Dear Participants, Yours sincerely, Silvia Cristofanelli EXCEMED

Transcription

1 EXCEMED Blended Education 2 nd interactive course in MS advanced management Live intervention in Toronto, Canada December 2018

2 Dear Participants, On behalf of EXCEMED, it is our pleasure to welcome you to the live intervention element of your Learning Journey, 2 nd interactive course in MS advanced management. This face-to-face learning experience consists of frontal lectures, discussions, clinical cases and visit to the premises. lectures, discussions, clinical cases and visit to the premises. learning The learning continues after the live intervention. Visit your Learning Journey page after the face-to-face meeting to access the in-depth interactive tutorials. You will access one video contribution by Professor Jiwon Oh and a slide kit by Professor Georgina Arrambide. Complete the entire journey including the assessment surveys and get access to a Diploma signed by the Chairs as well as the final Outcomes & Feedback Report. We look forward to seeing you in person and online! Yours sincerely, Silvia Cristofanelli EXCEMED

3 ONLINE PREPARATORY TUTORIALS November 2018 LIVE INTERVENTION December 2018 ONLINE IN-DEPTH TUTORIALS January nd interactive course in MS advanced management Overview The field of multiple sclerosis (MS) is constantly evolving. Immunological pathways, diagnostic criteria and prognostic markers are updated year by year. In addition, new treatments with innovative mechanisms of action have been recently approved. The design of this course aims to strengthen the knowledge and competence of neurologists in charge of MS patients according to the most recently discoveries in the field. Participants will also benefit from the expertise of internationally renowned speakers and will have the opportunity to discuss clinical cases in an interactive setting. Seminal lectures on hot topics in MS will also be delivered via webinar to extend the learning opportunity to participants from other countries. An EXCEMED Learning Journey The EXCEMED blended education approach reinforces concepts from different angles using diverse formats which strengthen the learning experience. A multistep approach is used, encompassing web- based and live activities. All activities in-person and online involves the full interactivity of learners. At three stages throughout the process, you will be asked to give your feedback on the learning experience through the 3 surveys. The aim of this learner-centered programme is to enhance clinical practice by exploring the ideal outcomes desired by patients, neurologists, and clinicians following MS, with individualized approaches toward attaining these goals. After completing your Learning Journey with EXCEMED, you will receive a Diploma signed by the Chairs and a final Outcomes and Feedback Report. Target audience This programme is designed for neurologists working in the field of multiple sclerosis. Chairs Xavier Montalban Division of Neurology University of Toronto St Michael s Hospital Multiple Sclerosis Centre of Catalonia (Cemcat) Neurology-Neuroimmunology Department Vall d Hebron University Hospital Barcelona, Spain Daniel Selchen Division of Neurology University of Toronto St Michael s Hospital Learning objectives By attending this programme, you will be able to: Illustrate immunological abnormalities in MS Describe how to diagnose and classify MS Explain the main symptomatic and non symptomatic treatment strategies 2 3

4 CME Provider EXCEMED is a non profit foundation dedicated, since the last four decades, to the development of high-quality medical education programmes all over the world. EXCEMED adheres to the guidelines and standards of the European Accreditation Council for Continuing Medical Education (EACCME ) which states that continuing medical education must be balanced, independent, objective and scientifically rigorous. ONLINE PREPARATORY TUTORIALS EXCEMED - Excellence in Medical Education Programme Manager: Silvia Cristofanelli T F silvia.cristofanelli@excemed.org Medical Advisor: Doriana Landi doriana.landi@libero.it EXCEMED adheres to the principles of the Good CME Practice group (gcmep). ONLINE PREPARATORY TUTORIALS November

5 ONLINE PREPARATORY TUTORIALS November 2018 LIVE INTERVENTION December 2018 ONLINE IN-DEPTH TUTORIALS January 2019 ONLINE PREPARATORY TUTORIALS November 2018 VIDEO CONTRIBUTION This online preparatory tutorial is a video contribution by Professor M. Comabella on genetic and non genetic biomarkers in MS and will enable to: Illustrate the genetic variants and alleles associated with heightened risk of developing MS Describe the most important soluble biomarkers in MS and their prognostic value Describe their current use in clinical practice VIDEO LECTURE This video lecture by Professor Hemmer will enable to: Describe the main immunological dysfunction subtending MS Illustrate the differential role of B and T cells Define the role of peripheral and compartmentalised inflammation in disease progression LIVE INTERVENTION LIVE INTERVENTION December

