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  "Tackling Progressive Multiple Sclerosis: Utilization of an Evidence-Based Approach"
Clinical Dialogue eCase Challenge

Clinical Dialogues are engaging, video-based roundtable discussions focusing on new guidelines, recent publications, and hot topics in patient management.  In tandem with the clinically-focused eCase Challenge, this educational activity creates a complete learning experience.

eCase Challenges are interactive, text-based case studies designed to integrate the educational objectives into day-to-day clinical practice.  The video "Clinical Pearl" summarizes key clinical aspects of this activity.

     
   
CME InfoHelp
Title:
Jointly Provided by: The University of Texas Southwestern Medical Center and Medical Logix, LLC
Release Date: September 30, 2020
Expiration Date: September 30, 2021
Estimated time to complete each part of this activity: 45 minutes for each of the two programs. Each part of this activity has been approved for a maximum of 0.75 TM.
Acknowledgement of Commercial Support: Supported by independent educational grants from Novartis Pharmaceuticals Corporation and Sanofi Genzyme.
Learning Objectives
After participating in this activity, the participant will demonstrate the ability to:
  • Utilize knowledge of the definitions and evaluation of progressive MS to make more timely and accurate clinical decisions.
  • Describe the historical data on outcomes in progressive multiple sclerosis.
  • Explain the latest data from controlled clinical trials for the treatment of progressive MS.
  • Apply the use of paraclinical outcomes when managing patients with MS.
As an accredited provider, UT Southwestern Medical Center requires that the content of our activities are:
  • Independent, objective, scientifically rigorous, balanced and free of bias.
  • Based on scientific studies utilized or referenced from sources acceptable to the scientific and medical community.
  • Acceptable to the medical community as it relates to patient recommendations and do not recommend any unscientific modalities or those not supported by evidenced based sources.
Statement of Need
Multiple sclerosis (MS) is classically a chronic neurologic disease characterized by attacks of focal neurological deficits secondary to inflammatory, demyelinating plaque(s). While inflammation is a hallmark of the disease, there is increasing evidence of a degenerative component. Historically, multiple sclerosis has been divided into three subtypes: relapsing remitting (RRMS), primary progressive (PPMS), and secondary progressive (SPMS). Collectively termed progressive multiple sclerosis, both primary and secondary progressive multiple sclerosis constitute 15 to 40% of the total population of patients with multiple sclerosis.  
A distinction between the subtypes of multiple sclerosis first appears in the modern literature in 1952, followed by the first treatment failure in 1973. Despite the first FDA-approved treatments for relapsing remitting multiple sclerosis appearing in 1993, history is studded with numerous negative clinical trials for progressive MS. In 2000, mitoxantrone received FDA approval for progressive multiple sclerosis, but longitudinal data eventually prompted the 2018 AAN Recommendation against its general use. With multiple therapies approved for treatment of progressive forms of multiple sclerosis, a new chapter in the fight against MS starts; now more than ever there is a need to distinguish the subtypes of multiple sclerosis for appropriate evaluation and treatment.  
Intended Audience
This activity is intended to meet the educational needs of clinicians treating patients with MS.
Contributors and Planners
Faculty:
Benjamin M. Greenberg, MD, MHS
Distinguished Teaching Professor
Vice Chair of Research
Department of Neurology
Director, Perot Foundation Neurosciences Translational Research Center
O’Donnell Brain Institute
UT Southwestern Medical Center
Dallas, Texas
Olaf Stuve, MD, PhD
Professor
Department of Neurology and Neurotherapeutics
UT Southwestern Medical Center
Dallas, Texas
Chief of Neurology
VA North Texas Health Care System
UT Southwestern Medical Center
Dallas, Texas
Lindsay Horton, MD
Assistant Professor of Neurology
Department of Neurology and Neurotherapeutics
UT Southwestern Medical Center
Dallas, Texas
Reviewer:
Lauren Tardo, MD
Department of Neurology
UT Southwestern Medical Center
Dallas, Texas
Disclosure of Commercial Interest:
