6-8 July Vancouver, Canada

Transcription

1 FINAL PROGRAMME Preceptorship on Advances in Multiple Sclerosis (MS) and Neuro-Myelitis Optica (NMO) 6-8 July Vancouver, Canada

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3 General information Venue This live educational course takes place at the: Vancouver, Canada Language The official language of this live educational course is English. Scientific secretariat EXCEMED - Excellence in Medical Education Salita di San Nicola da Tolentino, 1/b Rome, Italy Programme and Relations Manager, Neurology and Oncology: Serena Dell Ariccia T: F: info@excemed.org Specialist Medical Advisor: Doriana Landi EXCEMED is a Swiss Foundation with headquarters in 14, Rue du Rhône, 1204 Geneva, Switzerland Organising secretariat Meridiano Congress International Via Sapri, Rome, Italy Congress Manager: Concetta Di Palma T F concetta.dipalma@meridiano.it follow us on EXCEMED_Neuro 1

4 Preceptorship on Advances in Multiple Sclerosis (MS) and Neuro-Myelitis Optica (NMO) EXCEMED live educational course: Preceptorship on Advances in Multiple Sclerosis (MS) and Neuro-Myelitis Optica (NMO) 6-8 July Vancouver, Canada Aim The emerging basic science and clinical breakthroughs in MS and NMO are transforming patient care. Clinicians caring for this patient population need a strong understanding of latest treatments, diagnostic criteria and other exciting developments. This live educational course offers a comprehensive review of MS and NMO diagnosis, treatment and science with lectures by world renowned experts. Learning objectives By attending this live educational course participants will be able to: Acquire an advanced understanding of progressive MS and opportunities for repair Apply and manage a comprehensive approach to clinical decision making with the complex range of MS therapies Select and apply the new diagnostic criteria for NMO and treatment approaches for the management of Neuromyelitis Optica (NMO) and Neuromyelitis Optica Spectrum Disorder (NMOSD) Target audience Clinicians and scientists currently involved in MS and/or NMO management. Accreditation This event is an Accredited Group Learning Activity eligible for up to 17.5 Section 1 credits as defined by the Maintenance of Certification program of the Royal College of Physicians and Surgeons of Canada. This program has been reviewed and approved by UBC Division of Continuing Professional Development. Each physician should claim only those credits he/she actually spent in the activity. EXCEMED adheres to the principles of the Good CME Practice Group (gcmep) 2

5 Scientific organisers Robert Carruthers Division of Neurology Department of Medicine Anthony Traboulsee Division of Neurology Department of Medicine EXCEMED designed this programme in partnership with the MS and NMO Center of the (UBC), Vancouver, Canada Share your opinion with us We are always looking for ways to bring our educational activities to the next level and meet your needs as a healthcare practitioner. You will be asked to answer a real-time survey during this event, followed by a post-event online survey to find out if the experience met your educational expectations. Your views also help us tailor future initiatives. Thank you for taking the time to participate. 3

6 Faculty members Jason Barton Departments of Medicine (Neurology), Ophthalmology and Visual Sciences, Psychology Nancy Bogle Research Nurse Multiple Sclerosis Clinical Trials Group Department of Medicine Robert Carruthers Division of Neurology Department of Medicine Stacy Elliott Sexual Medicine Departments of Psychiatry and Urologic Sciences Mark S. Freedman Multiple Sclerosis Research Unit The Ottawa Hospital Ottawa, Canada Kelly Grant B.E. Kelly Grant CRA West Vancouver, Canada Lesley Houle Sexual Health Clinician GF Strong Rehab Centre & Blusson Spinal Cord Centre Shannon Kolind Division of Neurology Department of Medicine Tanja Kuhlmann Institute of Neuropathology University Hospital Münster Münster, Germany David Li Department of Radiology Department of Medicine Katrina McMullen Division of Neurology Department of Medicine Ana- Luiza Sayao Division of Neurology Department of Medicine Anthony Traboulsee Division of Neurology Department of Medicine Carles Vilariño-Güell Department of Medical Genetics Faculty of Medicine Dean M. Wingerchuk Multiple Sclerosis Center Department of Neurology Mayo Clinic Scottsdale, USA Ann Yeh Division of Neurology The Hospital for Sick Children Toronto, ON, Canada V. Wee Yong Hotchkiss Brain Institute and Departments of Clinical Neurosciences and Oncology University of Calgary Calgary, Canada 4