6 ONLINE PREPARATORY TUTORIALS November 2018 LIVE INTERVENTION December 2018 ONLINE IN-DEPTH TUTORIALS January 2019 LIVE INTERVENTION December 2018 The live component of this Learning Journey is a compination of frontal lectures, panel discussions and interactive clinical cases. By attending the live intervention you will be able to: List the key immunological mechanisms subtending MS Discuss the new criteria for MS diagnosis Describe the main features of paediatric MS and related disorders Illustrate how to evaluate treatment efficacy in everyday clinical setting Venue This live intervention takes place at the: Pantages Hotel 200 Victoria St Language The official language of the live intervention is English. FACULTY Jack Antel Department of Neurology and Neurosurgery Montreal Neurological Institute Montreal, Québec, Canada Amit Bar-Or Department of Neurology and Neurosurgery Clinical Research Unit Montreal Neurological Institute McGill University Montreal, Québec, Canada Multiple Sclerosis Division Department of Neurology Perelman School of Medicine University of Pennsylvania Philadelphia, PA, USA Ralph H.B. Benedict Department of Neurology and Psychiatry University at Buffalo Buffalo, NY, USA Aditya Bharatha Department of Medical Imaging Division of Neuroimaging University of Toronto St. Michael s Hospital Tania Bruno Department of Neurology Toronto Rehabilitation Institute Anthony Feinstein Division of Psychiatry University of Toronto Jennifer Gommerman Department of Immunology University of Toronto Marika Hohol Department of Medicine Division of Neurology St. Michael's Hospital Liesly Lee Sunnybrook Health Sciences Centre Department of Medicine Division of Neurology University of Toronto 8 9

7 Xavier Montalban Division of Neurology University of Toronto St Michael s Hospital Multiple Sclerosis Centre of Catalonia (Cemcat) Neurology-Neuroimmunology Department Vall d Hebron University Hospital Barcelona, Spain Jiwon Oh Department of Medicine Division of Neurology St. Michael's Hospital Alexander Prat Department of Immunology, Infectiology and Microbiology Montreal University Montreal, Québec, Canada Dalia Rotstein Department of Medicine Division of Neurology St. Michael's Hospital Gustavo Saposnik Department of Medicine Division of Neurology St. Michael's Hospital Raphael Schneider Department of Laboratory Medicine and Pathobiology University of Toronto St Michael s Hospital Daniel Selchen Division of Neurology University of Toronto St Michael s Hospital Eluen Ann Yeh Department of Paediatrics Division of Neurology University of Toronto The Hospital for Sick Children PROGRAMME Wednesday, 12 December Registrations Welcome and introduction X. Montalban (Canada and Spain), D. Selchen (Canada) Session I L1: Epidemiology and risk factors of MS D. Rotstein (Canada) L2: Immunopathogenesis of MS A. Prat (Canada) L3: Role of B cells in the pathogenesis and treatment of MS J. Gommerman (Canada) Coffee break Session II L4: Diagnostic criteria in MS M. Hohol (Canada) L5: MRI as a diagnostic tool in MS J. Oh (Canada) L6: Cognitive involvement in MS and how to measure it R.H.B. Benedict (USA) Lunch Legend: L : Lecture CC : Clinical cases : Wrap up : Site visit 10 11

8 Thursday, 13 December L7: Novel treatment targets J. Antel (Canada) L8: Progressive MS X. Montalban (Canada and Spain) L9: MS and NMO in children E.A. Yeh (Canada) Session III CC: Clinical cases on MS and differential diagnoses work up A. Bharatha (Canada), L. Lee ( Canada) End of the first day Session IV L10: Update on MS therapy X. Montalban (Canada and Spain) L11: Therapeutic Inertia G. Saposnik (Canada) L12: Measures of treatment response in clinical trials and in real life setting J. Oh (Canada) Coffee break L13: Recent trends in serum and CSF biomarker development R. Schneider (Canada) L14: Risks of treatment suspension and immune-reconstitution dynamic A. Bar-Or (Canada and USA) L15: Comprehensive neurohabilitation approach to MS T. Bruno (Canada) L16: Emotional burden and disturbances in MS A. Feinstein (Canada) Wrap up of the educational course and closing remarks X. Montalban (Canada and Spain) Lunch Visit to Neurorehabilitation center TBD Return to the Hotel and end of the live intervention 12 13

