Continuum Postreading Test 28(4) August 2022 (Multiple Sclerosis and Related Disorders)

Contributors^a

Myla D. Goldman, MD, MSc, FAAN, Guest Editor
Professor of Neurology, Division Chair of Neuroimmunology, Vice-Chair of Faculty Development, VCU Health, Department of Neurology, Richmond, Virginia

Relationship Disclosure: Dr Goldman has received personal compensation in the range of $500 to $4999 for serving as a consultant for Greenwich Biosciences, Inc, Merck & Co, Inc, and Novartis AG and as a data safety monitoring board member for BrainStorm Cell Limited; has received personal compensation in the range of $5000 to $9999 for serving as a consultant for Biogen, EMD Serono, Genentec, Inc, Immunic Therapeutics, and Sanofi; and has received personal compensation in the range of $10,000 to $49,999 for serving as a consultant for Adamas Pharmaceuticals, Inc.
Unlabeled Use of Products/Investigational Use Disclosure: Dr Goldman discusses the unlabeled/investigational use of rituximab, Bruton tyrosine kinase inhibitors, and vitamin D supplementation for the treatment of multiple sclerosis.

Laura Adang, MD, PhD, MSTR
Assistant Professor of Child Neurology, Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, PennsylvaniaRelationship Disclosure: Dr Adang has received personal compensation in the range of $500 to $4999 for serving on a speakers bureau for Middle East Genetics & Metabolic Academy and as a consultant for Takeda Pharmaceutical Company Limited.

Unlabeled Use of Products/Investigational Use Disclosure: Dr Adang discusses the unlabeled use of gene therapy for the treatment of metachromatic leukodystrophy and therapies for the treatment of leukodystrophies in children; these include chenodeoxycholic acid, guanabenz, human immunodeficiency virus (HIV) reverse transcriptase inhibitors, Janus kinase inhibitors, Lorenzo’s oil, N-acetyl cysteine, and 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitor therapy. Several ongoing clinical trials are also discussed, including gene therapy trials, enzyme replacement therapy, and small interfering RNA therapies.

Lilyana Amezcua, MD, MS, FAAN
Associate Professor of Neurology, University of Southern California, Keck School of Medicine, Los Angeles, California

Relationship Disclosure: Dr Amezcua has received personal compensation in the range of $5000 to $9999 for serving as a consultant for Biogen and Novartis AG and in the range of $10,000 to $49,999 for serving as a consultant for Genentech, Inc, and EMD Serono. The institution of Dr Amezcua has received research support from Bristol- Myers Squibb Company, Genentech, Inc, MedDay Pharmaceuticals, the National Institutes of Health National Institute of Neurological Disorders and Stroke, and the National Multiple Sclerosis Society.

Unlabeled Use of Products/Investigational Use Disclosure: Dr Amezcua reports no disclosure.

J. Nicholas Brenton, MD
Associate Professor of Neurology and Pediatrics; Director, Pediatric Multiple Sclerosis and Related Disorders Clinic, University of Virginia, Charlottesville, Virginia

Relationship Disclosure: Dr Brenton has received personal compensation in the range of $500 to $4999 for serving as a grant reviewer with the Department of Defense and for providing an expert interview with MDedge. The institution of Dr Brenton has received research support from the Integrated Translational Health Research Institute of Virginia (iTHRIV) and the National Institute of Health/National Institute of Neurological Disorders and Stroke (1K23NS116225).

Unlabeled Use of Products/Investigational Use Disclosure: Dr Brenton discusses the unlabeled/investigational use of therapeutic options for children with demyelinating disorders; these include azathioprine, cyclophosphamide, dimethyl fumarate, eculizumab, interferon beta, glatiramer acetate, IV immunoglobulin G, mycophenolate, natalizumab, rituximab/ocrelizumab, teriflunomide, and tocilizumab.