7 Scientific programme

8 Scientific programme Monday, 6 July 2015 Day 1 MS Basics Chairpersons: Robert Carruthers and Anthony Traboulsee (Canada) Breakfast EXCEMED Opening Introduction welcome to UBC Hospital MS/NMO Centre and introduction to Day 1 Anthony Traboulsee (Canada) Real-time survey KNS1: Pathology of progression and repair Tanja Kuhlmann (Germany) L1: Genetics of MS Carles Vilariño-Güell (Canada) Visit of Djavad Mowafaghian Centre for Brain Health premises End of the first day Working dinner at Djavad Mowfaghian Centre for Brain Health - 3 rd Floor, A-B & C Coffee break KNS2: Stem cells in MS Mark S. Freedman (Canada) KNS3: Applied immunology V. Wee Yong (Canada) Working lunch MRI Snapshots / Case studies S1: Establishing an early diagnosis Robert Carruthers and David Li (Canada) CS1: MRI Diagnostic Red Flags Anthony Traboulsee (Canada) S2: Advanced MRI Shannon Kolind (Canada) Discussion Legend: L : Lecture; KNS : Key Note Speech; S : Snapshot CS : Case Studies PD : Panel Discussion 6

9 Tuesday, 7 July 2015 Day 2 MS Clinical Practice Chairpersons: Robert Carruthers and Anthony Traboulsee (Canada) Breakfast Introduction to Day 2 Robert Carruthers (Canada) CS2: Therapeutic decision making in MS Ana-Luiza Sayao (Canada) PD1: Panel discussion on: Shared decision making - A patient s perspective Nancy Bogle and Robert Carruthers (Canada) S7: High efficacy infusion based therapies in MS Nancy Bogle and Anthony Traboulsee (Canada) S8: How to set up and run a clinical trial unit Kelly Grant and Anthony Traboulsee (Canada) S9: Pregnancy in MS Ana-Luiza Sayao (Canada) End of the second day Coffee break L2: PML Diagnosis, Risk Stratification and Management Robert Carruthers and David Li (Canada) MRI in clinical practice S3: Standardized protocol David Li (Canada) S4: Routine monitoring of MS Anthony Traboulsee (Canada) S5: Brain atrophy monitoring David Li (Canada) Discussion Working lunch Group picture S6: Sexual health in MS Stacy Elliott and Lesley Houle (Canada) L3: Neuro-opthalmology: what neurologists need to know about the eyes Jason Barton (Canada) 7

10 Wednesday, 8 July 2015 Day 3 NMO Update Chairpersons: Robert Carruthers and Anthony Traboulsee (Canada) Breakfast Introduction to Day 3 Anthony Traboulsee (Canada) KNS4: NMO update & 2015 Diagnostic Criteria Dean M. Wingerchuk (United States) KNS5: Bridging MS and NMO: lessons from pediatric Acute Demyelinating Syndromes Ann Yeh (Canada) Coffee break L4: Acute management of NMO relapses Anthony Traboulsee (Canada) L5: NMO Preventative therapy Robert Carruthers (Canada) S10: International collaborations in NMO Katrina McMullen (Canada) Course wrap-up Anthony Traboulsee (Canada) Revisiting real-time survey End of the live educational course Closing lunch 8

