Should new therapies for MS be subjected to clinical trials even with poor scientific support
Capsule: Over the past three decades, numerous drugs were approved for multiple sclerosis (MS), but in many patients the disease is not fully controlled. In this session, the debaters will outline the pros and cons of developing interventions based on limited scientific evidence, such as high dose vitamin D or HBO.
08:30-08:40
Host: Olaf Stuve, USA
08:40-08:55
Yes: Ralf Linker, Germany
08:55-09:10
No: Konrad Rejdak, Poland
09:10-09:20
Discussion and rebuttals
09:20-10:10
Are MS patients at increased risk for developing cancer?
Capsule: Whether people with MS are at higher risk of developing cancer has not been definitively established. The increased rate of general comorbidity would indicate a higher risk of cancer. On the other hand, some register and large cohort studies have not found an association. Could it be that there is higher risk of specific cancers, but not all cancers? And can newer highly potent immunosuppressive treatments modify the long term risk?
09:20-09:30
Host: Cris Constantinescu, UK
09:30-09:45
Yes: Ali Manouchehrinia, Sweden
09:45-10:00
No: Melinda Magyari, Denmark
10:00-10:10
Discussion and rebuttals
10:10-10:25
Coffee Break
10:25-12:05
DIAGNOSIS
10:25-11:15
Are the 2017 MS McDonald criteria too liberal and should be more restrictive?
10:25-10:35
Host: Ralf Linker, Germany
10:35-10:50
Yes: Brian Weinshenker, USA
10:50-11:05
No: Christopher Hawkes, UK
11:05-11:15
Discussion and rebuttals
11:15-12:05
Does OCT make VEP redundant?
Capsule: Visual evoked potentials (VEP) have traditionally been used to support the existence of subclinical involvement of the optic nerve in MS patients. The newly developed optical coherence tomography (OCT) is sensitive to anatomical changes in the retina and optic nerve. Does the OCT make the VEP obsolete or does the physiological measure add important information?
11:15-11:25
Host: Abhijit Chauduri, UK
11:25-11:40
Yes: Hadas Stiebel-Kalish, Israel
11:40-11:55
No: Mario Habek, Croatia
11:55-12:05
Discussion and rebuttals
12:15-13:15
Industry Supported Symposium
13:15-14:15
Lunch Break
13:15-14:15
Meet the Expert
14:15-15:45
DISEASE COURSE
14:15-14:55
Newly diagnosed MS patients should be started on aggressive therapy
Capsule: Early treatment is claimed to improve long-term prognosis in MS. Recent studies also suggest that early aggressive therapy with potent immunosuppressive drugs (“induction therapy”) may improve long-term outcomes and lower the risk of conversion to secondary-progressive MS. Therefore, it is suggested that newly diagnosed MS patients should be started on such aggressive therapies. However, these therapies may be associated with serious risks. Do the potential benefits of aggressive therapies always outweigh their risks?
14:15-14:25
Host: Jera Kruja, Albania
14:25-14:35
Yes: Ron Milo, Israel
14:35-14:45
No: Uros Rot, Slovenia
14:45-14:55
Discussion and rebuttals
14:55-15:45
MS is a primary progressive disease in all cases, but some patients have superimposed relapses
Capsule: Patients with clinically isolated syndrome have been shown to have significant cortical changes in their brains. Subcortical asymptomatic alterations have also been described. Does that mean that MS is basically a degenerative disease with superimposed clinical flare-ups (“relapses”) as epiphenomena?
14:55-15:05
Host: Bart van Wijmeersch, Belgium
15:05-15:20
Yes: Antonio Scalfari, UK
15:20-15:35
No: Bianca Weinstock-Guttman, USA
15:35-15:45
Discussion and rebuttals
15:45-16:00
Coffee Break
16:00-19:00
COGNITION IN MS I
16:00-16:55
In MS patients with significant cognitive decline, drug treatment should be modified.
Capsule: Approximately 50% of people with MS become unemployed with a median EDSS of 3.0-3.5.They usually acquired hidden disabilities related to cognitive impairment. Should MS specific drug treatment be modified in patients with cognitive decline whose EDSS is otherwise unchanged?
16:00-16:10
Host: Thomas Berger, Austria
16:10-16:25
Add a new agent: Ron Milo, Israel
16:25-16:40
Not so fast: Amos Korczyn, Israel
16:40-16:55
Discussion and rebuttals
16:55-17:50
Cognitive decline is sufficient to define transition to secondary progressive multiple sclerosis (SPMS).
Capsule: There is no biomarker that indicates when a patient has transitioned from relapsing-remitting MS (RRMS) to SPMS, and consequently SPMS is a retrospective diagnosis. The period of diagnostic uncertainty separating RRMS and SPMS diagnoses often lasts many years. Testing all aspects of clinical disease progression may or may not alleviate this uncertainty.
16:55-17:05
Host: Dimitrios Karussis, Israel
17:05-17:20
Yes: Klaus Schmierer, UK
17:20-17:35
No: Thomas Berger, Austria
17:35-17:50
Discussion and rebuttals
16:00-19:00
COGNITION IN MS II
17:50-18:45
We are well enough equipped to identify fake news in MS therapy before it can cause harm.Capsule: Fake news is news, stories or hoaxes created to deliberately misinform or deceive readers. Information that patients with MS read online, and especially in their social media feeds, often inaccurate or untrue. Misinformation about MS therapies have also been disseminated to care providers