Medscape InDiscussion: Multiple Sclerosis

Most MS patients are women, often diagnosed during their childbearing years. Drs Anne Cross and Riley Bove discuss maternal health, IVF, birth control, and menopause when living with MS.

Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/977036). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

Multiple Sclerosis https://emedicine.medscape.com/article/1146199-overview

Teriflunomide (Rx) https://reference.medscape.com/drug/aubagio-teriflunomide-999771

Sphingosine 1-Phosphate Receptor Modulators https://reference.medscape.com/drugs/sphingosine-1-phosphate-receptor-modulators

Natalizumab Prescribing Information https://www.tysabri.com/content/dam/commercial/tysabri/pat/en_us/pdf/tysabri_prescribing_information.pdf

Association Between Breastfeeding and Postpartum Multiple Sclerosis Relapses https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6902174/

Perinatal Depression and Anxiety in Women With Multiple Sclerosis https://n.neurology.org/content/96/23/e2789

Risk Factors for Peripartum Depression in Women With Multiple Sclerosis https://journals.sagepub.com/doi/10.1177/13524585211041108

Long-Acting Reversible Contraception: Comparing Methods https://www.medscape.com/viewarticle/857253

Neonatal and Delivery Outcomes in Women With Multiple Sclerosis https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3625744/

Familial Risk of Early- and Late-Onset Multiple Sclerosis: A Swedish Nationwide Study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6373346

Drs Cross and Katz Sand discuss the science behind diet and lifestyle interventions for patients living with MS. Learn about studies underway to help clinicians better incorporate diet and lifestyle recommendations into practice.

Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/977035). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

Multiple Sclerosis https://emedicine.medscape.com/article/1146199-overview

Randomized-Controlled Trial of a Modified Mediterranean Dietary Program for Multiple Sclerosis: A Pilot Study https://www.msard-journal.com/article/S2211-0348(19)30383-9/fulltext

Mediterranean Diet Is Linked to Less Objective Disability in Multiple Sclerosis https://journals.sagepub.com/doi/10.1177/13524585221127414

Dietary Factors and MRI Metrics in Early Multiple Sclerosis https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8515355/

Multiple Sclerosis Functional Composite (MSFC) https://www.nationalmssociety.org/For-Professionals/Researchers/Resources-for-MS-Researchers/Research-Tools/Clinical-Study-Measures/Multiple-Sclerosis-Functional-Composite-(MSFC)

Kurtzke Expanded Disability Status Scale https://emedicine.medscape.com/article/2172461-overview

How to Incorporate Diet Into Multiple Sclerosis Care https://www.medscape.com/viewarticle/972812

Drs Cross and Bainbridge discuss cannabis, safety issues, drug-drug interactions, potential liver toxicity, tolerance, and possible dependency for people living with MS.

Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/977034). The topics and discussions are planned, produced, and reviewed independently of advertiser. This podcast is intended only for US healthcare professionals.

Resources

Cannabinoids in Medicine: Limitless Hope or Hype? https://www.medscape.com/viewarticle/973874

Medicinal Cannabis: History, Pharmacology, and Implications for the Acute Care Setting https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5312634/

Sativex Prescribing Information https://www.tga.gov.au/sites/default/files/auspar-nabiximols-130927-pi.pdf

Epidiolex Prescribing Information https://pp.jazzpharma.com/pi/epidiolex.en.USPI.pdf

Cannabinoid Poisoning Workup https://emedicine.medscape.com/article/833828-workup

Cannabis and Psychosis: Recent Epidemiological Findings Continuing the "Causality Debate" https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2021.21111126

Cannabinoid Hyperemesis Syndrome https://www.ncbi.nlm.nih.gov/books/NBK549915/

Trial Evaluating Nabiximols Oromucosal Spray in Adult Participants With Multiple Sclerosis Spasticity https://investor.jazzpharma.com/news-releases/news-release-details/jazz-pharmaceuticals-announces-top-line-results-phase-3-trial

As patients with MS in the United States get older, questions about therapies shift from treatment to discontinuation. Drs Cross and Corboy discuss the DISCOMS trial to address these questions.

Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/977033). The topics and discussions are planned, produced, and reviewed independently of advertiser. This podcast is intended only for US healthcare professionals.

