Host: Prof. Hans Peter Hartung In the management of multiple sclerosis there are essentially two therapeutic approaches. The first is a high-efficacy treatment typically reserved for patients with severe disease and a high number of relapses; the second is a slowly intensifying approach known as escalation in which less efficacious treatments are assessed before escalating to a second or third drug. High efficacy treatment comes with a higher risk/reward ratio than does escalation; but escalation can allow disease processes to continue beyond the window of opportunity for highest therapeutic benefit. How can clinicians make the correct choice for their patients? 

On the Frontlines of Multiple Sclerosis

Reconsidering the Concept of First-Line, High-Efficacy Treatment

Host: Matt Birnholz, MD Guest: Maria K. Houtchens, MD Guest: Maria Lopes, MD Patients with multiple sclerosis (MS) are increasingly choosing to start families. It is incumbent on us as healthcare professionals to try to ensure their chances for healthy pregnancies while maintaining adequate disease control. In this program, Dr. Houtchens and Dr. Lopes discuss the importance of patient/healthcare provider partnerships in family planning. Specific points of focus include the role of effective contraception, key concepts regarding the use of disease modifying therapies, and important practical considerations related to patient care in the time before, during, and after pregnancy. EMD Serono is a business of Merck KGaA, Darmstadt, Germany. ©EMD Serono, Inc. All rights reserved. US/NPR/1019/0558a

Family Planning in Multiple Sclerosis: Enhancing Patient Care

Host: Jennifer Caudle, DO Guest: Riley Bove, MD Guest: Bianca Weinstock-Guttman, MD The disease course of multiple sclerosis (MS) can take many paths based on numerous factors, including age at diagnosis, gender, and MS subtype. Layered upon the typical MS management challenges are those that can occur with the physical and physiological changes of the normal aging process. How might the care of a patient with MS need to be modified as they age? In this discussion, Dr. Bove and Dr. Weinstock-Guttman will review: The effects that aging may have on patients with MS The interplay between menopause and MS How aging may affect the approach to disease management EMD Serono is a business of Merck KGaA, Darmstadt, Germany. ©EMD Serono, Inc. All rights reserved. US/NPR/1019/0520B

Multiple Sclerosis & Aging: Considerations for Diagnosis & Treatment

Host: Jennifer Caudle, DO Guest: Catherine Apicella, MPT, PYT-C, PRPC With less and less primary care physicians partnering with physical therapists, it’s time we ask: are we doing ourselves—and our patients—a disservice by not taking advantage of this option? To find out, Dr. Jennifer Caudle sits down with physical therapist Catherine Apicella to discuss the often-overlooked benefits of physical therapy and how primary care physicians and physical therapists can work together to benefit their patients.

Is Primary Care Taking Full Advantage of Physical Therapy?

Host: Patricia K. Coyle, MD Guest: Clyde E. Markowitz, MD Multiple sclerosis (MS) is one of the leading causes of disability worldwide. As the treatment armamentarium continues to grow, patient involvement in the development of an effective treatment strategy is becoming increasingly important. In this Clinical ExchangesSM activity, leading MS specialists discuss issues of diagnosing MS, initiating treatment, and switching therapies, all in the context of practical shared decision-making techniques demonstrated by their own patients. 

Detangling Difficult Conversations About Multiple Sclerosis: Clinical Exchanges

Host: Shiv Saidha, MBBCh, MD, MRCPI Guest: Jiwon Oh, MD Guest: Kerstin Hellwig, MD Pregnancy is a major point of discussion for all women of child-bearing age, and when you factor in diseases like multiple sclerosis, it only further complicates matters. Hear from experts Dr. Kerstin Hellwig, Dr. Jiwon Oh, and Dr. Shiv Saidha about their approach to managing MS patients before, during, and after pregnancy. 

Clinical Perspectives on Pregnancy & MS Patients

Host: Prof. Dr. Hans Lassmann The basic pathologic hallmark of multiple sclerosis is inflammation, but the causal factors involved in the formation of confluent plaques of demyelination and neurodegeneration in the brain, as well as loss of brain volume, have been difficult to elucidate. Efforts to identify downstream sequences leading to demyelination have resulted in the development of newer pharmacologic agents, but the larger questions are if, in the clinic, these agents are 1) really effective; and 2) focusing on the right targets?

From Neuropathology to New Pathophysiological Concepts & Clinical Perspectives

Host: Prof. David Wraith B cells have generally been considered to be only peripherally involved in the pathogenesis of multiple sclerosis. More recently, however, drug agents that deplete B cells have been shown to profoundly impact multiple sclerosis, greatly improving outcomes for patients affected by this autoimmune disease. Nonetheless, B-cell involvement in multiple sclerosis, for some, remains controversial.

Burning Debate: B cells vs. T cells

Host: Jennifer Caudle, DO Guest: Catherine Apicella, MPT, PYT-C, PRPC Guest: Crystal Gouldey Frustrating multiple sclerosis (MS) symptoms like urinary frequency and incontinence can be detrimental to a patient’s quality of life, but there are resources available to help. To explore the benefits of pelvic floor physical therapy for MS, Dr. Jennifer Caudle sits down with two special guests: physical therapist Catherine Apicella from CORE 3 Physical Therapy and her patient—and ReachMD’s very own employee—Crystal Gouldey. 

How Pelvic Floor Physical Therapy Can Help MS Patients

Welcome to On the Frontlines of Multiple Sclerosis, a ReachMD series with the latest education and information on diagnostic and prognostic advancements and treatment options for patients with Multiple Sclerosis.

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Reconsidering the Concept of First-Line, High-Efficacy Treat...

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