Could NfL and GFAP redefine how clinicians track progression in MS? Dr Mark Freedman joins Dr Anne Cross to explain the evolving science behind these powerful biomarkers.

Relevant disclosures can be found with the episode show notes on Medscape https://www.medscape.com/viewarticle/1002608. 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

Fluid Biomarkers in Multiple Sclerosis: From Current to Future Applications https://pubmed.ncbi.nlm.nih.gov/39444698/

National Hospital for Neurology and Neurosurgery https://www.uclh.nhs.uk/our-services/our-hospitals/national-hospital-neurology-and-neurosurgery

Neurofilament Biophysics: From Structure to Biomechanics https://pubmed.ncbi.nlm.nih.gov/38598299/

Glymphatic System: An Emerging Therapeutic Approach for Neurological Disorders https://pubmed.ncbi.nlm.nih.gov/37485040/

Axonal Transection in the Lesions of Multiple Sclerosis https://pubmed.ncbi.nlm.nih.gov/9445407/

The Combination of CSF Neurofilament Light Chain and Glial Fibrillary Acidic Protein Improves the Prediction of Long-Term Confirmed Disability Worsening in Multiple Sclerosis https://pubmed.ncbi.nlm.nih.gov/39587121/

Amit Bar-Or, MD https://www.med.upenn.edu/apps/faculty/index.php/g324/p8937426

Anxiety, Depression, and Expanded Disability Status Scale Independently Predict the Perception of Disability in Persons With Multiple Sclerosis: A Cross-Sectional Study https://pubmed.ncbi.nlm.nih.gov/39839740/

Diagnosis of Multiple Sclerosis: 2024 Revisions of the McDonald Criteria https://pubmed.ncbi.nlm.nih.gov/40975101/

Radiologically Isolated Syndrome: A 6-Year Follow-Up Study in Chile https://pubmed.ncbi.nlm.nih.gov/40120160/

Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease: Current Insights Into the Disease Pathophysiology, Diagnosis and Management https://pubmed.ncbi.nlm.nih.gov/33374173/

How can imaging biomarkers enhance our understanding of MS? Dr Anne Cross and Dr Matthew Brier examine MRI advancements that provide new insights into diagnosis, progression, and treatment.

Relevant disclosures can be found with the episode show notes on Medscape https://www.medscape.com/viewarticle/1002607. 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

Emerging MRI Biomarkers for the Diagnosis of Multiple Sclerosis https://pubmed.ncbi.nlm.nih.gov/39511991/

Diagnostic Performance of Cortical Lesions and the Central Vein Sign in Multiple Sclerosis https://pubmed.ncbi.nlm.nih.gov/38079177/

Biomarkers for Diagnosis and Prognosis of Myelin Oligodendrocyte Glycoprotein Antibody–Associated Disease: Review Article https://pubmed.ncbi.nlm.nih.gov/40547008/

Update on Neuromyelitis Optica Spectrum Disorder https://pmc.ncbi.nlm.nih.gov/articles/PMC7771018/

Sjogren Syndrome https://emedicine.medscape.com/article/332125-overview

Detection of Multiple Sclerosis Lesions by Susceptibility-Weighted Imaging: A Systematic Review and Meta-Analyses https://pubmed.ncbi.nlm.nih.gov/39406601/

The Central Vein Sign on T2*-Weighted Images as a Diagnostic Tool in Multiple Sclerosis: A Systematic Review and Meta-Analysis Using Individual Patient Data https://pubmed.ncbi.nlm.nih.gov/31796822/

Paramagnetic Rim Lesions Are Highly Specific for Multiple Sclerosis in Real-World Data https://pubmed.ncbi.nlm.nih.gov/39371137/

Gadolinium and Multiple Sclerosis: Vessels, Barriers of the Brain, and Glymphatics https://pubmed.ncbi.nlm.nih.gov/30385472/

Slowly Expanding Lesions Are Associated With Disease Activity and Gray Matter Loss in Relapse-Onset Multiple Sclerosis https://pubmed.ncbi.nlm.nih.gov/39390692/

TSPO PET in Multiple Sclerosis: Emerging Insights Into Pathophysiology, Prognosis, and Treatment Monitoring https://pubmed.ncbi.nlm.nih.gov/40450829/

An Update on the Use of Sphingosine 1-Phosphate Receptor Modulators for the Treatment of Relapsing Multiple Sclerosis https://pubmed.ncbi.nlm.nih.gov/36946625/

Drs Anne Cross and Scott Newsome discuss new horizons in MS treatment strategies, including the TREAT-MS trial and shared decision-making for optimal patient care.

