Harnessing the Clinical Value of Biomarkers in MS:
Diagnosis, Assessment, and Therapeutic Sequencing

Program Description

Multiple sclerosis is a complex disease with several mechanisms contributing to its pathophysiology. Early diagnosis and treatment is extremely important in MS because early intervention can help slow the disease process and the progression of disability. Biomarkers may be able to identify which processes are at work and hold promising value in the diagnosis and stratification of MS type, identification of disease stage, prediction of disease course, selection of treatment, detection of response to treatment, improvement of prognostic capabilities, and the evaluation of novel therapeutics. With recent advances in biomarker research, MS clinicians must have the knowledge and skills to appropriately incorporate the use of biomarkers into MS diagnosis and treatment.

The goal of this educational program is to improve clinicians’ understanding of emerging molecular biomarkers in MS and provide a better understanding of how these markers are related to pathologic processes, disease activity, and clinical progression, in order to improve patient care and outcomes.

Faculty

	FRANCISCO J. QUINTANA, PhD (Chair) Assistant Professor of Neurology, Center for Neurologic Diseases Brigham and Women’s Hospital Harvard Medical School Boston, MA Read Biography Francisco Quintana, PhD graduated as a biologist from Buenos Aires University in 1999. He obtained his PhD in immunology from the Weizmann Institute of Science in 2003, under the direction of Prof. Irun Cohen, where he studied the immune response to HSPs and its exploitation for immunoregulation using DNA vaccines and antigen arrays. He remained at the institute as a postdoctoral fellow for a year, working in collaborative projects between Prof. Irun Cohen and Yechiel Shai on structural immunology studies on the interaction between HIV and its host. In 2005, Dr. Quintana moved to Brigham and Women’s Hospital at the Harvard Medical School. Under the direction of Professor Howard Weiner he explored the use of Zebrafish for the identification of signaling pathways that control the adaptive and the innate immune response. Those studies led to the identification of AHR as regulator of T cell polarization and DC activity. Starting in 2009, Dr. Quintana has led a research group at the Center of Neurologic Diseases at Brigham and Women’s Hospital, Harvard Medical School.
	SUHAYL DHIB-JALBUT, MD Professor with Tenure and Chairman Department of Neurology UMDNJ-Robert Wood Johnson Medical School Chief, Neurology Service Robert Wood Johnson University Hospital New Brunswick, NJ Read Biography Dr. Suhayl Dhib-Jalbut is Professor and Chairman of the Department of Neurology at the UMDNJ-Robert Wood Johnson Medical School and Chief of the Neurology Service at the Robert Wood Johnson University Hospital. Dr. Dhib-Jalbut graduated Alpha-Omega-Alpha from the American University of Beirut, Lebanon, completed his neurology training at the University of Cincinnati, and a neuro-immunology fellowship at the National Institutes of Health. Dr. Dhib-Jalbut has served on several national and international scientific committees and as an Associate Editor for the Journal of Neuroimmunology. He has published more than 100 manuscripts in the scientific literature. Dr. Dhib-Jalbut conducts basic and clinical research in multiple sclerosis funded by the NIH, the National Multiple Sclerosis Society, and industry. His research interests include how MS therapies work, biomarkers of treatment response in MS, and neuroprotective gene therapy.
	AARON E. MILLER, MD Professor of Neurology Medical Director, The Corinne Goldsmith Dickinson Center for Multiple Sclerosis Mount Sinai Medical Center New York, NY Read Biography A specialist in the field of multiple sclerosis, Aaron E. Miller, MD is Professor of Neurology at Mount Sinai Medical Center and Medical Director of the Corinne Goldsmith Dickinson Center for Multiple Sclerosis in New York, NY. Recruited to direct clinical affairs at the Multiple Sclerosis Center, Dr. Miller is widely recognized for his preeminence as a clinician. He also is the Chairman of the Clinical Advisory Committee of the New York City Chapter of the National Multiple Sclerosis Society (NMSS). Dr. Miller graduated from Brandeis University in 1964 and received his medical doctorate from New York University School of Medicine in 1968. Following his residency in neurology at the Albert Einstein College of Medicine, he received additional postdoctoral training in neurovirology and immunology at the Johns Hopkins University School of Hygiene and Public Health and at Albert Einstein College of Medicine. During this time, Dr. Miller was the recipient of a fellowship from the National MS Society. Prior to his 2004 appointment as Medical Director of the CGD Center for Multiple Sclerosis, Dr. Miller served 23 years as head of the Division of Neurology at Maimonides Medical Center in Brooklyn, NY, where he continues to serve as Co-director of the MS Care Center. Dr. Miller became the Chief Medical Officer and Chairman of the Medical Advisory Board of the NMSS in October 2001, and served as Chairman of the Clinical Advisory Committee of the New York Chapter of the NMSS from 1991-2004. He also was Chairman of the Professional Education Committee of the NMSS and is a Past President of the Consortium of MS Centers. He was the first Chairman of the Multiple Sclerosis Section of the American Academy of Neurology, and has participated in numerous clinical trials of new treatments for MS. Dr. Miller is active with the American Academy of Neurology, for which he currently serves as Editor of Continuum, their bimonthly continuing education publication. He is also a member of the Education Committee and the Meeting Management Committee.

