Scientific Program - Multiple Sclerosis

Please see below the CONy Scientific Program. Please click on the appropriate section (ordered by ABC) to view the relevant program. Please note that the program and timing is subject to change. To view the program timetable, please click here
Section Heads: Halina Bartosik-Psujek, Poland, Ralf Linker, Germany & Olaf Stuve, USA
FRIDAY, MARCH 23, 2018
Hall A
08:00-08:45 Meet the Experts Session - (in UB II)
08:00-08:45 Meet the Experts Session - (in Hazel)
  Chairs: Zbigniew Stelmasiak, Poland & Robert Lederman, Israel
MS is primarily an inflammatory disease with secondary neurodegeneration
There is overwhelming evidence to support an inflammatory component of the pathogenesis of MS. Also, all disease-modifying therapies are anti-inflammatory. However, axonal loss can also be detected in tissue of MS patients, and from the very early stages of the disease. There is an ongoing debate about the sequence of events: Is inflammation triggering neurodegeneration? Does neurodegeneration lead to a secondary inflammatory response?
Host: Joab Chapman, Israel
Pro: Heinz Wiendl, Germany
09:15-09:35 Con: Alicja Kalinowska, Poland
09:35-09:50 Discussion and Rebuttals
09:50-10:55 In patients with clinical evidence of MS-like disease and a confirmatory MRI, CSF examination can be avoided in most cases
The 2010 McDonald criteria were mainly based on clinical and magnetic resonance imaging (MRI) data. However, misinterpretation of non specific white matter abnormalities is the most common reason for misdiagnosis of MS. Therefore, the new 2017 McDonald criteria again include CSF examination. Which patients should have CSF examination? Does the absence of oligoclonal bands in CSF exclude the diagnosis of MS?
Host: Ralf Linker, Germany
Yes: Jacek Losy, Poland
10:20-10:40 Con: Uros Rot, Slovenia
Discussion and Rebuttals
Coffee Break
  Chair: Jerzy Kotowicz, Poland & Melchor Rodrigo, Argentina
Cognitive dysfunction is improved by disease modifying drugs (DMD)
Cognitive dysfunction is reported in up to 70% of MS patients.Insights into effects of DMD on cognition mainly stem from open-label studies. Thus, there is an ongoing debate whether DMD influence cognitive dysfunction. Should the occurrence or worsening of cognitive decline lead to a switch in DMD and which compound is best suited?
Host: Friedemann Paul, Germany
11:20-11:40 Pro: Alicja Kalinowska, Poland
11:40-12:00 Con: Joao Jose Araujo Cerqeuira, Spain
12:00-12:15 Discussion and Rebuttals
Progressive forms of MS respond to agents used for relapsing forms of the disease
Most DMD do not show efficacy in progressive MS (PMS), and progressing disability is the biggest platform in these patients. Only a few drugs are effective in the treatment of PMS and mainly in patients with superimposed relapses.
12:15-12:25 Host: David Leppert, Switzerland
12:25-12:45 Pro: Ron Milo, Israel
12:45-13:05 Con: Robert Zivadinov, USA
13:05-13:20 Discussion and Rebuttals
Plenary Industry Sponsored Symposium (Not for CME)
Lunch Break - Meet the Expert session (UB II)
  Chair: Robert Bonek, Poland & Elena Chorbadzhieva, Bulgaria
15:05-16:00 Second line therapies should be first line in patients with aggressive MS
In case of breakthrough MS on first line therapy, second-line therapy with natalizumab,fingolimod or alemtuzumab should be chosen based on benefit-risk stratification. These drugs are also used in highly active RR MS. Some data based on clinical trials ( including subgroup analysis) support this approach. But do we have enough evidence for that? What about alternative treatment with cladribine or motoxantrone?
15:05-15:15 Host: Patrick Vermersch, France
15:15-15:30 Pro: Jacek Losy, Poland
15:30 -15:45 Con: Xavier Montalban, Spain
15:45-16:00 Discussion and Rebuttals
16:00-16:55 Bone marrow transplantation the ultimate treatment in aggressive disease
Capsule: Aberrant adaptive immune responses are a critical pathogenic event in MS.. The adaptive immune system generates memory, both within the B cell and the T cell compartments. Only the elimination of miseducated B and T cells can lead to sustained disease remission. Autologous hematopoietic stem cell transplantation (aHSCT) is the most aggressive form of leukocyte depletion. Even if it offers the highest probability of eradicating autoreactive memory clones, do potential side effects of aHSCT limit its use?
16:00-16:10 Host: Krzystof Selmaj, Poland
16:10-16:25 Pro: Mark Freedman, Canada
16:25-16:40 Con: Brian Weinshenker, USA
16:40-16:55 Discussion and Rebuttals  
Coffee Break
  Chair: TBA
17:10-18:05 Should treatment be stopped in patients who had an apparently inactive diseases for 5 years?
Numerous DMD are approved for relapsing-remitting MS (RRMS). However, all these agents have potential severe side effects. In addition, the cost of MS medications is extremely high and rising. Also, most patients with RRMS will eventually convert to secondary-progressive MS (SPMS), which does not respond to many of these agents. Is it ethical and safe to test whether patients will be stable off therapy?