9 FACULTY DISCLOSURES EXCEMED adheres to guidelines of the European Accreditation Council for Continuing Medical Education (EACCME ) and all other professional organizations, as applicable, which state that programmes awarding continuing education credits must be balanced, independent, objective and scientifically rigorous. Investigative and other uses for pharmaceutical agents, medical devices and other products (other than those uses indicated in approved product labelling/package insert for the product) may be presented in the programme (which may reflect clinical experience, the professional literature or other clinical sources known to the presenter). We ask all presenters to provide participants with information about relationships with pharmaceutical or medical equipment companies that may have relevance to their lectures. This policy is not intended to exclude faculty who have relationships with such companies; it is only intended to inform participants of any potential conflicts so that participants may form their own judgements, based on full disclosure of the facts. Further, all opinions and recommendations presented during the programme and all programme-related materials neither imply an endorsement nor a recommendation on the part of EXCEMED. All presentations represent solely the independent views of the presenters/authors. Liesly Lee Xavier Montalban Jiwon Oh Alexander Prat Dalia Rotstein Gustavo Saposnik Daniel Selchen Eluen Ann Yeh The following faculty provided information regarding significant commercial relationships and/or discussions of investigational or non-emea/fda approved (off-label) uses of drugs: Xxx Xxx Xxx Xxx Declared no potential conflict of interest. Declared no potential conflict of interest. The following faculty have provided no information regarding significant relationship with commercial supporters and/or discussion of investigational or non-emea/fda approved (offlabel) uses of drugs as of 00 December Jack Antel Amit Bar-Or Ralph H.B. Benedict Aditya Bharatha Tania Bruno Anthony Feinstein Jennifer Gommerman Marika Hohol 14 15

10 16 BIOGRAPHIES

11 Jack Antel Department of Neurology and Neurosurgery Montreal Neurological Institute Montreal, Québec, Canada Amit Bar-Or Department of Neurology and Neurosurgery Clinical Research Unit, Montreal Neurological Institute McGill University, Montreal, Québec, Canada Multiple Sclerosis Division, Department of Neurology Perelman School of Medicine, University of Pennsylvania Philadelphia, PA, USA Jack Antel is a clinical neurologist who coordinates the multiple sclerosis research and treatment program at the Montreal Neurological Institute. He is a Professor at McGill University where he has served as Chairman of the Department of Neurology and Neurosurgery. Prior to his work at McGill, Dr. Antel was a Professor of Neurology at the University of Chicago. He was the initial director of the Canadian Institute of Health Research supported training program in Neuro-inflammation. From he was the National Scientific Director of the endms Research and Training Network supported by the MS Society of Canada. Dr. Antel served as Chairman of the Medical Advisory Board of the Multiple Sclerosis Society of Canada from January From 2004 to 2006 he served as President of the International Society of Neuroimmunology. He is currently the president of ACTRIMS (American Committee for Research and Treatment of Multiple Sclerosis). He serves as the Editor for the Americas of the Multiple Sclerosis Journal. His research interests include understanding the mechanisms of tissue injury and repair that account for the characteristic disease course of multiple sclerosis and how these can be therapeutically targeted. He has published more than 400 articles in scientific journals. Dr. Antel was the recipient of the 2005 Dystel Award from the National Multiple Sclerosis Society and the American Academy of Neurology. Amit Bar-Or is a neurologist and neuroimmunologist, Professor of Neuroimmunology and Associate Director Translational Research, at the Montreal Neurological Institute, McGill University, where he also serves as Director of the Experimental Therapeutics Program which integrates mode of action studies of novel therapies, with studies of human disease mechanism. Prof. Bar-Or s clinical focus is in the area of multiple sclerosis and related CNS inflammatory disorders, and he currently serves as President of the Canadian Consortium of MS Clinics (CNMSC). His lab examines basic principles of immune regulation and immune-neural interaction in the context of CNS inflammation, injury and repair. Immune system studies include elucidation of effector and regulatory properties of distinct immune cell (principally B cell, myeloid cell and T cell) subsets, their interactions and how these may contribute to inflammatory neurological diseases such as multiple sclerosis, in both children and adults. Studies of immune-neural interaction consider both relapsing and progressive disease biology, including mechanisms by which neural cells respond to, as well as contribute to, CNS inflammation and degeneration. An overarching theme is translation of basic lab discoveries towards understanding and development of novel experimental therapies. This includes human in vivo biological proof-of-principle studies of therapeutic mode-of-action and immune reconstitution, development and application of biological assays to monitor disease activity and evaluate response to treatments and the development of clinically meaningful biomarkers for patients with autoimmune and neurological disease supported