Target Audience

Educational Objectives

This program is designed to address the following IOM competencies: provide patient-centered care and employ evidence-based practice.

At the conclusion of this activity, participants should be able to demonstrate the ability to:

• Recognize the limitations of the current standard-of-care in MS and the need to incorporate biomarkers into management decisions
• Using biomarkers, develop algorithms to guide initiation and sequencing of disease-modifying therapy (DMT) for maximum potential impact
• Apply diagnostic biomarkers to allow for earlier diagnosis of MS
• Assess the clinical utility of biomarkers to monitor disease activity and response to DMT

Accreditation

This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of the Potomac Center for Medical Education and Rockpointe. The Potomac Center for Medical Education is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Designation Statement

The Potomac Center for Medical Education designates this enduring activity for a maximum of 1.25 AMA PRA Category 1 credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

     For questions regarding CME credit, the post-test, or evaluation, please email contact@potomacme.org

Disclosure Statement

The Potomac Center for Medical Education (PCME) adheres to the policies and guidelines, including the Standards for Commercial Support, set forth to providers by the Accreditation Council for Continuing Medical Education (ACCME) and all other professional organizations, as applicable, stating those activities where continuing education credits are awarded must be balanced, independent, objective, and scientifically rigorous.

All persons in a position to control the content of a continuing medical education program sponsored by the Potomac Center for Medical Education are required to disclose any relevant financial relationships with any commercial interest to PCME as well as to learners. All conflicts are identified and resolved by PCME in accordance with the Standards for Commercial Support in advance of delivery of the activity to learners.

The content of this activity was vetted by an external medical reviewer to assure objectivity and that the activity is free of commercial bias.

The steering committee and faculty reported the following with commercial interests.

Francisco J. Quintana, PhD: Consultant: Teva; Speaker: EMD Serono; Research: EMD Serono

Suhayl Dhib-Jalbut, MD: Consultant: Bayer, Biogen, EMD Serono, Teva; Investigator/Research Grants: Bayer, EMD Serono, Teva

Aaron Miller, MD: Consultant: Acorda, Nuron Biotech, Ono Pharmaceutical, Sanofi-Aventis, Teva; Consultant/Research Support: Biogen Idec, Novartis

Non-faculty content contributors and/or reviewers reported the following relevant financial relationships that they or their spouse/partner have with commercial interests:

Matthew Horn, MD; Bradley Pine; Blair St. Amand; Jay Katz, Dana Simpler, MD: Nothing to Disclose

FDA Disclosure

The contents of some CME/CE activities may contain discussions of non-approved or off-label uses of some agents mentioned. Please consult the prescribing information for full disclosure of approved uses.

System Requirements

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Instructions for Participants and Obtaining CME Credit

There is no fee for this activity. To receive credit, participants must take the pre-test, view this CME activity in its entirety, and then complete the post-test and evaluation. To complete the evaluation online, choose the best answer to each question. The estimated time for completion of this activity is 1.25 hours. To receive their certificates, participants must demonstrate mastery of the presented material via the post-test.

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