11 Faculty Disclosure Statement In accordance with the Committee on Accreditation of Continuing Medical Education (CACME) Standards for Commercial Support, all faculty participation in these programmes are expected to disclose to the programme audiences any real or apparent conflict of interest related to the content of their preparation. Name Nancy Bogle Robert Carruthers Stacy Elliott Kelly Grant Lesley Houle Shannon Kolind Affiliations, financial or otherwise, with a commercial organization that may have a direct or indirect connection to the content of my presentation. Nothing to disclose. Declared to be/have been part of Roche, Genzyme, Novartis and Teva clinical trials in the last two years, declared the ownership of Dr. R. Carruthers Neurology Inc. and declared his wife performed a phase 1 trial with Genentech. Declared to be member of Abbott s and Lilly s advisory board and Speakers bureau. Declared the receipt of grant from PPDI and the receipt of a Research Organization contract as Clinical Research Associate from Quintiles. Nothing to disclose. Declared the receipt of honoraria, consultation fees and research grants from Roche and Genzyme. Tanja Kuhlmann Declared to be member of Genzyme Neuroprotection in MS Advisory Board Meeting in June Declared the receipt of honoraria and consultation fees from Novartis, Biogen Idec Canada. She declared the receipts of Grants from the German Research Foundation and the Hetie Foundation. David Li Ana- Luiza Sayao Anthony Traboulsee Carles Vilariño-Güell Ann Yeh Declared to be member of Opexa, Novartis, Nuron, Roche advisory board, declared the receipt of research grants from Genzyme, Roche and Merck Serono. He declared to be/have been part of Nuron, Perceptive and Sanofi clinical trials in the last two years. He declared the receipt of honoraria and consultation fees from Vertex Pharmaceuticals. Declared to be member of Roche, Teva, Merck Serono, Biogen, Novartis and Genzyme Advisory board and Speakers bureau. She declared to have taken part of an MS clinic s clinical trial and declared the receipt of honoraria from Roche, Teva, Merck Serono, Biogen, Novartis and Genzyme. Declared to be member of Roche Clinical Trial Steering Committee, to be member of Sanofi and Genzyme speakers bureau. He declared to be/have been part of Roche, Biogen, Genzyme clinical trials in the last two years. Declared the receipt of honoraria from Teva Innovation, EMD Serono, Sanofi and Genzyme. He declared to be involved in the design of clinical studies concerning the use of products manufactured Roche and Genzyme and he declared to have relationships with the following government agencies, regulatory bodies, and not for profit agencies: Canadian Institute for Health Research, MS Society of Canada. Declared the receipt of research grants from Novartis Pharmaceuticals. Nothing to disclose. V. Wee Yong Declared to be member of Teva Neuroscience Speakers bureau and the receipt of honoraria and consultation fees from Teva, Biogen Idec, Genzyme and EMD Serono. The following faculty have provided no information regarding significant relationship with commercial supporters and/or as of 26 June Jason Barton Mark S. Freedman Katrina McMullen Dean M. Wingerchuk 9

12 Biographies

13 Jason Barton Departments of Medicine (Neurology), Ophthalmology and Visual Sciences, Psychology Jason Barton obtained his MD from the in 1984, where he completed a neurology residency in He was a fellow in neuro-ophthalmology at the University of Iowa from 1990 to 1991 and the University of Toronto from 1991 to 1995, and obtained his PhD from the University of Toronto in He was assistant and then associate professor of neurology at Harvard Medical School, and director of neuro-ophthalmology at the Beth Israel Deaconess Medical Center from 1996 to Since 2004 he has been director of clinical neuro-ophthalmology at Vancouver General Hospital. He is currently professor, Canada Research Chair and Marianne Koerner Chair in Brain Diseases, in neurology, ophthalmology and visual sciences at the University of British Columbia. His research is focused on cortical processing of vision, in particular high-level object perception, such as face and word recognition, and also on the use of saccadic eye movements to explore issues of cognitive control. He has published 2 books, 51 chapters, and 167 research articles. He received the Francis McNaughton Award from the Canadian Neurological Sciences Federation, the Young Investigator Award from the North American Neuro-ophthalmology Society, the Norman Geschwind Award in Behavioural Neurology from the American Academy of Neurology, and the 2009 Distinguished Achievement Award for Overall Excellence from the UBC faculty of medicine. In general, though, he would rather be out cycling. Nancy Bogle Research Nurse Multiple Sclerosis Clinical Trials Group, Department of Medicine, Nancy Bogle is a graduate of the BSN Nursing program at UBC following years of study of a BA at Acadia University in Wolfville, Nova Scotia. Aside from a short stint to explore Community Health work and Pediatric Neurology, the balance of her career has been in the area of MS. Nancy first came to the UBC Clinic in 1995 and was involved in the initiation of the Special Therapies Program for the first approved disease modifying therapies in MS. In late 1996, Nancy moved over to the area of MS Research at the UBC Clinic and has remained there since with the occasional day in the UBC MS Clinic. Nancy is a published author of a paper on Psychological Determinants as a factor to Coping with MS, a co author on an article for Nursing specialization in MS for the International MS Order of Nurses and a previous presenter at a plenary session of The Canadian Neurological Nurses Association, 1999 and a poster presentation of the MS Consortium in Nancy considers the ability to work with persons and their families with MS a privilege. 11