12 Ralph H.B. Benedict Department of Neurology and Psychiatry University at Buffalo Buffalo, NY, USA Aditya Bharatha Department of Medical Imaging, Division of Neuroimaging University of Toronto, St. Michael s Hospital Ralph H.B. Benedict, Ph.D., is a professor of neurology and psychiatry at the University at Buffalo (UB), State University of New York (SUNY). He is director of the clinical neuropsychology program at UB, and provides neuropsychological services for the Jacobs Multiple Sclerosis Center. Dr. Benedict received his psychology degree from the Ohio State University and his PhD in clinical psychology from the Arizona State University. He completed his residency and fellowship training at the Johns Hopkins School of Medicine. In Buffalo, he initiated research in the areas of vascular dementia, cognitive neuroscience and memory test development before commencing a program of work in MS Neuropsychology. More recently his research efforts have been devoted to structural MRI and implementing neuropsychological tests to better define MS disease activity. Dr. Benedict has received grant support from NIH, National MS Society and industry. He is President of the International MS Cognition Society and has chaired or served on task forces for the American Academy of Neurology, NINDS, Consortium of MS Centers, and the National MS Society. His CV lists over 250 peer-reviewed papers and 20,000 citations. Aditya Bharatha is a Diagnostic and Interventional Neuroradiologist at St. Michael s Hospital and Assistant Professor in the Departments of Medical Imaging and Surgery at the University of Toronto. His clinical and research interests focus on advanced imaging applications in neurovascular disease, multiple sclerosis, brain tumors and trauma

13 Tania Bruno Department of Neurology Toronto Rehabilitation Institute Anthony Feinstein Division of Psychiatry University of Toronto Tania Bruno is a specialist physician in Physical Medicine and Rehabilitation and a Clinician-Teacher/Lecturer in the Department of Medicine at the University of Toronto. She holds a full time Staff appointment at the University Health Network Toronto Rehab site and is the Director of EMG at Toronto Rehab as well as the Clinical Lead for the MS Rehab outpatient program. She completed her undergraduate medical training at Queen s University and postgraduate training at Dalhousie University where she earned a Killam Scholarship. She went on to complete a Clinical Neuromuscular and Electromyography fellowship at McGill University and is certified by the Canadian Society of Clinical Neurophysiologists. She was appointed Assistant Professor for the Departments of Medicine and Neurology /Neurosurgery at McGill and held this position until 2012 and was embedded in the EMG labs of both the Montreal Neurological Institute and the Montreal General Hospital as well as the MNI MS Clinic. Her current clinical focus remains Electrodiagnosis and MS Rehabilitation. Her interests extend to research collaboration in the field of MS Rehabilitation, MS and Exercise, and advocacy for MS and other episodic and chronic illnesses. Anthony Feinstein received his medical degree in South Africa at the University of the Witwatersrand, before training as a neuropsychiatrist at the Institute of Neurology, Queen Square in London. His Master of Philosophy and Ph.D. Degree were obtained through the University of London, England. He is Professor of Psychiatry at the University of Toronto and former Chair of the Medical Advisory Committee of the MS Society of Canada. Dr. Feinstein is the author of Dangerous Lives: War and the Men and Women Who Report It (Thomas Allen, Toronto 2003), In Conflict (New Namibia Books, 1998), The Clinical Neuropsychiatry of Multiple Sclerosis (Cambridge University Press 1999, with a second edition in 2007), Michael Rabin, America s Virtuoso Violinist (Amadeus Press, 2005, with a second edition in 2011 and audiobook in 2017), Journalists Under Fire: the Psychological Hazards of Covering War (John Hopkins University Press) and Battle Scarred (Tafelberg Press, 2011). He has published widely in peer-reviewed journals and has authored many book chapters. Dr. Feinstein is the recipient of a Guggenheim Fellowship. In 2012, a documentary, Under Fire produced by him and based on his research of journalists in war zones was shortlisted for an Academy Award. The documentary received a 2012 Peabody Award. His series Shooting War ( for the Globe and Mail Newspaper was shortlisted for a 2016 EPPY award