Fiona Costello, MD, FRCPC
Professor, Departments of Clinical Neurosciences and Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada

Relationship Disclosure: Dr Costello has received personal compensation in the range of $500 to $4999 for serving as a consultant for Alexion Pharmaceuticals, Inc, and F. Hoffmann-La Roche Ltd and for serving on a speakers bureau for Accure Therapeutics, Alexion Pharmaceuticals, Inc, Novartis AG, and The Sumaira Foundation.

Unlabeled Use of Products/Investigational Use Disclosure: Dr Costello discusses the unlabeled/investigational use of numerous immunosuppressive agents including azathioprine, cyclophosphamide, IV immunoglobulin G, methotrexate, mitoxantrone, mycophenolate mofetil, rituximab, and tocilizumab for the treatment of neuromyelitis optica spectrum disorders.

Anne Cross, MD, FAAN
Professor of Neurology and the Manny and Rosalyn Rosenthal-Dr. John L. Trotter MS Center Endowed Chair in Neuroimmunology of Barnes-Jewish Hospital Foundation; Section Head of Neuroimmunology, Washington University School of Medicine, Saint Louis, Missouri

Relationship Disclosure: Dr Cross has received personal compensation in the range of $500 to $4999 for serving as a consultant for Biogen, EMD Serono, Janssen Global Services, LLC, and TG Therapeutics, Inc and in the range of $5000 to $9999 for serving as a consultant for Genentech, Inc, Horizon Therapeutics plc, Jazz Pharmaceuticals, Inc, and Novartis AG; for serving on the scientific advisory board for EMD Serono, Novartis AG, and Race to Erase MS; and for serving as the Secretary of Board of Governors for The Consortium of Multiple Sclerosis Centers. Dr Cross has received intellectual property interests from a discovery or technology relating to health care, and the institution of Dr Cross has received research support from and F. Hoffman-La Roche Ltd, and Genentech, Inc

Unlabeled Use of Products/Investigational Use Disclosure: Dr Cross reports no disclosure.

Erin Longbrake, MD, PhD, FAAN
Assistant Professor of Neurology, Yale University, New Haven, Connecticut

Relationship Disclosure: Dr Longbrake has served on the editorial board for Neurology: Neuroimmunology and Neuroinflammation and Journal of Neuroimmunology and has received personal compensation in the range of $0 to $499 for serving as the scientific advisory board chair and as a steering committee member for Genentech, Inc, and in the range of $500 to $4999 for serving as an advisory board member for Genentech, Inc, Janssen Global Services, LLC, and TG Therapeutics, Inc; for serving as an assistant associate editor for Annals of Neurology; and for serving as a study section member with the Department of Defense (Congressionally Directed Medical Research Programs). The institution of Dr Longbrake has received research support from Genentech, Inc, the National Institute of Neurological Disorders and Stroke (K23107624 and UL1 TR001863), Race to Erase MS, and the and Robert E. Leet and Clara Guthrie Patterson Trust.

Unlabeled Use of Products/Investigational Use Disclosure: Dr Longbrake discusses the unlabeled/investigational use of immunomodulators, none of which is approved for the treatment of myelin oligodendrocyte glycoprotein–associated disorders.

Jiwon Oh, MD, PhD, FRCPC
Associate Professor of Medicine (Neurology), University of Toronto; Medical Director, Barlo MS Centre at St. Michael’s Hospital, Toronto, Ontario, Canada

Relationship Disclosure: Dr Oh has received personal compensation in the range of $500 to $4999 for serving as a consultant for Biogen, Bristol-Myers Squibb Company, and Novartis AG and in the range of $5000 to $9999 for serving as a consultant for EMD Serono, F. Hoffmann-La Roche Ltd, and Sanofi. The institution of Dr Oh has received research support from Biogen, EMD Serono, and F. Hoffman-La Roche Ltd.

Unlabeled Use of Products/Investigational Use Disclosure: Dr Oh reports no disclosure.

