Reshaping the Paradigm: Implications of Recent Clinical Advances in the Diagnosis and Treatment of Neuromyelitis Optica Spectrum Disorder (NMOSD)

Overview:

Neuromyelitis Optica Spectrum Disorders (NMOSD) are rare, immune-mediated diseases of the CNS typically characterized by inflammation of the optic nerve and spinal cord. Its characteristic relapses and remissions cause it to be frequently confused with MS leading to inappropriate and even harmful treatment approaches. In fact, only fairly recently was NMOSD recognized as its own clinical entity aided by the discovery of the aquaporin-4 (AQP4) antibody and its role in the disease process. Based on this breakthrough, a targeted immunosuppressive therapy, eculizumab, became the first FDA approved agent for the treatment of NMOSD in 2019 followed in short succession by inebilizumab and, most recently, satralizumab. Due to the potential long-term disability and even mortality that may result from repeated disease insult and treatment mismanagement, accurate recognition and action in this condition are critical for improving long-term outcomes.

This 1 hour case-based activity is designed to present several key analytic and diagnostic skills required to effectively characterize and treat NMOSD. Presenting faculty will work together through complex real-life cases that help elucidate the major considerations and most common pitfalls in differentiating NMOSD from MS. The program will also review the current and rising pharmacological landscape for NMOSD and discuss how best to determine the optimal treatment course for patients suffering from this spectrum of disorders.

Target Audience

This activity is intended for neurologists, nurse practitioners, physician assistants, pharmacists, and other providers involved in the care of patients with NMOSD.

Learning Objectives

•  Describe the role of anti-AQP4 antibodies in the pathogenesis of NMOSD and develop appropriate testing algorithms to assess individuals suspected of harboring it.
• Recognize the updated diagnostic criteria for NMOSD and utilize this information to assist in making an accurate and timely diagnosis for individuals with seropositive or seronegative presentations of the disease.
• Describe the biologic rationale for, differential mechanisms of action of and Phase 3 research data evaluating recently approved agents designed for relapse prevention to determine their current and/or potential clinical utility.

Faculty

Brian G. Weinshenker, MD
Professor of Neurology and Consultant
Mayo Clinic
Rochester, Minnesota

Benjamin M Greenberg, MD, MHS
Vice Chair of Translational Research and Strategic Initiatives
Professor, Department of Neurology and Neurotherapeutics
University of Texas Southwestern Medical Center
Dallas, Texas

Jérôme de Sèze, MD, PhD
Professor of Neurology
Neuroimmunological Department Head
Strasbourg University Hospital
Strasbourg, France

ACCREDITATION STATEMENT

In support of improving patient care, this activity has been planned and implemented by the Consortium of Multiple Sclerosis Centers (CMSC) and Efficient LLC. CMSC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Physician Credit
The CMSC designates this live activity for a maximum of 1.00 AMA PRA Category 1 Credit(s)^_TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nurse Credit
The CMSC designates this live material for 1.00 contact hours.

Pharmacists
The Consortium of Multiple Sclerosis Centers (CMSC) is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education and will award 1.0 contact hours (.1 CEUs) to pharmacists who (1) participate in the activity, (2) pass the post-test; and (3) complete the evaluation form. This knowledge-based activity, UAN # JA4008165-9999-20-028-L01-P, qualifies for 1.0 contact hours (.1 CEUs) of continuing pharmacy education credit.

Certificate of Participation for Other Healthcare Professionals
A Certificate of Participation will be given upon completion of the live activity enabling participants to register their credit with the appropriate licensing boards or associations.

Disclosures

Commercial Support Acknowledgement
This continuing education activity is supported by an educational grant from Genentech, a member of the Roche Pharmaceuticals Group

Disclosure of Financial Relationships
It is the policy of CMSC to ensure balance, independence, objectivity, and scientific rigor in all educational activities. All faculty, activity planners, content reviewers, and staff participating in this activity have disclosed any relevant financial relationships they or their spouse/life partner have within the previous 12 months with manufacturers of any commercial products/devices and/or providers of commercial services included in this educational activity. The intent of this disclosure is not to prevent a person with a relevant financial relationship from participating in the activity, but rather to provide participants with information on which they can base their own judgments. All presentations were reviewed by an independent clinician with no relevant financial relationships for the purpose of resolution of any identified conflict of interest and a determination of evidence-base and fair balance.

Faculty Disclosures
The program faculty reported the following relevant financial relationships that they have with commercial interests:

Dr. Weinshenker discloses the following:
Consultant: Roche, VielaBio, Alexion, Chugai, Mitsubishi Tanabe Royalties/Inventions: RSR Ltd., Oxford University, Hospices Civil de Lyon, MVZ Labor PD Dr. Volkmann und Kollegen GbR

Dr. Greenberg discloses the following:
Grant support: CLENE Nanomedicine, NIH, NMSS, SRNA, Guthy JAckson Charitable Foundation, PCORI
Consultant: Alexion, EMD Serono, Novartis, Viela Bio, Roche, Greenwich Bio, Axon Advisors, Rubin Anders, Abcam
Board Member (unpaid): Seigel Rare Neuroimmune Association

Dr de Seze discloses the following:
Board Honorarium: Roche, Cellgen, Alexion, Novartis, Biogen. Sanofi Genzyme

Staff Disclosures
The staff at CMSC and Efficient, LLC who are in a position to influence content have disclosed no relevant financial relationships

Disclosure of Unlabeled Use
CMSC and Efficient LLC require faculty to disclose to the attendees when products or procedures being discussed are off-label, unlabeled, experimental, and/or investigational (not FDA approved); and any limitations on the information that is presented, such as data that are preliminary or that represent ongoing research, interim analyses, and/or unsupported opinion. Faculty in this activity may discuss information about pharmaceutical agents that is outside of US Food and Drug Administration approved labeling. This information is intended solely for continuing education and is not intended to promote off-label use of these medications. If you have questions, contact the medical affairs department of the manufacturer for the most recent prescribing information.

Disclaimer
CMSC presents this information for educational purposes only. The content is provided solely by faculty who have been selected because of recognized expertise in their field. Participants have the professional responsibility to ensure that products are prescribed and used appropriately on the basis of their own clinical judgment and accepted standards of care. CMSC, Efficient, and the commercial supporters assume no liability for the information herein.

If you have any questions about this activity, please contact Efficient at [email protected].