Relevant disclosures can be found with the episode show notes on Medscape https://www.medscape.com/viewarticle/1002606. 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

Interferon Beta and Glatiramer Acetate Therapy https://pubmed.ncbi.nlm.nih.gov/23264098/

Traditional Versus Early Aggressive Therapy for Multiple Sclerosis Trial (TREAT-MS) https://www.clinicaltrials.gov/study/NCT03500328

Initiation Patterns of Disease-Modifying Therapies for Multiple Sclerosis Among US Adults and Children, 2001 Through 2020 https://pubmed.ncbi.nlm.nih.gov/37428482/

What We Learned From the History of Multiple Sclerosis Measurement: Expanded Disability Status Scale https://pubmed.ncbi.nlm.nih.gov/30692861/

The Multiple Sclerosis Functional Composite Measure (MSFC): An Integrated Approach to MS Clinical Outcome Assessment. National MS Society Clinical Outcomes Assessment Task Force https://pubmed.ncbi.nlm.nih.gov/10467383/

Long-term Efficacy and Safety of Alemtuzumab in Participants With Highly Active MS: TOPAZ Clinical Trial and Interim Analysis of TREAT-MS Real-World Study https://pubmed.ncbi.nlm.nih.gov/39935588/

Imaging Outcome Measures for Progressive Multiple Sclerosis Trials https://pubmed.ncbi.nlm.nih.gov/29041865/

Current Use of Fluid Biomarkers as Outcome Measures in Multiple Sclerosis (MS): A Review of Ongoing Pharmacological Clinical Trials https://pubmed.ncbi.nlm.nih.gov/38117403/

Patient-reported Disability Progression Outcomes Among Patients With Multiple Sclerosis: Results of an Outcomes-Based Agreement https://pubmed.ncbi.nlm.nih.gov/39471272/

Insights for Healthcare Providers on Shared Decision-making in Multiple Sclerosis: A Narrative Review https://pubmed.ncbi.nlm.nih.gov/38180727/

Practice Guideline Update Summary: Vaccine-Preventable Infections and Immunization in Multiple Sclerosis: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology https://pubmed.ncbi.nlm.nih.gov/31462584/

Can BTK inhibitors finally move the needle in progressive MS? Dr Robert Fox joins Dr Anne Cross to unpack the results of the HERCULES trial and explore what's next.

Relevant disclosures can be found with the episode show notes on Medscape https://www.medscape.com/viewarticle/1002605. The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

Tolebrutinib in Nonrelapsing Secondary Progressive Multiple Sclerosis https://pubmed.ncbi.nlm.nih.gov/40202696/

Bruton Tyrosine Kinase Inhibitors in Multiple Sclerosis: Evidence and Expectations https://pubmed.ncbi.nlm.nih.gov/38533819/

Safety and Efficacy of Tolebrutinib, an Oral Brain-Penetrant BTK Inhibitor, in Relapsing Multiple Sclerosis: A Phase 2b, Randomised, Double-Blind, Placebo-Controlled Trial https://pubmed.ncbi.nlm.nih.gov/34418400/

Long Term Safety and Efficacy Study of Tolebrutinib (SAR442168) in Participants With Relapsing Multiple Sclerosis https://clinicaltrials.gov/study/NCT03996291

Tolebrutinib versus Teriflunomide in Relapsing Multiple Sclerosis https://pubmed.ncbi.nlm.nih.gov/40202623/

Primary Progressive Multiple Sclerosis (PPMS) Study of Bruton's Tyrosine Kinase (BTK) Inhibitor Tolebrutinib (SAR442168) (PERSEUS) (PERSEUS) https://clinicaltrials.gov/study/NCT04458051

Fenebrutinib, a Bruton's Tyrosine Kinase Inhibitor, Blocks Distinct Human Microglial Signaling Pathways https://pubmed.ncbi.nlm.nih.gov/39465429/

Rilzabrutinib, a Reversible Covalent Bruton's Tyrosine Kinase Inhibitor: Absorption, Metabolism, Excretion, and Absolute Bioavailability in Healthy Participants https://pubmed.ncbi.nlm.nih.gov/37060187/

Orelabrutinib: First Approval https://pubmed.ncbi.nlm.nih.gov/33704654/

Temporal Relationship Between Serum Neurofilament Light Chain and Radiologic Disease Activity in Patients With Multiple Sclerosis https://pubmed.ncbi.nlm.nih.gov/38648580/

Phase 2 Trial of Ibudilast in Progressive Multiple Sclerosis https://pubmed.ncbi.nlm.nih.gov/30157388/

Join Drs Anne Cross and Rob Motl as they discuss how new data and clinical insights are reshaping how exercise helps people with MS.

