Joseph P. Van Der Meulen Symposium in Clinical Neuroscience
Multiple Sclerosis:
Current Treatments
and Future Promise
Saturday, May 12, 2012
Louis B. Mayer Auditorium
USC Health Sciences Campus
Los Angeles, California
presented by
Office of Continuing Medical Education
and the Department of Neurology
JOSEPH P. VAN DER MEULEN, M.D.
The annual Joseph P. Van Der Meulen Symposium in Clinical Neuroscience honors Dr. Van Der Meulen, former Chairman of the Department of Neurology at the University of Southern California, for his contributions to the development of clinical and basic neuroscience. Dr. Van Der Meulen continues at USC as Professor of Neurology and Vice President for Health Affairs, Emeritus.
Dr. Van Der Meulen was born in Boston, Massachusetts and educated at the Public Latin School and Boston College before receiving his M.D. from Boston University. He completed an internal medicine internship at Bellevue Hospital (Cornell Service) in New York and received his neurology training at the Harvard Neurological Unit of the Boston City Hospital under Dr. Derek Denny-Brown. He subsequently spent two years at the Karolinska Institute studying neurophysiology with Professor Ragnar Granit, a Nobel Laureate. After serving on the faculty at Harvard and Case-W estern Reserve, Dr. Van Der Meulen joined the Department of Neurology at USC in 1971, serving as Chairman until 1979. He served as Vice President for Health Affairs (1977-2005), and Director of the Independent Health Professions (1991-2005).
During his tenure as Chairman of Neurology, he restructured the department and initiated the development of neuroscience. He served as Dean of the School of Medicine in 1985 and 1986 and as Interim Dean from 1995-1997. In addition to his organizational and administrative contributions, he has continued to teach and practice clinical neurology. His continuing activities on behalf of the medical community, the USC family, and the development of clinical and basic neurosciences make him a leader in education, health care, and research in the United States.
NEEDS ASSESSMENT AND COURSE DESCRIPTION
Multiple Sclerosis (MS) is a com plex neurological disease that has been diagnosed in approxim ately 400,000 individuals in the United States, with worldwide estim ates of 1.2 m illion, and rising. It is the m ost com m on cause of nontraum atic disability in young adults and is typically diagnosed between the ages of 20-40 although diagnoses at younger and older ages are not uncom m on. Econom ic costs of this disease are estim ated at $10 billion annually. Although the cause of MS is unknown, it is believed that an autoim m une attack on m yelin in the central nervous system is triggered by environm ental factors in genetically susceptible individuals. Clinically, MS can take one of several form s, from a relatively m ild relapsing-rem itting form , to rapidly1 progressive disease. Sym ptom s, disease course, and treatm ent response are variable and at this point largely unpredictable, presenting challenges to recognition and m anagem ent. Research in the area of biom arkers is beginning to shed light on som e of these areas. Multiple clinical trials have shown that early diagnosis and treatm ent of MS can delay disability. To this end,2 3 the diagnostic criteria have been m odified to incorporate MRI data which facilitate accurate diagnosis as early as possible. New4 insights into epidem iology, genetics, pathogenesis and treatm ent have been em erging at a rapid pace. New state-of-the art MRI techniques have facilitated earlier diagnosis and have contributed to a better understanding of inflam m atory and neurodegenerative characteristics of the disease. Genetic, epidem iologic and im m unologic studies have provided new5 inform ation about risk factors for developing MS, susceptibility to different form s of MS, and m ay also assist in predicting response to currently approved disease m odifying drugs.6,7,8,9 New research efforts have provided inform ation about the role of race and ethnicity in disease presentation and activity, and have revealed special characteristics of MS in children.10,11 MS is unique am ong m any neurological diseases in that m any disease m odifying drugs are available that are capable of controlling inflam m ation and delaying neurodegenerative disease progression. Prom ising new disease m odifying drugs are currently being tested in clinical trials which have resulted in FDA applications, and several new strategies to prom ote neural repair and12 regeneration are being explored, including those that use or target stem cells. Given the rapid pace of discovery and the13 changing arm am entarium for treatm ent it is essential for neurologists and other caretakers to be well inform ed in order to translate these advances to best clinical practice.
References
Courtney AM, et al. Multiple Sclerosis. Med Clin North Am. 2009;93(2):451-476.
1
Hecker M, Paap BK, Goertsches RH, Kandulski O, Fatum C, et al. (2011) Reassessment of Blood Gene Expression Markers for the Prognosis of Relapsing-Remitting
2
Multiple Sclerosis. PLoS ONE 6(12): e29648. doi:10.1371/journal.pone.0029648. e.g. Champions Study Group. Neurology. 2006;66:678-684.
3
Polman CH, et al. Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol. 2011;69(2):292-302.
4
Ali EN, Buckle GJ. Neuroimaging in multiple sclerosis. Neurol Clin. 2009;27(1):203-219.