14 Jennifer Gommerman Department of Immunology University of Toronto Marika Hohol Department of Medicine Division of Neurology St. Michael's Hospital Jennifer Gommerman received her Ph.D. (Immunology) at the University of Toronto in She went on to do a post-doctoral fellowship at Harvard Medical School studying the complement pathway and then joined Biogen Inc. as a Staff Scientist in During her tenure at Biogen, she became interested in B cells, multiple sclerosis and the TNF superfamily of molecules. After 3 years in Industry, she returned to Academia as an Assistant Professor (Immunology) at the University of Toronto in 2003, and in 2015 was promoted to full Professor. Dr. Gommerman s basic research continues to focus on how members of the TNF superfamily of molecules regulate immunity and autoimmunity. With respect to translational work, Dr. Gommerman has been examining the role of B lymphocytes in multiple sclerosis patients, and she is the lead PI on a study examining the effect of global migration on susceptibility to autoimmune disease. Marika Hohol obtained her medical degree and neurology training at the University of Toronto. From 1991 to 1993 she was a clinical fellow in multiple sclerosis at the Center for Neurologic Diseases, Brigham and Women s Hospital, Harvard Medical School in Boston, Massachusetts. She remained at the Center for Neurologic Diseases as a faculty member, until 1996, when she returned to Toronto. She is currently on staff at St. Michael s Hospital in Toronto, and works in the Multiple Sclerosis Clinic

15 Liesly Lee Sunnybrook Health Sciences Centre Department of Medicine, Division of Neurology University of Toronto Xavier Montalban Division of Neurology, University of Toronto St Michael s Hospital, Multiple Sclerosis Centre of Catalonia (Cemcat) Neurology-Neuroimmunology Department Vall d Hebron University Hospital, Barcelona, Spain Liesly Lee is a consultant neurologist at the Sunnybrook Health Sciences Centre. He completed his training in Neurology at the University of Toronto in 1997 and completed one year of Fellowship training in multiple sclerosis (MS). He has been the director of the Sunnybrook MS Clinic since His interests include clinical trials in MS, general neurology, including medicine in the developing world. Areas of interest include various novel agents in the treatment of MS and treatment of neurological disease in the developing world. He is currently an Associate Professor of Medicine (Neurology) at the University of Toronto, and is actively involved in the Neurology teaching program in both the undergraduate and graduate levels at the university. Xavier Montalban is Professor of Medicine and the Department Division Director, Division of Neurology, at the University of Toronto and Director of the MS Centre at St Michael s Hospital. He is also the chair of the Department of Neurology- Neuroimmunology and Director of the Multiple Sclerosis Centre of Catalonia at the Vall d Hebron University Hospital in Barcelona, where he is former director of the Department of Neuroscience, as well as the chief of the Neuroimmunology Research Group at the Vall d Hebron Research Institute. He is Professor of Neurology at Universitat Autònoma de Barcelona. Xavier Montalban is the President of the Cemcat Foundation. He is the chairman of the International Medical and Scientific Board of the MSIF and former President of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS). Dr Montalban is a member of the International Panel on Multiple Sclerosis Diagnostic Criteria and Clinical Trials and Editor for Clinical cases of the Multiple Sclerosis Journal. He is a member of the Board of the European Charcot Foundation. Xavier Montalban received his medical license, trained as a Neurology specialist and completed his PhD in Neuroimmunology at the Universitat Autònoma de Barcelona. He went on to undertake a postdoctoral fellowship at the Lupus Research Institute, Guy s & St. Thomas Hospital with additional clinical training at the National Hospital for Neurology and Neurosurgery, Queen Square in London, United Kingdom. For the past twenty-five years, Prof. Montalban has been in the inception phases and on steering committees of many clinical trials related to multiple sclerosis. He has authored over 500 original and revision publications in international peer-reviewed journals plus several book chapters. Recently, he co-directed the development of the first ECTRIMS- EAN Multiple Sclerosis Treatment Guidelines. His research interests include clinical trials, clinical aspects of MS, MR and biological prognostic factors of disease evolution and treatment response, immunological mechanisms of the disease and other aspects of clinical management of MS. Of note in medical education is the UAB postgraduate online Master s Degree in Neuroimmunology of which he is the director and professor. In 2012 Xavier Montalban saw the culmination of over twenty years of constant strive to make MS management truly a continuous care process through the MS Centre of Catalonia: a purpose built, 2000 square metre building for diagnosis, treatment, rehabilitation, research and teaching. More than 70 health care, research and other professionals power the center; together they cater for the needs of over 5,000 persons with MS and their families. Dr. Montalban will also lead a city-wide Multiple Sclerosis Program based at St. Michael s Hospital