17:10-17:20 Host: David Leppert, Switzerland
17:20-17:35 Pro: Adam Czaplinski, Switzerland
17:35-17:50 Con: Hans-Peter Hartung, Germany
17:50-18:05 Discussion and Rebuttals
18:05-19:00 Is the switch from ethical to generic drugs safe and justified?
Capsule: Currently approved DMD are expensive. and difficult to afford for many patients. As some DMD are losing patent protection, generic versions of them and bio-similar drugs become available. Do generic agents and bio-similar drugs possess the same efficacy and safety as the originally approved agents? Should patients that are doing well on an original DMD be switched to new generic forms, which are cheaper?
18:05-18:15 Host: Xavier Montalban, Spain
18:15-18:30 Pro: Olaf Stuve, USA
18:30-18:45 Con: Ron Milo, Israel
18:45-19:00 Discussion and Rebuttals  
Hall C
  Chair: Diego Santos Garcia, Spain & Larysa Sokolova, Ukraine
Should we consider immune reconstitution for patients with more active MS?
 Capsule: Immune treatment of MS is still not fully effective and better approaches for managing patients are needed. An immune reconstitution therapy is given as a short course, i.e. intermittently and not continuously. It may offer the ability to induce long-term remission and even the possibility of a cure. Maintenance therapy may induce long-term remission, but will not result in a cure. Which therapies actually offer the option of immune reconstitution in MS? Which patients should we offer the option of immune reconstitution therapy? How do we mitigate the associated risks?
13:55-14:05 Host: Jacek Losy, Poland
14:05-14:20 Pro: Patrick Vermersch, France
14:20-14:35 Con: Cris Constaninescu, UK
14:35-14:55 Discussion and Rebuttals
14:55-15:55 Are MS therapies safe and effective in the elderly?
 Capsule: Elderly patients represent a growing minority among all patients with MS. The existing guidelines for the MS treatment are established for younger patients. Is the treatment of elderly patients enough safe and effective,considering frequent changes in renal and hepatic functions in this group and coexistence of co-morbidities?
14:55-15:05 Host: Jera Kruja, Albania
15:05-15:20 Pro: Bianca Weinstock-Guttman, USA
15:20-15:35 Con: Olaf Stuve, USA
15:35-15:55 Discussion and Rebuttals
Coffee Break
  Chair: Bernd Leplow, Denmark & Jorge Villacura, Colombia
16:15-16:30 New Players on the Block - CSL Behring:
CIDP - Subcutaneous IG after IVIG treatment: The PATH trial
Orell Mielke, Germany
16:30-16:45 New Players on the Block - Merck Israel:
A novel, safer and effective way for immune reconstitution in MS-cladribine tablets
Dimitrios Karusis, Israel
16:45-16:55 Targeting key signaling factors as a way to control microglial activation and induction of neuroinflammation: Bogna Badyra, Poland
16:55-17:05 Characteristics of multiple sclerosis relapses and factors affecting relapses frequency in patients with immunomodulatory therapy: Myroslav Bozhenko, Ukraine
17:05-17:15 Progressive multiple sclerosis patients have a higher burden of autonomic dysfunction compared to relapsing remitting phenotype: Luka Crnosija, Croatia
17:15-17:25 Hydrodynamic hypothesis as an attempt to explain the uhthof`s phenomenon mechanism: Piotr Nogal, Poland
17:25-18:10 Is the central vein sign (CVS) really helpful in differentiating MS from other white-matter diseases?
 Capsule: MRI is a pivotal tool for the early and accurate diagnosis of MS. Yet, the current MRI criteria still lack perfect speciality and sensitvity. Recently, the CVS has been proposed as a new MRI marker which may improve the accuracy and speed of diagnosing MS. However, the predictive value of the CVS for the development of clinical MS in patients at risk is still not clear.
17:25-17:35 Host: Mark Freedman, Canada
17:35-17:50 Pro: Robert Zivadinov, USA
17:50-18:05 Con: Cris Constanienscu, UK
18:05-18:10 Discussion and Rebuttals
18:10-19:00 The only certain measure of the effectiveness of MS therapy is serum neurofilament (NF) levels
 Capsule: Neurodegeneration is the pathology underlying permanent disability in MS, but identification of biomarkers reflecting neurodegenerative aspects of MS remains an unmet need. NF protein subunits are potential biomarkers for axonal injury. In particular, the NF light chains may reflect acute axonal damage and was shown to have prognostic value for conversion from clinically isolated syndrome to definite MS. Recent studies revealed serum NF levels to be altered upon immunomodulatory treatment. What is the predictive value of serum NF in MS? Is there added value of analyzing NF beyond MR imaging?
18:10-18:20 Host:  David Leppert, Switzerland
18:20-18:35 Pro: Jens Kuhle, Switzerland
18:35-18:50 Con: Georgina Arrambide, Spain
18:50-19:00 Discussion and Rebuttals