5
International Multiple Sclerosis Genetics Consortium & the Wellcome Trust Case Control Consortium. Genetic risk and a primary role for cell-mediated immune mechanisms
6
in multiple sclerosis. Nature. 2011;476: 214-219.
Edwards L, et al. Central Inflammation versus peripheral regulation in Multiple Sclerosis. J Neurol. 2011; 258(8):1518-27.
7
Axtell R, Chander R, Steinman l. (2012) Clinic Rev Allerg Immunol DOI 10.1007/s12016-011-8296-5.
8
Freedman et al. Recognizing and treating suboptimally controlled multiple sclerosis: steps toward regaining command. Curr Med Res Opin. 2009;25(10):2459-2470.
9
Yeh EA, et al. Pediatric multiple sclerosis. Nat Rev Neurol. 2009;5(11):621-631.
10
Chitnis T, et al. Pediatric Multiple Sclerosis, Neurol Clin. 2011;29:481–505.
11
Stuve O, et al. Translational research in neurology and neuroscience 2010.Arch Neurol. 2010;67(11):1307-1315.
12
Uccelli A, et al. Mesenchymal stem cells for the treatment of multiple sclerosis and other neurological diseases. Lancet Neurology. 2011;10(7):649-656.
13
This course will address current therapy after outlining essentials of pathophysiology and diagnosis. M anagem ent issues such as treatm ent choice and assessm ent of efficacy will be outlined. Prom ising future treatm ents for both prevention of new lesion and restoration of existing dam aged tissue will be presented.
COURSE OBJECTIVES
At the conclusion of this program , the participant should be able to:
• Im plem ent the m ost current diagnostic criteria in order to facilitate early recognition of MS • Explain current concepts in the pathophysiology and how this relates to treatm ent of MS • Evaluate the com plex genetics of MS and what they tell us about MS pathogenesis
• Cite and assess current and future treatm ent m odalities, including risk profiles and m echanism s of action • Evaluate the contributions of epidem iology and ethnicity in MS m anagem ent
• Apply MRI data in the diagnosis and prognosis of the individual patient • Assess treatm ent efficacy
• Define the status of neuroregenerative m edicine in MS
SCHEDULE
7:15 a.m . Registration and Continental Breakfast
8:00 a.m . W elcom e and Introductory Rem arks
Margaret Burnett, MD and Leslie P. W einer, MD
8:15 a.m . M ultiple Sclerosis Overview / Pathophysiology
Lawrence Steinman, MD
9:15 a.m . M RI in Diagnosis and Prognosis Nancy L. Sicotte, MD
10:15 a.m . Break
10:30 a.m . Epidem iology of M ultiple Sclerosis Annette M. Langer-Gould, MD, PhD, MS
11:15 a.m . Ethnic Influences in M ultiple Sclerosis Lilyana Amezcua, MD
12:00 noon Panel Discussion
Drs. Amezcua, Langer-Gould, Sicotte, and Steinman
12:15 p.m . Lunch
1:15 p.m . The Com plex Genetics of M ultiple Sclerosis Speaker to be determined
2:15 p.m . Current Therapies for M ultiple Sclerosis and Possible Algorithm s for Their Use Regina Berkovich, MD, PhD
2:45 p.m . New and Emerging Therapies for M ultiple Sclerosis
Margaret Burnett, MD
3:15 p.m . Break
3:30 p.m . Pediatric M ultiple Sclerosis: W hat It Tells Us about M ultiple Sclerosis and How M anagem ent Differs From the Adult Patient
Em manuelle L. W aubant, MD, PhD
4:15 p.m . Neuroprotection, Neuroregeneration and Stem Cells
Leslie P. W einer, MD
5:00 p.m . Panel Discussion
Drs. Berkovich, Burnett, W aubant, and W einer
5:15 p.m . Adjourn
Desirable Physician Attributes: In alignment with the CME mission of the Keck School of Medicine, programs are planned in the context of desirable physician attributes as designated by the ACGME/ABMS and the Institute of Medicine: 1) Patient Care and Patient Centered Care, 2) Medical Knowledge, 3) Practice-based Learning, 4) Interpersonal and Communication Skills, 5) Professionalism, 6) Systems-based Practice, 7) Work in Interdisciplinary Teams, 8) Apply Quality Improvement, 9) Utilize Informatics, and 10) Employ Evidence-based practice. This program and the objectives have been developed in the context of attributes 1, 2, 3, 5, and 10.
CME CREDIT
The Keck School of Medicine of the University of Southern California is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing m edical education for physicians.
The Keck School of Medicine of the University of Southern California designates this live activity for a m axim um of 7.5 AMA
PRA Category 1 Credits™ . Physicians should claim only the credit com m ensurate with the extent of their participation in the
activity.
The California State Board of Registered Nursing accepts courses approved for AMA PRA Category 1 Credits™ as m eeting the continuing education requirem ents for license renewal.