14 Biographies Robert Carruthers Division of Neurology, Department of Medicine Robert Carruthers joined UBC Staff in August He graduated from Tulane School of Medicine in 2008 and then completed his internship at Massachusetts General Hospital and residency at Brigham and Women s Hospital and Massachusetts General Hospital. His two year Multiple Sclerosis Fellowship at Brigham and Women s Hospital was funded by a grant from the National Multiple Sclerosis Society and included an equal mix of research and clinical training. His interests include clinical trial work and optimizing clinical care in Multiple Sclerosis, Neuromyelitis Optica and other neuro-immunologic disorders. Stacy Elliott Sexual Medicine Departments of Psychiatry and Urologic Sciences, Stacy Elliott is a Sexual Medicine Physician whose interests lie in the sexual and reproductive consequences of medical or surgical problems, particularly neurological disability. She is a Clinical Professor in the Departments of Psychiatry and Urologic Sciences, and PI and Faculty member at International Collaboration of Repair Discoveries (ICORD),. She is the Medical Manager of the BC Center for Sexual Medicine, Co-Director for the Vancouver Sperm Retrieval Clinic, sexual medicine consultant to the Men s Health Initiative, the Prostate Cancer Supportive Care program at the Prostate Center, and the GF Strong Sexual Rehabilitation Service in Vancouver B.C. She is the current Past Chair of the Canadian Male Sexual Health Council, and an invited member to the prestigious International Consensus of Sexual Medicine slated for June She participates on several national and international academic committees and advisory boards. She teaches at the UBC Medical School for undergraduates and post-graduates, is active in CME of her colleagues, and is the author of many peer-reviewed journal articles and book chapters. Dr. Elliott is an internationally recognized expert in sexual rehabilitation and fertility following spinal cord injury, and in 2012, received the QE II Jubilee medal for her work. 12

15 Mark S. Freedman Multiple Sclerosis Research Unit The Ottawa Hospital Ottawa, Canada Mark S. Freedman is currently professor of medicine in the field of neurology at the University of Ottawa, as well as director of the Multiple Sclerosis Research Unit at the Ottawa Hospital, General Campus and a Senior Scientist at the Ottawa Hospital Research Institute. A graduate of the University of Toronto, Dr. Freedman holds his Masters Degree in Molecular Neurochemistry and continued his postgraduate work specializing in neurology and neuroimmunology. His specialized training took him to the Weizmann Institute of Science, Israel; The National Hospital, Queen Square, London UK, as well as the Montreal Neurological Institute, where he subsequently was an Assistant Professor. He holds his specialist certification in Quebec CSPQ and all of Canada FRCP(C) and is a Fellow of both the American Neurological Association (FANA) and the American Academy of Neurology (FAAN). Dr. Freedman has published over 250 pieces, including articles, books, book chapters and abstracts and has been invited to give hundreds of lectures and presentations nationally and internationally. His extensive research includes the area of molecular neurochemistry, cellular immunology, neuroimmunology and clinical studies in MS. He is currently holding peer reviewed and industry related funding for translational research investigating immune mechanisms of damage in multiple sclerosis, with particular interest in the role of gamma-delta T-cells. He is also the lead investigator in the Canadian Bone Marrow Transplant Study in MS and co-chair of the International Mesenchymal Stem Cell Transplantation Study Group. Dr. Freedman has over 25 years of experience in the management of patients with multiple sclerosis and has been the principal investigator on numerous clinical trials with new therapeutic agents for MS. He has experience from serving on several research study steering committees as well as data safety monitoring boards. He serves on the editorial boards for several journals including the Multiple Sclerosis Journal. He has also served on several national and international committees and is currently the Treasurer of the Americas Committee for Treatment and Research in MS (ACTRIMS). Kelly Grant B.E. Kelly Grant CRA West Vancouver, Canada Kelly Grant, RN, BA, CCRA, after completing nursing school at UBC and obtaining a BA Psych, Kelly also completed post-graduate course work in neurosciences, research design and statistics. Kelly has worked many years as a study nurse/coordinator, a national clinical trial coordinator, and as a monitor/cra since She became an independent consultant CRA in 1997 and obtained ACRP (Association of Clinical Research Professionals) CCRA certification. She has worked for the pharmaceutical industry, for CROs and for government-funded trials in many areas. Her greatest interest remains with neurology clinical trials. 13

16 Biographies Lesley Houle Sexual Health Clinician GF Strong Rehab Centre & Blusson Spinal Cord Centre Lesley Houle graduated from the Kwantlen College Nursing Program in She has been nursing for 20 years and has spent a majority of time working with people with disabilities and chronic illness in rehabilitation. Lesley currently is a Sexual Health Clinician at GF Strong Rehab Centre and the Blusson Spinal Cord Centre providing sexual health education, teaching, and support to clients, their families and health care professionals as it relates to illness and disability. Shannon Kolind Division of Neurology, Department of Medicine Shannon Kolind completed her graduate studies in Physics at the under the supervision of Dr. Alex MacKay, developing quantitative MRI techniques specific to myelin content. She then took up a Postdoctoral Fellowship from the MS Society of Canada at the University of Oxford with Drs. Sean Deoni and Heidi Johansen-Berg. There she further developed myelinspecific imaging, as well as other advanced MRI techniques, and applied them to the study of several clinical applications. In the Department of Neuroimaging at the Institute of Psychiatry, King s College London, she was able broaden the range of clinical applications for these techniques. She then returned to the to take up a Michael Smith Foundation for Health Research Postdoctoral Fellowship, changing departments (from Physics to Medicine (Neurology)) to work directly with the director of the UBC MS Clinic and Research Centre, Dr. Anthony Traboulsee. There she has focused on the application of advanced MRI techniques including myelin water imaging in clinical trials for diseases such as MS. 14

