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Addressing the Challenges of Diagnosing and Managing Pediatric Multiple Sclerosis

Addressing the Challenges of Diagnosing and Managing Pediatric Multiple Sclerosis

Format

Roundtable

Time to Complete

1.75 hours

Released

March 15, 2019

Expires

March 15, 2020
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Maximum Credits

1.75 / AMA PRA Category 1 CreditsTM

Accredited Provider

Jointly provided by The University of Texas Southwestern Medical Center and Medical Logix, LLC

Commercial Supporter

This activity is supported by an educational grant from Novartis Pharmaceuticals Corporation.

Program Description

It is estimated that 3-10% of individuals with multiple sclerosis (MS) develop symptoms in childhood and adolescence. While pediatric-onset MS is thought to represent the same disease process as adult onset forms of the disease, it poses unique challenges to the treating clinician. Diagnosing pediatric MS can be difficult due to the rarity of the disease in this age group and the existence of a broad array of disease mimics. Diagnosis may also be delayed due to a lack of recognition or dismissal of symptoms early in the course of the disease. Furthermore, pediatric providers are often unfamiliar with disease modifying treatments (DMT) for multiple sclerosis, as until recently, none were FDA licensed for use in children. The recent Food and Drug Administration (FDA) licensure of fingolimod as the first agent to treat pediatric MS is a significant event for the field, highlighting a growing recognition of pediatric-onset MS and the need for efficacy and safety data on DMTs used in children.

Intended Audience

This activity is intended for healthcare professionals, specifically, neurologists, pediatricians, family practice physicians, nurse practitioners, physician assistants, nurses and other providers involved in the care of pediatric patients with multiple sclerosis.

Educational Objectives

Upon completion of this educational activity, participants should be able to:

  • Describe the possible presentations of multiple sclerosis (MS) in a child including vision, motor, sensory, and bowel/bladder related syndromes.
  • Identify the categories of diseases that can mimic pediatric MS including inflammatory, neoplastic, vascular, metabolic, genetic, and mitochondrial disorders.
  • Cite the types of disease-modifying therapies used in pediatric MS including the routes of administration, mechanisms of action, and efficacy/safety profiles of these agents.
  • Identify symptoms suggestive of new demyelinating episodes versus pseudoexacerbations and be familiar with management strategies for both.
  • Perform history-taking and counseling on areas most commonly impacted by pediatric MS, such as cognition, mood, fatigue, pain, and academic achievement.

Conflict of Interest Disclosure Policy

All individuals who affect the content of continuing education activities are required to disclose to the audience any real or apparent conflict of interest related to the activity. The activity faculty are further required to disclose discussion of off-label/investigational uses in their presentations. The following relationships have been reported for this activity:

Faculty

Moderator
Benjamin M. Greenberg, MD, MHS

Vice Chair of Translational Research and Strategic Initiatives
Cain Denius Scholar of Mobility Disorders
Distinguished Teaching Professor
Department of Neurology and Neurotherapeutics
Department of Pediatrics
UT Southwestern Medical Center
Dallas, Texas

Dr. Greenberg discloses the following:
Research Activities: Chugai, Medday. MedImmune, Genentech
Consultant: Alexion, EMD Serono, Novartis

Brenda L. Banwell, MD, FRCPC, FAAN
Professor of Neurology and Pediatrics
Chief of the Division of Neurology
Children’s Hospital of Philadelphia
Perelman School of Medicine
University of Pennsylvania
Philadelphia, Pennsylvania

Dr. Banwell discloses the following:
Consultant: Novartis

Cynthia Wang, MD
Assistant Professor
Pediatrics
Neurology and Neurotherapeutics
UT Southwestern Medical Center
Dallas, Texas

Dr. Wang has no relevant financial relationships to disclose.

Reviewer:
Teri L. Schreiner, MD, MPH

Associate Professor and Associate Director
Residency Training Program
Department of Neurology
University of Colorado Hospital
Children’s Hospital
Aurora, Colorado

Dr. Schreiner discloses the following:
Applied Clinical Intelligence-Independent Adjudicator for TERIkids Clinical Trials. Dr. Schreiner’s role was limited to evaluating the validation of study participants with neurologic symptoms consistent with an MS relapse. She had no other involvement in the operations of the clinical trial.

No other planners have indicated that they have any financial interests or relationships with a commercial entity.

Accredited Provider Disclosure

The following UT Southwestern employee, Ericka Harden-Dews, JD, CHCP, has no relationship with any commercial interests whose products or services may be mentioned during this presentation.

Publishing Staff Disclosures

Michael Speidel and John Gentile, Medical Logix, LLC have no relationship with any commercial interests whose products or services may be mentioned during this presentation.

Credit

1.75

Type

AMA PRA Category 1 Credit(s)TM

Accreditation Statement

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 providership of The University of Texas Southwestern Medical Center and Medical Logix LLC. The University of Texas Southwestern Medical Center is accredited by the ACCME to provide continuing medical education for physicians.

Designation Statement

The University of Texas Southwestern Medical Center designates this enduring material for a maximum of 1.75 AMA PRA Category 1 CreditsTM  .  Participants should claim only the credit commensurate with the extent of their participation in the activity.

Additional Credit Information

Nurse Practitioner and Physician Assistant Credit Reciprocity
American Association of Nurse Practitioners (AANP) National Certification Program accepts AMA PRA Category 1 CreditTM   from organizations accredited by the ACCME.

American Academy of Physician Assistants (AAPA) accepts certificates of participation for educational activities certified for AMA PRA Category 1 CreditTM   from organizations accredited by the ACCME. Physician Assistants may receive a maximum of 1.75 credits of Category 1 for completing this program.

Disclosure of Unlabeled Use

Drs. Banwell, Greenberg, and Wang: alemtuzumab, dimethyl fumarate, glatiramer acetate, interferons, natalizumab, ocrelizumab, rituximab, teriflunomide

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Instructions

To obtain credit, a score of 70% or better on the post-test is required. This activity is offered at no cost to participants. Please proceed with the activity until you have successfully completed this program, answered all test questions, completed the post-test and evaluation, and have received a digital copy of your credit certificate. Your online certificate will be saved on myCME within your Profile/Exam History, which you can access at any time.

If you have any questions relating to the accreditation of this activity, please contact The Office of Continuing Medical Education and Public Education at UT Southwestern Medical Center at cmeregistrations@utsouthwestern.edu.

If you have any questions relating to your certificate or other issues with this activity, please contact myCME.Support@haymarketmedical.com.

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