16 Jiwon Oh Department of Medicine Division of Neurology St. Michael's Hospital Alexander Prat Department of Immunology, Infectiology and Microbiology Montreal University Montreal, Québec, Canada Jiwon Oh is Assistant Professor of Medicine in the Division of Neurology at the University of Toronto. Dr. Oh is a staff neurologist at St. Michael s Hospital, and specializes in the care of patients with multiple sclerosis (MS). Concurrently, she holds appointments as a scientist at the Keenan Research Centre of the Li Ka Shing Knowledge Institute and a parttime Assistant Professor in the Department of Neurology at Johns Hopkins University. Dr. Oh s research focuses on developing advanced MRI techniques in the spinal cord and brain for use in clinical settings. She leads the MRI research program at St. Michael s Hospital and is the principal investigator (PI) on a number of local MRI studies, including one study that is prospectively assessing quantitative spinal cord MRI measures in patients with radiologically-isolated syndrome. In addition, Dr. Oh is the PI of a prospective, multi-center study assessing leptomeningeal inflammation in a mixed cohort of MS patients at JHU and the National Institutes of Health. Dr. Oh has led the establishment of a MS clinic registry at St. Michael s Hospital which has, to date, captured data from nearly half of the 7000 patients followed yearly and will soon to contribute to international registries such as MSBase. Dr. Oh is also the Secretary and one of the founding Steering Committee members of the North American Imaging in MS Cooperative (NAIMS) representing a multi-national collaborative MRI research endeavor in MS. Over the last four years, NAIMS has grown from seven to 27 independent sites and has multiple active multicenter research projects with many more at various stages of development and implementation. Finally, she is leading the development of the Canadian National Progression Cohort, which will be a prospective cohort study that will be designed to better understand progression in MS. Alexandre Prat obtained his undergraduate degree (B.Sc.) in biochemistry from Université de Montréal, QC, Canada in 1990 and a combined MD-MSc in Dr. Prat completed his Neurology residency training at McGill University (Montreal Neurological Institute) in 2003, after having completed a Ph.D. degree (2000) in the laboratory of Dr Jack P. Antel. His PhD work focused on the development of the human Blood- Brain Barrier. Dr. Prat is an active member of the Royal College of Physician and Surgeons of Canada (Neurology) since 2003 and the Royal Society of Canada since Dr. Prat is a staff neurologist at the CHUM-Notre Dame Hospital (Montréal, QC, Canada), is a Full Professor of Neuroscience (with Tenure) at Université de Montréal and the Deputy Director, Academic Development at CRCHUM. Dr. Prat holds the Donald Paty Research Chair of the Multiple Sclerosis (MS) Society of Canada and a Tier 1 CRC. He is a senior Scholar of the FRQ-S ( ). In 2000, he received the prestigious S. Weir Mitchell Award of the American Academy of Neurology for his contribution to the clinical and basic science of multiple sclerosis. The current research interests of the Prat lab include the immunological roles of the BBB, the mechanisms of monocytes and lymphocyte migration across the BBB and the physiological regulation of the Blood- Brain Barrier functions by glial cells. The underlying hypothesis of Dr. Prat s work is that deciphering the mechanisms by which the Blood- Brain Barrier controls the passage of cells and molecules to the CNS should lead to the understanding of diseases such as MS and brain tumors, as well as to the discovery of novel routes for delivery of drugs and chemotherapies into the CNS. Currently, the research team of Dr. Prat is composed of 4 post-doctoral fellows, 6 Ph.D. students, 4 M.Sc. students and 3 Research Assistant. Most of the students and post-docs in the Prat lab hold prestigious National or International studentship or fellowships. The lab is supported by 4 operating grants from the Canadian Institutes of Health Research (CIHR), 2 CIHR team grants, 2 operating grants from the MS Society of Canada and one large operating grant from the MS Research Foundation of Canada. During the first 10 years of his career, Dr. Prat has published more than 120 peer-reviewed research articles. Dr. Prat has published his research in international journals such as Science, Nature Medicine, Nature Immunology, PNAS, The Journal of Neuroscience, The Journal of Immunology, Annals of Neurology, PLOSone and Brain