17 Tanja Kuhlmann Institute of Neuropathology University Hospital Münster Münster, Germany Tanja Kuhlmann studied medicine at the University of Göttingen, Germany where she received her medical degree in She specialized in neuropathology and worked as medical resident and research fellow in different neuropathological departments in Germany and as a post-doc at McGill, Canada in the research groups of Dr. Jack Antel and Dr. Alan Peterson. In 2008, she became senior consultant and associate professor for neuropathology at the University Hospital Münster, Germany. Her key research interests are mechanisms leading to oligodendroglial and axonal pathology in multiple sclerosis lesions. She has published several publications in well known international journals on the topic of MS pathology, especially on oligodendroglial loss and remyelination. David Li Department of Radiology Department of Medicine Professor of Radiology and Associate Member in Neurology at the (UBC) and Director of the UBC MS/MRI Research Group. He was formerly Head of Radiology at the UBC Hospital and Interim Head, Department of Radiology,. After obtaining his medical degree and radiology residency at UBC, which included additional training in nuclear medicine at Harvard Medical School and body CT at University of California (San Francisco), he did postgraduate studies in MRI at the Royal Postgraduate Medical School (London). His primary research interest is the application of MR techniques in the study of patients with multiple sclerosis. 15

18 Biographies Katrina McMullen Division of Neurology Department of Medicine Katrina McMullen completed her PhD in clinical neuroscience at Kings College London before moving to Vancouver to undertake a postdoctoral fellowship under Dr Traboulsee and Dr Kolind at UBC. Her research focuses on understanding the cognitive and psychological symptoms in MS and NMO and how they relate to changes in neurobiology observed using structural and functional imaging. She is currently the manager of the NMO Clinic and Research Program at UBC, working with Dr Traboulsee and Dr Carruthers to develop a program of research investigating the causes and treatment of NMO. Ana- Luiza Sayao Division of Neurology Department of Medicine Ana-Luiza Sayao, BSc, MD, FRCPC, is currently a Neurologist at St. Paul s Hospital and the Multiple Sclerosis Clinic. She completed her residency training at UBC and Royal College board certification in Neurology in Highlights of her residency include an elective in Oxford England, where she studied history of Multiple Sclerosis, and wining the Ludmila and Henry Zeldowicz award for Neurology Resident Research in MS. She then completed a Fellowship in Multiple Sclerosis at UBC in 2010 with a research focus on clinical epidemiology and evaluating patients with Benign MS, specifically assessing cognitive, psychosocial, quality of life and MRI changes in this unique group of MS patients. After a few years of general Neurology and MS practice, she completed a mini-fellowship in Electroencephalography in 2014 and just successfully passed the Canadian EEG certification exam. She is actively involved in education of Neurology residents on communication skills, Multiple Sclerosis and general aspects of Clinical Neurology. She is the adult Neurology Lead in the BC Pediatric Transition Care Project where she and colleagues are creating transition care plans for young persons with neurological disorders including Multiple Sclerosis and other Neuro-inflammatory conditions. She is currently an Assistant Clinical Professor at UBC. 16