Claire Riley, MD
Karen L. K. Miller Assistant Professor of Neurology, Columbia University Irving Medical Center; Medical Director, Columbia Multiple Sclerosis Center, New York, New York

Relationship Disclosure: Dr Riley has received personal compensation in the range of $500 to $4999 for serving on an advisory board for Janssen Global Services, LLS; in the range of $5000 to $9999 for serving as a consultant for Novartis AG and for serving on an advisory board for Biogen, EMD Serono, Genentech, Inc, and Novartis AG; and in the range of $10,000 to $49,999 for serving on a relapse adjudication panel for TG Therapeutics, Inc.

Unlabeled Use of Products/Investigational Use Disclosure: Dr Riley reports no disclosure.

Rebecca Spain, MD, MSPH, FAAN
Associate Professor of Neurology, Oregon Health & Science University; Director, Multiple Sclerosis Regional Program, VA Portland Health Care System, Portland, Oregon

Relationship Disclosure: Dr Spain has received personal compensation in the range of $500 to $4999 for serving as a consultant for Gerson Lehrman Group, Inc. The institution of Dr Spain has received research support from the Department of Veterans Affairs, the MS Society of Canada, and The National Multiple Sclerosis Society.

Unlabeled Use of Products/Investigational Use Disclosure: Dr Spain discusses the unlabeled use of acetazolamide, lacosamide, and oxcarbazepine for the treatment of trigeminal neuralgia/tonic spasms; amantadine, dalfampridine, methylphenidate, and modafinil for the treatment of fatigue; baclofen, clonazepam, clonidine, gabapentin, and memantine for the treatment of eye movement abnormalities; clonidine and gabapentin for the treatment of muscle spasticity; dalfampridine for the treatment of finger dexterity, cognitive function, depression, and imbalance; lamotrigine for the treatment of neuropathic pain; onabotulinumtoxinA for the treatment of trigeminal neuralgia; selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors (SNRIs), and tricyclic antidepressants for the treatment of pseudobulbar affect; and vitamin D for the treatment and prevention of multiple sclerosis. Dr Spain discusses investigational uses of acupuncture, aquatic exercise, cannabis and cannabinoids, and mindfulness for the treatment of multiple sclerosis.

Melanie Ward, MD
Assistant Professor, Department of Neurology, West Virginia University Rockefeller Neuroscience Institute, Morgantown, West Virginia

Relationship Disclosure: Dr Ward has received personal compensation in the range of $500 to $4999 for serving as a consultant for Bristol-Myers Squibb Company, Celgene Corporation, EMD Serono, Inc, Genentech, Inc, and Novartis AG. The institution of Dr Ward has received research support from Genentech, Inc.

Unlabeled Use of Products/Investigational Use Disclosure: Dr Ward discusses the unlabeled/investigational use of rituximab, Bruton tyrosine kinase inhibitors, and vitamin D supplementation for the treatment of multiple sclerosis.

Self-Assessment and CME Test Writers

Adam G. Kelly, MD, FAAN
Associate Professor of Neurology; Director of Teleneurology and Regional Neurology, University of Rochester, Rochester, New York

Relationship Disclosure: Dr Kelly has received personal compensation in the range of $500 to $4999 for serving as a consultant for Included Health, Inc, and a CME question writer for the American Academy of Neurology and in the range of $5000 to $9999 for serving as a CME editor for the American Academy of Neurology.

Unlabeled Use of Products/Investigational Use Disclosure: Dr Kelly reports no disclosure.

Allison L. Weathers, MD, FAAN
Associate Chief Medical Information Officer, Cleveland Clinic; Assistant Professor, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio

Relationship Disclosure: Dr Weathers has a noncompensated relationship as chair of the adult neurosciences specialty steering board for Epic and as co-chair of the neurology leadership council for Cerner Corporation and has received personal compensation in the range of $0 to $499 for serving as a consultant for Dent Neurologic Institute and in the range of $500 to $4999 for serving as an associate editor and as a CME question writer and presenter with the American Academy of Neurology.

Unlabeled Use of Products/Investigational Use Disclosure: Dr Weathers reports no disclosure.

^AAll relevant financial relationships have been mitigated.

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