17 Dalia Rotstein Department of Medicine Division of Neurology St. Michael's Hospital Gustavo Saposnik Department of Medicine Division of Neurology St. Michael's Hospital Dalia Rotstein is a neurologist at St. Michael s Hospital and an assistant professor in the Department of Medicine, Division of Neurology at the University of Toronto. Her clinical subspecialization is in multiple sclerosis (MS) and demyelinating diseases. She is a graduate of Harvard University, received her MD from McGill University and MPH from the Harvard School of Public Health. She completed a neurology residency at the University of Toronto and MS fellowship at Brigham and Women s Hospital. Her research is focused on the epidemiology of MS and neuromyelitis optica (NMO), in particular the role of ethnicity, gender, and vitamin D in disease risk and disease course. In addition, she is actively involved in international neurology education. In 2009 she founded the Neurology International Residents Videoconferencing Exchange (NIRVE) and now serves as the faculty mentor for this program. Gustavo Saposnik is a scientist and Associate Professor of Neurology at the University of Toronto interested in Outcomes research & Neuroeconomics (also called Decision neuroscience). His vision is improving clinical outcomes through cost effective, high impact, innovative research by applying concepts from Neuroeconomics that is integrated within existing clinical care services across Canada (and Worldwide). Following his PhD in Decision Neuroscience (Neuroeconomics) at the University of Zurich, he gained experience and great interest in understanding how physicians make decisions. He created a platform applying concepts from Neuroeconomics (Decision-making) to facilitate research studies by assessing physicians' and patients' factors associated with therapeutic inertia, herding, over confidence, etc. His team developed and is currently implementing an educational intervention to ameliorate therapeutic inertia. Prof. Saposnik s international leadership in outcomes research and decision neuroscience is reflected by peer-reviewed grants (22 as PI), personal awards, over 220 peer-reviewed publications (93 as first and 64 senior author), collaborations, invitations as key note speaker and visiting professor, and several roles in Guideline development (American heart Association, Canadian Stroke Network, Ontario Ministry of Health, among others). He is an enthusiastic collaborator interested in international partnerships to apply his neuroeconomic's platform into medical decision-making

18 Raphael Schneider Department of Laboratory Medicine and Pathobiology University of Toronto, St Michael s Hospital Daniel Selchen Division of Neurology University of Toronto, St Michael s Hospital Xxx xxx Daniel Selchen is Head of the Division of Neurology at St. Michael s Hospital, University of Toronto, Director of the Multiple Sclerosis Clinic at St. Michael s until the recent arrival of Prof. Xavier Montalban, and Medical Director of the Regional Stroke Program for Southeast Toronto. Prior to joining St. Michael s Dr. Selchen was the Medical Director for the Neurology, Neurosurgery, and Musculoskeletal Programs at Trillium Health Centre, Director of the Multiple Sclerosis Clinic, and Medical Director of the West GTA Regional Stroke Network. Dr. Selchen s academic and research interests include risk/benefit assessment and therapeutic decision making, treatment of aggressive multiple sclerosis, and hyperacute stroke management. Dr. Selchen was a Rhodes Scholar and taught political philosophy prior to his medical career

19 Eluen Ann Yeh Department of Paediatrics, Division of Neurology University of Toronto, The Hospital for Sick Children Eluen 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. She is currently an Associate Professor of Pediatrics (Neurology) and Associate Scientist (SickKids Research Institute, Neurosciences and Mental Health) at the Hospital for Sick Children, University of Toronto, Canada, where she is the director of the MS and Neuroinflammatory Disorders Centre and served as director of the pediatric neurology training program ( ). She has authored over 100 papers and book chapters focused on pediatric MS and neuroinflammatory disorders, and has specific research interests in visual and psychosocial outcomes in pediatric MS and neuroinflammatory disorders, and wellness, physical activity and lifestyle in pediatric MS and other neuroinflammatory disorders. LEARNING OBJECTIVES 34

20 L1 Epidemiology and risk factors of MS D. Rotstein (Canada) L2 Immunopathogenesis of MS A. Prat (Canada) Define current epidemiological distribution of MS all over the world Illustrate factors explaining changes in MS epidemiology Describe the most known MS registries and their scope Describe the link between environment, genes and immune system in causing MS Debate the most known immune mechanisms subtending MS pathogenesis Define the role of innate immunity in MS 36 37

21 L3 Role of B cells in the pathogenesis and treatment of MS J. Gommerman (Canada) L4 Diagnostic criteria in MS M. Hohol (Canada) Describe evidence supporting the role of B cells in MS pathogenesis Elucidate the characteristics of B cells that populate the MS CNS, how they traffic into the CNS and how they may contribute to progressive forms Illustrate the available evidence supporting the efficacy of B-cells depleting agents in MS Illustrate the clinical work up to be performed in order to exclude MS mimickers Describe the most recent revision of the diagnostic criteria Explain the phenotypic classification of MS currently in use and pros and contra 38 39

