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
Multiple Sclerosis Section Heads: Halina Bartosik-Psujek, Poland, Ralf Linker, Germany & Olaf Stuve, USA
FRIDAY, MARCH 23, 2018
Hall A
08:00-08:45 Meet the Expert Sessions
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
Chairs: Jerzy Kotowicz, Poland & Larysa Sokolova, Ukraine
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 Cerqueira, 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 disability is the biggest problem 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 sessions
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 mitoxantrone?
15:05-15:15 Host: Ralf Linker, Germany
15:15-15:30 Pro: Jacek Losy, Poland
15:30 -15:45 Con: Thomas Mueller, Germany
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 critical pathogenic events in MS. The adaptive immune system generates memory, both within the B cell and the T cell compartments. Only the elimination of 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
Chairs: Nikolaos Grigoriadis, Greence & Anastasios Orologas, Greece
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: Dimitrios Karussis, Israel
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: Melchor Rodrigo, Argentina & Diego Santos Garcia, Spain
Should we consider immune reconstitution for patients with active MS?
Capsule: Immune treatment of MS is still fully effective and better approaches for managing patients are needed. 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. Which therapies actually offer the option of immune reconstitution in MS? Which patients should we offer the option of this therapy?
13:55-14:05 Host: Jacek Losy, Poland
14:05-14:20 Pro: Dimitrios Karussis, Israel
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 MS treatment are established for younger patients. Is the treatment of elderly patients enough safe and effective,considering age-related changes in renal and hepatic functions 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
16:15-17:00 NEW PLAYERS ON THE BLOCK (Not for CME)
16:15-16:30 CIDP - Subcutaneous Ig after IVIG treatment: The PATH trial
Konrad Rejdak, Poland
16:30-16:45 A novel, safer and effective way for immune reconstitution in MS - cladribine tablets
Dimitrios Karussis, Israel
16:45-17:00 Citicoline as potential neuroprotective compound in neurological diseases
Konrad Rejdak, Poland
Chair: Marcin Mycko, Poland & Jorge Villacura, Chile
17:00-18:00 NMO immunosuppression should be withheld in pregnant patients.
Capsule: Immunosuppression is always a problem in pregnant women. This is the standard treatment for NMO but no data esists to its realative benefits in NMO during pregnancy. Should it be avoided in order to protect the baby, and thus risking the pregnant mother?
17:00-17:10 Host: Halina Bartosik-Psujek, Poland
17:10-17:30 Pro: Friedemann Paul, Germany
17:30-17:50 Con: Brian Weinshenker, USA
17:50-18:00 Discussion and Rebuttals
18:00-19:00 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?
18:00-18:10 Host: David Leppert, Switzerland
18:10-18:30 Pro: Jens Kuhle, Switzerland
18:30-18:50 Con: Georgina Arrambide, Spain
18:50-19:00 Discussion and Rebuttals
11:00-11:45 Meet the Expert sessions