ACKNOWLEDGMENT
W e gratefully acknowledge an educational grant in support of the program from
COURSE FACULTY
COURSE DIRECTOR
Keck School of Medicine of USC
Margaret Burnett, MD
Assistant Professor of Neurology and Neuropathology Director, LAC+USC Multiple Sclerosis Clinic
GUEST FACULTY
Annette M. Langer-Gould, MD, PhD, MS
Research Scientist, Neurology
Department of Research and Evaluation Kaiser Permanente Southern California Associate Clinical Professor of Neurology Keck School of Medicine of USC
Nancy L. Sicotte, MD
Director, Multiple Sclerosis Program Department of Neurology
Cedars-Sinai Medical Center Associate Professor of Neurology
David Geffen School of Medicine at UCLA Los Angeles, California
Lawrence Steinman, MD
George A. Zimmerman Professor of Neurological Sciences, Neurology, Genetics and Pediatrics Stanford University School of Medicine
Stanford, California
Emmanuelle L. Waubant, MD, PhD
Associate Professor of Neurology University of California, San Francisco, School of Medicine
San Francisco, California
FACULTY AT THE KECK SCHOOL OF MEDICINE University of Southern California
Lilyana Amezcua, MD
Assistant Professor of Neurology
Division Co-chief, MS Comprehensive Care Center
Regina Berkovich, MD, PhD
Assistant Professor of Neurology
Leslie P. Weiner, MD
Professor of Neurology, Molecular Microbiology and Immunology
Richard Angus Grant, Sr., Chair in Neurology Leslie P. W einer Chair in Neurology
FACULTY DISCLOSURE
Current guidelines state that participants in continuing medical education activities should be aware of any affiliation or financial interest that could affect the speaker’s presentation(s). The Accreditation Council for Continuing Medical Education policy mandates that the CME provider adequately manage identified potential conflicts of interest prior to the educational activity. Faculty members have completed disclosure forms and potential conflicts of interest have been reviewed and resolved. All disclosures will be listed in the course syllabus.
Enjoy beautiful Los Angeles...
Photo credits: Cover, Keck Medical Center - Jose Aparicio; Los Angeles Beach - Joe Schlabotnik; Disney Concert Hall - Alan Turkus; Downtown Los Angeles - Jose Aparicio. Used with permission.
COURSE INFORMATION
Course Date: Saturday, May 12, 2012
Tuition: $50 if registered and paid by noon PST on 5/11/12; $65 if registering or paying on site.
Tuition is non-refundable. Pre-registration closes at noon on Friday, May 11, 2012.
Location:
Louis B. Mayer Auditorium
, Keith Administration Building, USC Health Sciences Campus,
1975 Zonal Avenue, Los Angeles, California 90033.
Registration, Continental Breakfast and Exhibits: 7:15 a.m. to 8:00 a.m.
, Louis B. Mayer Auditorium Lobby
Parking and lunch
are provided. Parking instructions and a map to the Health Sciences Campus will be
emailed to registrants before the course.
Information:
For additional information, call 323-442-2555 or 800-USC-1119. FAX application to 888-665-8650
(toll free). E-mail for CME course information: usccme@usc.edu Web site: www.usc.edu/cme
To register on line, go to http://bit.ly/GSOMXU
Registration confirm ation and parking inform ation will be em ailed. Please provide em ail address when registering!
Special Needs:
Advance notice of any special needs by May 1 will help us serve you better.
COURSE APPLICATION
Multiple Sclerosis: Current Treatment and Future Promise (#2705)
May 12, 2012
Tuition:
$50 if registered and paid by noon PST on 5/11/12; $65 if registering or paying on site.
Please print:
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(Last) (First) (Degree: MD, DO, RN, etc.)
Medical License Num ber:________________________________Em ail*:________________________________________ Daytim e phone: (_______) ______________________________ Fax: (_________) _______________________________ Mailing address:_____________________________________________________________________________________ City:________________________________________ State:________________ Zip + 4:_________________________ Specialty:__________________________________________________________________________________________ Please m ark one:
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Please mail to Office of Continuing Medical Education, Keck School of Medicine of USC, 1975 Zonal Avenue, KAM 317, Los Angeles, CA 90033-1039. To make course reservations, call 323-442-2555 or 800-USC-1119.
Registrations may be faxed to 888-665-8650 (toll free). To register on line, go to http://bit.ly/GSOMXU
Courses are subject to cancellation. Please check with the CM E office for course availability if you register within three weeks of the starting date. USC w ill not refund travel costs for canceled courses.
* Registration confirm ation and parking inform ation will be emailed. Please provide em ail address when registering!
O ff ice of C ont inui ng M edi cal Educat io n K e c k S c ho ol of M e d ic ine of US C U n iv er si ty of Sout h e rn C a li for ni a 1975 Zonal Av enue, KAM 317 Los Ange les, C a li fo rn ia 90 033-1039 No n-P rof it O rga niz atio n U. S. P ostag e PA ID Un iv ersit y of Sou ther n C alif orn ia