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Multiple Sclerosis View Time: 35 mins

touchEXPERT BRIEFING Multiple sclerosis today: Disease monitoring, biomarkers and family planning

Two experts discuss the role of biomarkers in MS, and the impact of MS on women of childbearing potential

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Expert Interviews
The role of biomarkers in the diagnosis, prognosis and management of MS

In this interactive discussion, Prof. Dr Eva Kubala Havrdová and Prof. Ludwig Kappos talk about the increasingly important role of biomarkers in the monitoring and management of MS, and how they would employ them in clinical practice.

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During this interactive discussion, Prof. Eva Kubala Havrdová asked Prof. Ludwig Kappos the following questions:

  • Considering the developments in MS therapies over recent years, what tools do we have to help make optimal treatment decisions?
  • What are the key MRI disease activity and progression markers?
  • Do you agree that inflammation and neurodegeneration are interconnected in MS?
  • Is the assessment of MRI lesions sufficient to assess disease activity and/or treatment efficacy?
  • What biomarkers beyond MRI would you recommend in clinical practice?
  • Would you consider neurofilament light chains a marker for inflammation, neurodegeneration, or both?
 
The impact of MS on women of childbearing potential

In this interactive discussion, Prof. Eva Kubala Havrdová and Prof. Ludwig Kappos talk about the key considerations for women with MS who may want to have children, the impact of the disease and treatments, and how healthcare practitioners can best guide and support them along this journey.

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During this interactive discussion, Prof. Ludwig Kappos asked Prof. Dr Eva Kubala Havrdová the following questions:

  • Should we stop/change MS treatments in women who want to have children, and what are the specific considerations? [case example: a 25-yr old woman who was diagnosed with MS 4 years ago and is currently receiving immunomodulatory treatment]
  • How would you assess disease activity, and what measures would you recommend before pregnancy?
  • What would be your considerations for a patient who wants to have children, but does not want to change their current treatment?
  • What would you normally recommend in the weeks following pregnancy and during breastfeeding?
  • What would you recommend for a woman with MS regarding fertility programs?
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Learning Objectives & Overview
Overview

With the availability of disease-modifying therapies in MS, achieving an early diagnosis and identifying optimal personalized treatment is essential to improving long term outcomes,1 and treatment goals have shifted from delaying disability to achieving ‘no evidence of disease activity’. While many measures involve clinical factors (relapses, gadolinium-enhancing lesions), biomarkers of disease activity could also be used to closely monitor disease progression and therapeutic efficacy.1 Also, as MS is most commonly diagnosed in young women, it is important that family planning and pregnancy are considered when starting any disease-modifying treatments.2,3 

In these two videos, experts in the field of MS will discuss these key topics, their personal experiences, and how best to achieve optimal patient outcomes in real-world practice.

Learning Objectives

After watching this activity, participants should be better able to:

  • Describe the importance of biomarkers in the diagnosis, prognosis and management of MS
  • Understand how biomarkers may be used to optimize treatment decisions and improve patient outcomes
  • Discuss key considerations for the management of MS in women of childbearing potential
Faculty & Disclosures
Prof. Dr Eva Kubala Havrdová

General University Hospital, Charles University, Prague, Czech Republic

Advisory Boards: Actelion, Biogen, Celgene, Genzyme, Novartis
Consultancy: Actelion, Biogen, Celgene, Genzyme, Merck Serono, Novartis
Travel or speaker honoraria: Actelion, Biogen, Celgene, Genzyme, Merck Serono, Novartis, Roche

 

Prof. Ludwig Kappos

University Hospital and University of Basel, Basel, Switzerland

Steering Committee, Advisory Board, Consultancy and/or support for educational activities: Allergan, Almirall, Baxalta, Bayer Healthcare, Biogen, Celgene/Receptos, CSL-Behring, Desitin, Excemed, Eisai, Genzyme, Japan Tobacco, Merck, Minoryx, Novartis, Pfizer, F. Hoffmann–La Roche Ltd, Roche, Sanofi Aventis, Santhera, Teva

References
References
  1. Smith AL, Cohen, JA, Hua, LH. Therapeutic Targets for Multiple Sclerosis: Current Treatment Goals and Future Directions. Neurotherapeutics. 2017; 14: 952–960.
  2. Dobson R, Dassan P, Roberts M, et al. UK consensus on pregnancy in multiple sclerosis: ‘Association of British Neurologists’ guidelines. Pract Neurol. 2019;19:106–114.
  3. Krysko KM, Bove R, Dobson R, et al. Treatment of women with multiple sclerosis planning pregnancy. Curr Treat options Neurol. 2021;23:11.
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