19 Anthony Traboulsee Division of Neurology, Department of Medicine Anthony Traboulsee is an Associate Professor and Research Chair of the MS Society of Canada at the in Vancouver, Canada. He is the Director of the MS/NMO Clinic and Clinical Trials Research Group at UBC Hospital. His research focus is on clinical trial design, the development of practice guidelines for the use of MRI in the management of MS, establishing advanced MRI imaging outcomes in Multiple Sclerosis, and the treatment of Neuromyelitis Optica. Carles Vilariño-Güell Department of Medical Genetics Faculty of Medicine, Vilariño-Güell is an expert molecular geneticist who has dedicated his career to the identification and understanding of genetic components of human diseases. His focus has been on the identification of mutations leading to familial forms of neurological disease, the analysis of complex epidemiological data in ethnically distinct populations, and to identify susceptibility variants acting as early precursors of disease development. In his relatively short career, he has published over 70 articles in many prestigious journals including New England Journal of Medicine, Nature Genetics, and American Journal of Human Genetics resulting in an h- index of 18 and over a thousand citations (Web of Science, September 4, 2014). Highlights include the identification of DCTN1 mutations for Perry syndrome, MEIS1 for restless legs syndrome, VPS35 and EIF4G1 for Parkinson disease, DNAJC13 mutations for Parkinson disease and essential tremor, and more recently NR1H3 for progressive multiple sclerosis. By the end of 2012 Dr. Vilariño- Güell obtained a Canada Research Chair award and started an independent research program at the. The main goal of this research program is to molecularly define the etiology of multiple sclerosis and to develop knowledge-based approaches to improve diagnostic accuracy and the generation of novel therapeutics aimed at treating the underlying molecular causes of disease. These goals are in line with Dr. Vilariño-Güell s experience, research approaches and successful achievements in other complex multifactorial neurological diseases. This goal will be achieved by identifying pathogenic mutations leading to multiple sclerosis in multi-incident families, a program already funded by the Canadian Institutes of Health Research; and the identification of risk alleles and genetic modifiers of disease course, a yet to be completed pilot has been funded by Novartis Pharmaceuticals Canada. The identification of functionally relevant genetic determinants in multiple sclerosis will define the molecular etiology of disease, provide an immediate means for accurate risk evaluation and early disease diagnosis, reveal novel targets and biomarkers for therapeutic intervention trials, highlight direct avenues for the creation of etiologic in vitro, ex vivo and in vivo models, and provide the rationale for high throughput assays to identify novel therapeutics to better treat this common disease. 17

20 Biographies Dean M. Wingerchuk Multiple Sclerosis Center Department of Neurology Mayo Clinic Scottsdale, USA Dean M. Wingerchuk, MD, MSc, FRCP(C) is Professor of Neurology at Mayo Clinic in Scottsdale, Arizona. He also serves as Chair of the Mayo Clinic Division of Multiple Sclerosis and Autoimmune Neurology. He obtained his medical degree at the University of Saskatchewan, Saskatoon, Canada, and completed a neurology residency at Mayo Clinic in Rochester, MN. He completed successive fellowship programs in clinical neuroimmunology at the Mayo Clinic and at the University of Western Ontario, London, Canada. He also completed a Master degree program in Clinical Epidemiology and Health Research Methodology at McMaster University in Hamilton, Canada. Dr. Wingerchuk s clinical and research interests focus on multiple sclerosis, neuromyelitis optica, and related disorders. He is currently the principal investigator for two therapeutic studies for neuromyelitis optica. Dr. Wingerchuk also codirects the Mayo Clinic s MERIT Center, a multidisciplinary evidence-based clinical practice educational and research program and is co-editor-in-chief of The Neurologist. Ann Yeh Division of Neurology The Hospital for Sick Children Toronto, ON, Canada Ann Yeh is a graduate of Harvard University, received an MA from McGill University (Montreal, Canada), and her MD at McMaster University (Hamilton, ON). She completed pediatrics training at McMaster University and pediatric neurology training at SUNY Buffalo, where she developed and co-directed the Pediatric MS and Demyelinating Disorders Center of Excellence. She is currently an Associate Professor of Pediatrics (Neurology) at the Hospital for Sick Children, University of Toronto, Canada, where she is the director of the MS and Demyelinating Disorders Clinic. She is the director of the pediatric neurology training program at the University of Toronto. Her research interests are in visual and neuro-cognitive outcomes in pediatric demyelinating conditions, rehabilitative interventions for this population, as well as therapies for pediatric MS. 18

21 V. Wee Yong Hotchkiss Brain Institute and Departments of Clinical Neurosciences and Oncology University of Calgary, Calgary, Canada V. Wee Yong is a Professor at the Hotchkiss Brain Institute and the Departments of Clinical Neurosciences and Oncology at The University of Calgary. He holds the Canada Research Chair in Neuroimmunology. Dr. Yong co-directs the Multiple Sclerosis (MS) NeuroTeam of the Hotchkiss Brain Institute, providing the basic science leadership, and he directs the Alberta endms Training Network. Dr. Yong received his Ph.D. from the, Vancouver, and started his faculty appointment at the Montreal Neurological Institute, McGill University, in He located to Calgary in Dr. Yong s research interests lie in the area of neuroimmunology, neuroprotection and CNS regeneration, and his projects have been guided by MS, spinal cord injury and malignant gliomas. Dr. Yong has published 240 peer-reviewed manuscripts and his research has been translated into clinical trials in MS and spinal cord injury. His work has been cited over 13,000 times by other authors in scientific publications. Dr. Yong is the immediate past chair of the Medical Advisory Committee of the MS Society of Canada; this and other volunteer activities resulted in Dr. Yong receiving the Queen s Golden Jubilee Year Medallion. Dr. Yong is on the editorial board of 7 international journals. He is the current President of the International Society of Neuroimmunology. Dr. Yong is an elected fellow of both the Canadian Academy of Health Sciences (2010) and the Royal Society of Canada (2014), which represent top honors for those working in the medical and academic sciences, respectively. 19