Relevant disclosures can be found with the episode show notes on Medscape https://www.medscape.com/viewarticle/1002604. The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

Intrathecal Baclofen for Multiple Sclerosis–Related Spasticity: A Twenty-Year Experience https://pubmed.ncbi.nlm.nih.gov/30366276/

Prevalence of Depression and Anxiety in Multiple Sclerosis: A Systematic Review and Meta-Analysis https://pubmed.ncbi.nlm.nih.gov/28017241/

Study Protocol: Exercise Training for Treating Major Depressive Disorder in Multiple Sclerosis https://pubmed.ncbi.nlm.nih.gov/38632556/

CDMRP Multiple Sclerosis https://cdmrp.health.mil/msrp/default

Effect of Exercise on Depressive Symptoms in Adults With Neurologic Disorders: A Systematic Review and Meta-Analysis https://pubmed.ncbi.nlm.nih.gov/25596001/

National MS Society Exercising With MS https://www.nationalmssociety.org/managing-ms/living-with-ms/diet-exercise-and-healthy-behaviors/exercise

Moderators of Exercise Effects on Depressive Symptoms in Multiple Sclerosis: A Meta-regression https://pubmed.ncbi.nlm.nih.gov/28602542/

Physical Activity, Fitness, and Gray Matter Volume https://pubmed.ncbi.nlm.nih.gov/24952993/

Exercise-Mediated Neurogenesis in the Hippocampus via BDNF https://pubmed.ncbi.nlm.nih.gov/29467613/

Integrative CNS Plasticity With Exercise in MS: The PRIMERS (PRocessing, Integration of Multisensory Exercise-Related Stimuli) Conceptual Framework https://pubmed.ncbi.nlm.nih.gov/30205784/

Effects of Physical Exercise on Plasma Brain-Derived Neurotrophic Factor in Neurodegenerative Disorders: A Systematic Review and Meta-Analysis of Randomized Controlled Trials https://pubmed.ncbi.nlm.nih.gov/34087277/

Multimodal Enhancement of Remyelination by Exercise With a Pivotal Role for Oligodendroglial PGC1α https://pubmed.ncbi.nlm.nih.gov/30232000/

Cognitive Rehabilitation and Aerobic Exercise for Cognitive Impairment in People With Progressive Multiple Sclerosis (CogEx): A Randomised, Blinded, Sham-Controlled Trial https://pubmed.ncbi.nlm.nih.gov/37739574/

Join Drs Anne Cross and Riley Bove as they discuss menopause in multiple sclerosis, including overlapping symptoms, hormone therapy, and why this transition shouldn't catch anyone off guard.

Relevant disclosures can be found with the episode show notes on Medscape https://www.medscape.com/viewarticle/1002583. The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

Hormonal Therapies in Multiple Sclerosis: A Review of Clinical Data https://pubmed.ncbi.nlm.nih.gov/38102502/

The 2022 Hormone Therapy Position Statement of The North American Menopause Society https://pubmed.ncbi.nlm.nih.gov/35797481/

Age-Specific Effects of Hormone Therapy Use on Overall Mortality and Ischemic Heart Disease Mortality Among Women in the California Teachers Study https://pubmed.ncbi.nlm.nih.gov/20881652/

Efficacy and Safety of Fezolinetant in Moderate to Severe Vasomotor Symptoms Associated With Menopause: A Phase 3 RCT https://pubmed.ncbi.nlm.nih.gov/36734148/

Risks and Benefits of Estrogen Plus Progestin in Healthy Postmenopausal Women: Principal Results From the Women's Health Initiative Randomized Controlled Trial https://pubmed.ncbi.nlm.nih.gov/12117397/

Effects of Menopause in Women With Multiple Sclerosis: An Evidence-Based Review https://pubmed.ncbi.nlm.nih.gov/33815241/

Uhthoff's Phenomenon in Multiple Sclerosis and Neuromyelitis Optica https://pubmed.ncbi.nlm.nih.gov/25195501/

Molecular Basis of Klotho: From Gene to Function in Aging https://pubmed.ncbi.nlm.nih.gov/25695404/

Re-WRAP (Remyelination for Women at Risk of Axonal Loss and Progression): A Phase II Randomized Placebo-Controlled Delayed-Start Trial of Bazedoxifene for Myelin Repair in Multiple Sclerosis https://pubmed.ncbi.nlm.nih.gov/37739167/

Clemastine Fumarate as a Remyelinating Therapy for Multiple Sclerosis (ReBUILD): A Randomised, Controlled, Double-Blind, Crossover Trial https://pubmed.ncbi.nlm.nih.gov/29029896/

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/