Latest MS Advances, Strategies for Clinical Challenges at CMSC

Nancy A. Melville

May 27, 2019

SEATTLE — The wide-ranging mix of healthcare providers involved in the management and treatment of multiple sclerosis (MS) convene in Seattle this week for the 2019 Annual Meeting of the Consortium of Multiple Sclerosis Centers (CMSC). The latest developments in the ever-evolving field will be presented by national and international experts throughout the week of networking and education.

"The take-home message from the CMSC annual meeting is that it is collaborative, participatory, and responsive to the educational needs of the MS team," June Halper, MSN, APN-C, MSCN, FAAN, and CEO of the CMSC, told Medscape Medical News.

"There is a level playing field for professionals, patients, and families...all those affected by MS," she said.

With an expected attendance of more than 2300 delegates and 70 exhibitors, the meeting's agenda is packed with more than 60 educational sessions, in addition to lectures, symposia, roundtables, and workshops, all aimed at advancing the understanding of and improving quality of care for MS.

Novel Concepts, Clinical Challenges

Among the meeting's highlights are its in-depth lectures — beginning with the opening lecture, "Mountains to Climb: The Cause, Treatment and Care of MS in the Pacific Northwest," to be delivered by James D. Bowen, MD, medical director of the Multiple Sclerosis Center at Seattle's Swedish Neuroscience Institute. Bowen will discuss the steep challenges and gratifying successes in establishing regional systems of care for MS in the Pacific Northwest.

In the John F. Kurtzke Memorial Lecture, Cleveland’s Case Western Reserve University expert Bruce D. Trapp, MD, will discuss "A Novel Subtype of Multiple Sclerosis" — specifically, myelocortical MS.

Trapp and his team recently identified and published their findings on the intriguing new subtype of the disease, which is characterized by neuronal loss, yet does not have the demyelination of the brain's white matter that is so characteristic of MS.

The Presidential Lecture, presented by Fred D. Lublin, MD, will explore the "Use and Abuse of the McDonald Criteria in MS Diagnosis," and the John Whitaker Memorial Lecture, to be given by Frauke Zipp, MD, will delve into the "Therapeutic Exploitation of Crosstalk Between the Immune and Nervous Systems."

Mental Health, Imaging, Mechanisms, and More

Further pressing issues in MS management, such as the challenging mental health aspects of the disease, will be addressed in sessions throughout the meeting. These include a new program on "Psychopharmacology and MS: The Nuts and Bolts" and a full morning of talks on Friday focusing on "Mental Health Care Delivery Models for Patients with MS."

In another new program, "Palliative Care in MS," quality-of-life care will be discussed, while another session will grapple with "Managing the Suicidal Patient in Your Clinic: Red Flags, Ethical Considerations & Emotional Aftermath."

Two sessions — "Mechanisms of Disease Pathogenesis in MS" and "Understanding the Mechanism of Action of B-cell Depleting Drugs: What Does That Reveal About the Role of B-cells in MS?" — will focus on the latest understanding of the underlying mechanisms of MS

Other highly anticipated sessions include the presentation of the latest findings on brain magnetic resonance imaging (MRI) in MS, such as the important role of perivenular lesions in the brain, or the "central vein sign," in improving the diagnosis of MS. This information will be presented in "The Future of MS Imaging" by chair Daniel S. Reich, MD, PhD, of the National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland.

Reich was among the team of researchers reporting last year in the Annals of Neurology the compelling findings that "central vein sign differentiates multiple sclerosis from central nervous system inflammatory vasculopathies."

Cannabis, Caregiving, Integrative Approaches

Much more on the latest developments in MS research will be presented in a poster session on Thursday evening, in addition to a full afternoon of platform sessions on Friday. Tracks include Psychosocial: Cognition and Depression, Disease Modifying Therapy, Rehabilitation, and Disease Assessment and Management.

"We divide the platforms into tracks to model the full meeting and to be of interest to all the specialists who join us throughout the four days," Halper said.

The ever-increasing questions clinicians face in terms of cannabis and MS will be discussed in "An MS Health Professional's Guide to Cannabis," and various other alternative treatments will be given needed attention in "Integrative Medicine: An Essential But Neglected Component of Comprehensive MS Care."

A further exploration of nonpharmacological treatments will include a session on "Utilizing the Power of the Arts in MS Care: Everyone Benefits," focusing on the therapeutic benefits for MS in everything from reflective writing to visual arts and music.

Issues of community and caregiving will be addressed in "Supporting and Caring For Each Other While Living with MS: The Support Partners' Perspective" and "The Importance of Community-Based Programs to Enhance Comprehensive MS Care," which will look at models such as a community-based yoga program for people with MS and a day-program model for MS achievement.

Another anticipated highlight will be the patient-family–focused program on Friday titled "More About MS," Halper explained.

"We are expecting over 150 participants in the 'More About MS' program," Halper said. "Led by Randall T. Schapiro, MD, a team of MS experts will interact with their audience and provide information on important topics in MS."

Clinical courses offered on the first and last days of the meeting will provide guidance on wide-ranging topics, including "Essential Topics in Caring for Persons with Progressive MS," "Challenges and Considerations With Infusible Therapies," "Treatment Adherence in MS: Identifying Suboptimal Adherence and Strategies for Improving Appointment Attendance and Medication Self-Management," and "Sex and MS: How to Help Patients With MS Who Experience Sexual Dysfunction."

Various Activities Geared Toward Younger Clinicians

Halper noted that the meeting is designed with numerous activities and sessions tailored toward the new generation of MS healthcare providers whose careers are just taking off.

"The most gratifying part of the meeting is the growth of the younger clinician attendance both at our mentorship program, the Whitaker Track, and the MS PIT [professionals in training] Special Interest Group," she said.

"In addition to our educational content, we will have two contests for young people — rehab innovations, spearheaded by Christopher Luzzio, MD, with a prize for the best invention in rehabilitation (see his booth in the exhibit hall), and neuro-innovations spearheaded by Darin Okuda, MD, again with a prize for the best digital invention."

Whether just beginning a career or decades into the field of MS management, however, the meeting should have something for everyone, Halper noted.

"I am looking forward to the entire meeting because it reflects the educational needs and contributions of the MS professional community."

Consortium of Multiple Sclerosis Centers (CMSC) 2019 Annual Meeting. May 28 to June 1, 2019.

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