22 L5 MRI as a diagnostic tool in MS J. Oh (Canada) L6 Cognitive involvement in MS and how to measure it R.H.B. Benedict (USA) Describe MRI sequences and protocols suitable to estimate MS related structural damage in the brain and in the spinal cord Illustrate key MRI features orienting differential diagnosis Describe the role of new imaging techniques (i.e. PET) in the evaluation of MS related brain damage Illustrate the cognitive profile of MS patients Describe cognitive assessment batteries most often used in MS Explain the neurobiological basis of cognitive impairment in MS 40 41

23 L7 Novel treatment targets J. Antel (Canada) L8 Progressive MS X. Montalban (Canada and Spain) Illustrate new treatment targets in relapsing-remitting and progressive MS according to novel insights on pathogenetic mechanisms of MS Explain the mechanisms of action of new treatments Provide an overview on the state of the art of clinical trials exploring the efficacy of new treatments Describe clinical course and diagnostic criteria of primary progressive MS Define the main prognostic factors of disability progression Illustrate pharmacological and non-pharmacological treatment approaches 42 43

24 L9 MS and NMO in children E.A. Yeh (Canada) CC Clinical cases on MS and differential diagnoses work up A. Bharatha and L. Lee ( Canada) Illustrate key clinical features of pediatric MS and NMO spectrum disorders Debate differential diagnosis of pediatric MS Define treatment strategies Learning objective: Point out the key clinical and radiological features to be taken into account in performing differential diagnosis in MS by discussing clinical cases 44 45

25 L10 Update on MS therapy X. Montalban (Canada and Spain) L11 Therapeutic Inertia G. Saposnik (Canada) Illustrate the mechanism of actions of the newest MS treatment Describe the results of the main clinical trials supporting the efficacy of MS treatments Discuss treatment strategies in the current therapeutic scenario Define the concept of therapeutic inertia in MS and other models of diseases Explain reasons for therapeutic inertia Illustrate strategies to overcome therapeutic inertia 46 47

26 L12 Measures of treatment response in clinical trials and in real life setting J. Oh (Canada) L13 Recent trends in serum and CSF biomarker development R. Schneider (Canada) Illustrate goals of treatment in MS Describe scores suitable to assess treatment response in patient treated with first line and second line therapies Compare measures of treatment response used in clinical trials and in real life settings Xxx xxx Xxx xxx Xxx xxx Xxx xxx 48 49

27 L14 Risks of treatment suspension and immune-reconstitution dynamic A. Bar-Or (Canada and USA) L15 Comprehensive neurohabilitation approach to MS T. Bruno (Canada) Describe the available evidence about the risk of disease reactivation after treatment suspension in MS Illustrate the different immunologic dynamics subtending disease reactivation after suspension Explain how we can minimize these risks for MS patients Illustrate the biological basis of the efficacy of rehabilitation and exercise Illustrate the evidence supporting the benefit of exercise in MS Describe how to plan individual and comprehensive neurorehabilitation plan 50 51

28 L16 Emotional burden and disturbances in MS A. Feinstein (Canada) Illustrate the most prevalent psychiatric disturbances associated to MS Define the neurobiological bases underling psychiatric disorders in MS Describe when and how to treat psychiatric disorders in MS 52 53

29 ONLINE IN-DEPTH TUTORIAL January 2019 ONLINE IN-DEPTH TUTORIAL 54

30 ONLINE PREPARATORY TUTORIALS November 2018 LIVE INTERVENTION December 2018 ONLINE IN-DEPTH TUTORIAL January 2019 Continue your Learning Journey after the live intervention! ONLINE IN-DEPTH TUTORIALS January 2019 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. This independent programme is made possible thanks to educational grants received from: Merck KGaA Darmstadt Germany and San Raffaele Hospital Milan. VIDEO LECTURE The in-depth tutorial will be a video talk by Professor J. Oh concerning spinal cord lesion. This tutorial will enable to: Explain why spinal cord lesions are prognostically relevant Illustrate technical issues that limit the investigation of spinal cord Comment on what is new in the field and how imaging can help in the differential diagnosis process SLIDE KIT The final online tutorial will be a slide kit by Professor G. Arrambide focusing on Optica-NMO and anti MOG disease. It will enable to: Describe specific clinical and radiological features of NMO and NMO spectrum disorder Define pathogenetic mechanisms subtending NMO and NMO spectrum disorder Illustrate treatment strategies 56 57

31 Improving the patient's life through medical education EXCEMED - Excellence in Medical Education 14, Rue du Rhône Geneva, Switzerland Copyright EXCEMED, All rights reserved.