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Anthony Reder, MD
Professor, Department of Neurology
University of Chicago
Director, Clinical Trials
Director of Infusion Therapy
Chicago-Greater Illinois Chapter of the NMSS -- Clinical Advisory Committee
Chicago, Illinois

Barry Singer, MD
Director, The MS Center for Innovations in Care
Missouri Baptist Medical Center
Assistant Professor of Clinical Neurology
Washington University School of Medicine
St. Louis, Missouri


This educational activity is intended to educate neurologists, physiatrists, urologists, gastroenterologists, primary care physicians, and other healthcare professionals involved in the management of multiple sclerosis and related symptoms.


Multiple sclerosis (MS) affects between 250,000 to 350,000 people in the United States and approximately 2.5 million people worldwide. It is an unpredictable disease with symptoms that can range from fairly mild to somewhat disabling to devastating. Many researchers believe that MS is an autoimmune disease in which the body's immune system attacks its own tissues. In the case of MS, the myelin that insulates the body's nerves is attacked. Such attacks may be linked to an unknown environmental trigger, perhaps a virus.

Most people experience their first symptoms of MS between the ages of 20 and 40 years. The initial symptom of MS is often blurred or double vision, color distortion, or even blindness in one eye. Other symptoms can include tingling, numbness, muscle spasms, and bladder control problems. Many people with MS have muscle weakness in their legs and arms and difficulty with coordination and balance. These symptoms may be severe enough to affect walking or even standing. In the worst cases, MS can cause partial or complete paralysis. Some people may also experience pain. Speech problems, tremors, and dizziness are other frequent symptoms. In some cases, people with MS will have hearing loss.

Approximately half of all people with MS experience central nervous system (CNS) problems, such as difficulties with concentration, attention, memory, and poor judgment. But these symptoms are usually mild and are often overlooked. Depression is another common feature of MS.

Because of the many manifestations, MS can be difficult to diagnose in many cases. While some MS patients have more predictable cases, others are less predictable. MS may be diagnosed in some patients soon after the onset ofthe symptoms. Unfortunately, in other patients the cause of the symptoms may not be easily identified, leading to years of uncertainty and multiple diagnoses complicated by confusing symptoms.

While some patients are mildly affected, in the worst cases MS can leave a person unable to write, speak, or walk. MS is a disease that comes and goes. The types of MS include relapsing-remitting MS, progressive MS, and secondary-progressive MS.

MS has no cure, however there are treatments that slow disease progression. Currently, there are a number drugs that have been approved by the US Food and Drug Administration (FDA). A tremendous amount of progress has been made. Most of these drugs target only the early stage of the disease, not the progressive stages that are worse. Treatment often depends on which type of MS an individual has.

Research has shown that early diagnosis and treatment of MS can reduce the impact of the disease, however much work remains to find better and more effective ways to diagnose and treat the disease. There are a number of new agents on the market and more in the pipeline being investigated. Considering the increased costs associated with relapse and advancing symptom severity, clinicians need to be aware of how pharmaceutical interventions aimed at delaying the progression of MS and mitigating the symptoms may help to improve quality of life for patients.


At the conclusion of this activity, participants should be better able to…

  1. Review the attributes, including efficacy and mortality data, of the various therapies that are used to treat patients with multiple sclerosis (MS)
  2. Identify the thorough screening that needs to be done to ensure that patients can use these modalities safely
  3. Describe the better side effect profiles for some of the new biologics that are helping to improve patient treatments for MS
  4. Recognize the benefits of early diagnosis and treatment to patients with MS, including reduced loss of physical and cognitive function


This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Dannemiller and CogniMed Inc. Dannemiller is accredited by the ACCME to provide continuing medical education for physicians.

Dannemiller designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

There is no charge for this activity. Statements of Credit will be provided by e-mail following activity participation and upon completion and electronic submission of the posttest and evaluation to Dannemiller. A link to the evaluation form is provided upon completion of the activity. If you have any questions about your certificate, please e-mail


To resolve identified/potential conflicts of interest, the educational content was fully reviewed by a physician member of the Dannemiller Clinical Content Review Committee who have no financial relationships with commercial interests. The resulting certified activity was found to provide educational content that is current, evidence based and commercially balanced.


It is the policy of Dannemiller to ensure fair balance, independence, objectivity, and scientific rigor in all programming. All faculty participating in sponsored programs are expected to identify and reference off-label product use and disclose any significant relationships with those supporting the activity or any others whose products or services are discussed. The faculty for this activity have disclosed that there will be discussion about the use of products for non–FDA-approved indications.

In accordance with the Accreditation Council for Continuing Medical Education standards, parallel documents from other accrediting bodies, and Dannemiller policy, the following disclosures have been made:

Dannemiller Staff
Michelle Montgomery, Director of Continuing Education, has nothing to disclose.

Bernard Abrams, MD, Dannemiller Medical Director and Content Reviewer, has nothing to disclose.

CogniMed Inc. Staff
Estelle Perera, Senior Director, Scientific Affairs and Program Design, has nothing to disclose.

Nancy Vogel, Production Editor, has nothing to disclose.

Al Saint Jacques, Writer and Editor, has nothing to disclose.

Anthony Reder, MD, is a consultant to and investigator for Bayer Healthcare Pharmaceuticals Inc, Biogen Idec, Teva Pharmaceuticals, Novartis, and Genzyme, and is a consultant to Questcor Pharmaceuticals, and EMD Serono.

Barry Singer, MD, is a speaker and consultant to Bayer Healthcare Pharmaceuticals Inc, EMD Serono, Pfizer Inc, and Teva Pharmaceuticals; is an investigator for Roche Laboratories, and Sanofi Aventis; is a speaker and investigator for Acordia Therapeutics; and is a speaker for, consultant to, and investigator for Biogen Idec, Genzyme, and Novartis.

The ideas and opinions presented in this educational activity are those of the faculty and do not necessarily reflect the views of Dannemiller and/or its agents. As in all educational activities, we encourage the practitioners to use their own judgment in treating and addressing the needs of each individual patient, taking into account that patient's unique clinical situation. Dannemiller disclaims all liability and cannot be held responsible for any problems that may arise from participating in this activity or following treatment recommendations presented.

This activity is supported by an independent educational grant provided by Bayer Healthcare Pharmaceuticals, Inc, and Novartis.


© 2014 CogniMed Inc. All rights reserved.                      MS15002                         Febuary 2014

Jointly sponsored by CogniMed Inc. and Dannemiller.

This activity is supported by an independent educational grant provided by
Bayer Healthcare Pharmaceuticals, Inc, and Novartis.

© 2014 CogniMed Inc. All rights reserved.