22 Learning objectives

23 KNS1. Pathology of progression and repair Tanja Kuhlmann Institute of Neuropathology, University Hospital Münster, Münster, Germany 1. Permanent disability in MS is a consequence of axonal loss 2. The CNS has an innate capacity to remyelinate 3. Progression in MS occurs when there is a loss of repair and excelarated neuronal loss KNS2. Stem cells in MS Mark S. Freedman Multiple Sclerosis Research Unit, The Ottawa Hospital, Ottawa, Canada 1. To learn about potential sources of stem cells for clinical use in transplantation 2. To become familiar with current attempts in utilizing stem cells for treatment in MS 3. To be able to differentiate between stem cell transplantation and bone marrow transplantation used for MS treatment KNS3. Applied Immunology V. Wee Yong Hotchkiss Brain Institute and Departments of Clinical Neurosciences and Oncology University of Calgary, Calgary, Canada 1. Loss of regulatory function in MS involves both B and T cells 2. MS therapies are targeted at specific immunological pathways 3. Contrast the immunology of progressive MS and relapsing MS 21

24 Learning objectives MRI Snapshots / Case Studies S1. Establishing an early diagnosis Robert Carruthers Division of Neurology, Department of Medicine, David Li Department of Radiology, Department of Medicine, 1. Understand the role of MRI in helping to diagnose MS in patients with CIS 2. Understand the importance and value of an earlier diagnosis of MS 3. To be familiar with and be able to use the 2010 McDonald criteria for the diagnosis of MS CS1. MRI Diagnostic Red Flags Anthony Traboulsee Division of Neurology, Department of Medicine, 1. Brain MRI is highly sensitive for detecting any pathology but relatively non specific 2. Spinal cord MRI can aid in the differential diagnosis of challenging cases 2. Contrast enhancement can distinguish MS from some rare mimics S2. Advanced MRI Shannon Kolind Division of Neurology, Department of Medicine, 1. Gain an overview of novel and advanced MRI techniques 2. Understand the relative sensitivity and specificity of these MRI techniques to various biological and pathological features 3. Consider the use of MRI beyond anatomical assessment in clinical trials for neurological disease therapies 22

25 L1. Genetics of MS Carles Vilariño-Güell Department of Medical Genetics, Faculty of Medicine, 1. Genetic contribution to MS 2. Risk alleles and pathogenic variants implicated in MS 3. Application of genetic discoveries Visit of Djavad Mowafaghian Centre for Brain Health premises 1. Introduction to Djavad Mowafaghian Centre for Brain Health and multi-disciplinary approach to MS Clinic 2. Tour of MS Clinic, Infusion Suite and Research Labs to show benefit of integrated neuroscience, integrating patient care and cutting-edge research 3. Show through integration aim is to speed up delivery of promising treatments and offer best care to patients CS2. Therapeutic decision making in MS Ana-Luiza Sayao Division of Neurology, Department of Medicine, 1. To provide a current overview of Multiple Sclerosis (MS) 2. To review the course and management issues of a representative patient with RRMS 3. To review the therapeutic landscape in MS, including both current and emergent treatments 23

26 Learning objectives PD1. Panel Discussion on: Shared decision making - A patient s perspective Nancy Bogle Research Nurse, Multiple Sclerosis Clinical Trials Group, Department of Medicine, Robert Carruthers Division of Neurology, Department of Medicine, 1. Identifying patient and care giver therapeutic goals. 2. Compare and contrast paternalism to shared decision making in MS therapeutics 3. How to balance risk versus benefit when discussing therapeutic options L2. PML Diagnosis, Risk Stratification and Management Robert Carruthers Division of Neurology, Department of Medicine, David Li Department of Radiology, Department of Medicine, 1. Describe how risk factors for PML have changed in recent decades 2. Describe the approach to diagnosing PML recommended by the AAN Neuro Infectious Disease Section 3. Discuss the treatment approach for PML and PML/IRIS 24