Resources

The Prevalence of MS in the United States https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6442006/pdf/NEUROLOGY2018886077.pdf

Discontinuation of Disease Modifying Therapies (DMTs) in Multiple Sclerosis (MS) (DISCOMS) https://clinicaltrials.gov/ct2/show/NCT03073603

Stopping Disease-Modifying Therapy in Relapsing and Progressive Multiple Sclerosis https://journals.lww.com/co-neurology/Abstract/2021/08000/Stopping_disease_modifying_therapy_in_relapsing.18.aspx

Discontinuation of Disease-Modifying Therapies (DMTs) in Multiple Sclerosis (MS): Extension of the DISCOMS Study https://www.ninds.nih.gov/health-information/clinical-trials/discontinuation-disease-modifying-therapies-dmts-multiple-sclerosis-ms-extension-discoms-study

North American Registry for Care and Research in Multiple Sclerosis (NARCRMS) https://www.narcrms.org/

How MS Disability Is Measured https://www.webmd.com/multiple-sclerosis/disability-measured

Treatment Switching and Discontinuation Over 20 Years in the Big Multiple Sclerosis Data Network https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8010264/pdf/fneur-12-647811.pdf

Natalizumab Discontinuation in a Dutch Real-world Cohort https://www.sciencedirect.com/science/article/abs/pii/S2211034821002418

Factors Associated With Fingolimod Rebound: A Single Center Real-life Experience https://www.sciencedirect.com/science/article/abs/pii/S2211034821005459

Serious Safety Events in Rituximab-Treated Multiple Sclerosis and Related Disorders https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7480911/

Agoraphobia, online yoga, pregnancy, and vaccines are all on the table as Drs Anne Cross and Scott Newsome discuss the COVID-19 pandemic and how it affects their patients with MS.

Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/977031). The topics and discussions are planned, produced, and reviewed independently of advertiser. This podcast is intended only for US healthcare professionals.

Resources

Coronavirus Disease 2019 (COVID-19) https://emedicine.medscape.com/article/2500114-overview

Multiple Sclerosis https://emedicine.medscape.com/article/1146199-overview

COViMS Registry https://www.covims.org/

An Italian Programme for COVID-19 Infection in Multiple Sclerosis https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7191287/

Paxlovid Emergency Use Authorization https://labeling.pfizer.com/ShowLabeling.aspx?id=16474

Bebtelovimab Fact Sheet for Healthcare Providers https://www.fda.gov/media/156152/download

Remdesivir Prescribing Information https://www.gilead.com/-/media/files/pdfs/medicines/covid-19/veklury/veklury_pi.pdf

Evusheld Fact Sheet for Healthcare Providers https://www.fda.gov/media/154701/download

New Diagnosis of Multiple Sclerosis in the Setting of mRNA COVID-19 Vaccine Exposure https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8656147/

COVID-19 in Patients With Neuromyelitis Optica Spectrum Disorders and Myelin Oligodendrocyte Glycoprotein Antibody Disease in North America: From the COViMS Registry https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8407145/

Neuro-Ophthalmologic Manifestations of Multiple Sclerosis https://emedicine.medscape.com/article/1214270-overview

Drs Anne Cross and Lauren Krupp talk about the latest research and their real-life experience identifying and treating cognitive dysfunction in patients with MS in the busy clinic setting.

Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/977030). The topics and discussions are planned, produced, and reviewed independently of advertiser. This podcast is intended only for US healthcare professionals.

Resources

Multiple Sclerosis https://emedicine.medscape.com/article/1146199-overview

A Preliminary Validation of the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) Tool in an Irish Population With Multiple Sclerosis (MS) https://www.msard-journal.com/article/S2211-0348(15)00111-X/fulltext

Digital Cognitive Testing Uncovers Hidden Impairment in MS https://www.medscape.com/viewarticle/892482

MIND Diet Adherence Might Be Associated With a Reduced Odds of Multiple Sclerosis: Results From a Case-Control Study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8857348/

Pediatric Multiple Sclerosis: Cognition and Mood https://n.neurology.org/content/87/9_Supplement_2/S82.long

Experimental Autoimmune Encephalomyelitis (EAE) as a Model for Multiple Sclerosis (MS) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3229753/

Cognitive Dysfunction in Early-Onset Multiple Sclerosis https://jamanetwork.com/journals/jamaneurology/fullarticle/780539