As an organization accredited by the Accreditation Council for Continuing Medical Education (ACCME), The University of Texas Southwestern Medical Center, Office of Continuing Medical Education (UTSW CME) requires that the content of CME activities and related materials provide balance, independence, objectivity, and scientific rigor. Planning must be free of the influence or control of a commercial entity, and promote improvements or quality in healthcare. All persons in the position to control the content of an education activity are required to disclose all relevant financial relationships in any amount occurring within the past 12 months with any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on patients.
The ACCME defines “relevant financial relationships” as financial relationships in any amount occurring within the past 12 months that create a conflict of interest. The UTSW Office of CME has implemented a mechanism to identify and resolve all conflicts of interest prior to the activity. The intent of this policy is to identify potential conflicts of interest so participants can form their own judgments with full disclosure of the facts.  Participants will evaluate whether the speaker’s outside interests reflect a possible bias in the planning or presentation of the activity.
Disclosures:
Benjamin M. Greenberg, MD, MHS
Independent Contractor: Abcam, Alexion, EMD Serono, Genentech, Greenwhich Bio, Novartis, Ruben Anders, Viela Bio
Grant/Contract: Clene Nanomedicine
Olaf Stuve, MD, PhD
Grant/Contract: Celgene, EMD Serono, Sanofi Genzyme
Lindsay Horton, MD
No relevant financial relationships to disclose
Reviewer:
Lauren Tardo, MD
No relevant financial relationships to disclose
No other planners have indicated that they have any financial interests or relationships with a commercial entity.
The following Medical Logix, LLC planners/managers, Megan Gentile, John Gentile, and Chris Fischer, hereby state that they or their spouse/life partner do not have any financial relationships or relationships to products nor devices with any commercial interest related to the content of this activity of any amount during the past 12 months.  
The following UT Southwestern employee, Reema Mustafa hereby states that she or her spouse/life partner do not have any financial relationships or relationships to products nor devices with any commercial interest related to the content of this activity of any amount during the past 12 months.
Off-Label Discussion
This educational activity may contain discussion of published and/or investigational uses of agents that are not approved by the U.S. Food and Drug Administration. For additional information about approved uses, including approved indications, contraindications, and warnings, please refer to the prescribing information for each product, or consult the Physicians’ Desk Reference.
Disclaimer
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
Accreditation Statement
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of The University of Texas Southwestern Medical Center and Medical Logix LLC. The University of Texas Southwestern Medical Center is accredited by the ACCME to provide continuing medical education for physicians.
Credit Designation Statement
The University of Texas Southwestern Medical Center designates this enduring material for a maximum of 1.5 TM. Participants should claim only the credit commensurate with the extent of their participation in the activity.
Format and Method of Participation
There are no fees for participating and receiving CME credit for this activity. During the accreditation period, participants must read the learning objectives and faculty disclosures and review this internet-based activity. To take the post-test, please click on the post-test button below the slide window of the player. Complete the post-test and evaluation and attest to the amount of time spent in the activity. Upon receiving a score of 70% or above, print your CME certificate.
For CME questions, please contact the UTSW Office of CME at cmeregistrations@utsouthwestern.edu.
Technical Requirements
Processor Speed:  1.4 GHz P3
Memory:  256 MB RAM (20MB available)
Operating Systems Supported: Windows 2000/XP, MAC
Browsers Supported:  Internet Explorer 5.5 or greater, Mozilla Firefox and Safari 3.525 or greater
Additional Requirements: Flash player 8.0 or greater, 800x600 Resolution or higher with 32-bit color
Connection Speed:  128 Kbps or better
Adobe Acrobat 6.0 or greater
Technical Questions:
Please click on the Help button within the online player, or email MS-Leaders at support@ms-leaders.com
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