27 MRI in Clinical Practice S3. Standardized Protocol David Li Department of Radiology, Department of Medicine, 1. To understand the need for a standardized MRI examination 2. To learn the details of a standardized MRI examination 3. To learn and apply the MRI guidelines for the use of a standardized MRI examination in the diagnosis and follow-up of patients with MS S4. Routine Monitoring of MS Anthony Traboulsee Division of Neurology, Department of Medicine, 1. Routine brain MRI can detect clinically silent disease activity 2. Detecting ongoing MRI activity can be helpful in therapeutic management S5. Brain Atrophy Monitoring David Li Department of Radiology, Department of Medicine, 1. To be updated on the importance of brain atrophy and monitoring of brain atrophy in patients with MS 2. To be introduced to methodological considerations for quantitative brain volume measurements 3. To become familiar with factors that affect changes in brain volume 25

28 Learning objectives S6. Sexual health in MS Stacy Elliott Sexual Medicine, Departments of Psychiatry and Urologic Sciences, Lesley Houle Sexual Health Clinician, GF Strong Rehab Centre & Blusson Spinal Cord Centre 1. Describe the most common sexual problems seen in these populations 2. Utilize the Sexual Health Framework to categorize multidisciplinary assistance 3. Summarize current therapies available to manage sexual dysfunctions 4. Demonstrate the approach to sexual health questioning for clinicians L3. Neuro-ophthalmology What neurologists need to know about the eyes Jason Barton Departments of Medicine (Neurology), Ophthalmology and Visual Sciences, Psychology, 1. Review the various ways multiple sclerosis and NMO affected the afferent visual pathway 2. Review the ocular motor manifestations of multiple sclerosis and their diagnosis S7. High efficacy infusion based therapies in MS Nancy Bogle Research Nurse, Multiple Sclerosis Clinical Trials Group, Department of Medicine, Anthony Traboulsee Division of Neurology, Department of Medicine, 1. High efficacy options for relapsing MS 2. Clinical indications for escalating therapy 3. Managing an infusion program 26

29 S8. How to set up and run a clinical trial unit Kelly Grant B.E. Kelly Grant, CRA West Vancouver, Canada Anthony Traboulsee Division of Neurology, Department of Medicine, 1. Basic makeup of a clinical trial team 2. Monitor's view from the trenches 3. Basic regulatory considerations S9. Pregnancy in MS Ana-Luiza Sayao Division of Neurology, Department of Medicine, 1. To review pregnancy related issues in patients with multiple sclerosis 2. To review multiple sclerosis medication safety in pregnancy KNS4. NMO update & 2015 Diagnostic Criteria Dean M. Wingerchuk Multiple Sclerosis Center, Department of Neurology, Mayo Clinic Scottsdale, USA 1. NMO is an astrocytopathy Diagnostic Criteria 27

30 Learning objectives KNS5. Bridging MS and NMO: lessons from pediatric Acute Demyelinating Syndromes Ann Yeh Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada 1. Risk of MS and NMO after pediatric ADS 2. Treatment of pediatric ADS, MS, NMO L4. Acute management of NMO relapses Anthony Traboulsee Division of Neurology, Department of Medicine, 1. Identify role of oral versus high dose steroids for NMO relapse 2. Criteria for escalation to apheresis (plasma exchange) 3. Discuss controversies around chemotherapy induction L5. NMO Preventative therapy Robert Carruthers Division of Neurology, Department of Medicine, 1. Understand existing data underlying commonly used therapies in NMO and its limitations 2. Become familiar with mechanisms of action of compounds being evaluated in clinical trials for patients with Neuromyelitis optica 28

31 S10. International Collaborations in NMO Katrina McMullen Division of Neurology, Department of Medicine, 1. NMO is a global disease 2. Collaborative international research is required to find the cause and cure (CIRCLES) 29

32 NOTES

33 NOTES

34 All EXCEMED programmes are organized solely to promote the exchange and dissemination of scientific and medical information. No forms of promotional activities are permitted. There may be presentations discussing investigational uses of various products. These views are the responsibility of the named speakers, and do not represent an endorsement or recommendation on the part of EXCEMED. Merck Serono, the biopharmaceutical division of Merck KgaA, Germany.

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36 Improving the patient's life through medical education EXCEMED - Excellence in Medical Education Headquarters 14, Rue du Rhône Geneva, Switzerland Representative Office Salita di San Nicola da Tolentino 1/b Rome, Italy T F Copyright EXCEMED, All rights reserved.