of Public Health.

Now an Assistant Professor of Neurology, Dr. Greenberg focuses on multiple sclerosis, transverse myelitis and infections of the central nervous system. He is actively involved in the evaluation and care of inpatients with infections of the nervous system while devoting his outpatient clinic to the care of patients with various immune mediated diseases of the central nervous system. His research examines the interaction between the nervous system and viruses, and strives to determine the causes of encephalitis, transverse myelitis and multiple sclerosis.

Faculty Disclosures
Full Disclosure Policy Affecting CME Activities
As a provider accredited by the Accreditation Council for Continuing Medical Education (ACCME), it is the policy of the Johns Hopkins University School of Medicine to require the disclosure of the existence of any significant financial interest or any other relationship a faculty member or a provider has with the manufacturer(s) of any commercial product(s) discussed in an educational presentation. The presenting faculty reported the following:

Dr. Benjamin Greenberg (Chair) Type of financial relationship:
Grants: Accelerated Cure Project, Genentech, National MS Society, Novartis
Honorarium: Biogen Idec, TEVA Neurosciences
Consulting: Genelogic, Accorda Therapeutics

Dr. Mary Jo DiMilia (Healthology) has no relevant conflict of interest to disclose.

Off-Label Discussion
No faculty member has indicated that their presentation will include information on off-label products.

Disclaimer
The opinions and recommendations expressed by faculty and other experts, whose input is included in this program are their own. This enduring material is produced for educational purposes only. Use of the Johns Hopkins University School of Medicine name implies review of educational format design and approach. Please review the complete prescribing information of specific drugs or combination of drugs, including indications, contraindications, warnings and adverse effects before administering pharmacologic therapy to patients.