The NeurologyLive® team has compiled a roundup of our discussions with leaders in the multiple sclerosis field following the 2021 Annual Meeting of the Consortium of Multiple Sclerosis Centers (CMSC).
The 2021 Annual Meeting of the Consortium of Multiple Sclerosis Centers (CMSC), October 25-28, was held in a hybrid format, with experts in the field of multiple sclerosis (MS) convening in Orlando, Florida, as well as virtually, to discuss the latest advances, ongoing developments, and future direction of research.
Presentations covered a breadth of subjects within the MS space, including disease-modifying therapies (DMTs) and interaction with available COVID-19 vaccines, a trial developed to address the lack of representation of minority populations in MS clinical trials, and the integration of registered dietitians and wellness programs for this patient population. Swipe through the slideshow below to browse our interviews with experts, both on-site and virtually, and be sure to check back for ongoing coverage from the conference.
Following her presentation at CMSC 2021, Mona Bostick, RDN, LDN, MSCS, founder, Food Matters 365, Greensboro, North Carolina, discussed the multidisciplinary care model for patients with MS and the vital part that registered dietitians can play in comorbidity management. While they are not always included, Bostick encouraged the incorporation of dietitians as part of the healthcare team, and further advised patients with MS to seek out a local dietitian in their community if need be.
Distinguishing between nutritionists and dietitians was another point Bostick emphasized, as all dietitians are nutritionists, but not all nutritionists are dietitians. According to Bostick, patients can feel confident in what they can expect from a dietitian, due to the required education, training, and knowledge base, but this is not always the case when seeing a nutritionist.
At CMSC 2021, Amit Bar-Or, MD, FRCPC, FAAN, FANA, Melissa and Paul Anderson President’s Distinguished Professor; director, Center for Neuroinflammation and Neurotherapeutics; and chief, Multiple Sclerosis Division, department of neurology, Perelman School of Medicine, University of Pennsylvania, gave a presentation outlining research and expert opinions on the safety and efficacy of the available COVID-19 vaccines for patients with multiple sclerosis also on DMTs. Following his presentation, Bar-Or sat down with NeurologyLive® to further discuss findings, as well as recommendations for this patient population.
According to Bar-Or, emerging data on vaccine response has informed experts on the interaction of that vaccines and DMTs, noting that experts do not believe any risk is posed if a patient gets vaccinated while also on a DMT. There is, however, concern about maximal vaccine response, with Bar-Or suggesting that patients ensure vaccinations are “up to speed” prior to starting a high-efficacy therapy, such as an anti-CD20 agent. As the currently approved COVID-19 vaccinations are not categorized as live or attenuated, Bar-Or added there is no associated risk of the vaccine contributing to or spreading infection, nor causing infection-related complications in vaccinated patients.
While emerging data suggest the risk of developing and incidence of MS is highest for Black people in the US—specifically Black women—minority populations continue to be underrepresented in MS clinical trials. Following her presentation at CMSC 2021, Mitzi Joi Williams, MD, board certified neurologist and multiple sclerosis specialist, and founder and CEO, Joi Life Wellness Group Multiple Sclerosis Center, spoke with NeurologyLive® about the genesis of the CHIMES trial (NCT04377555), which aims at understanding this underrepresentation in a controlled setting.
Smaller numbers of minority patients in clinical trials may be due to mistrust and the “history of unfair experimentation,” Williams said, as well as institutional barriers to enrollment and trials. Comparably, a lack of diverse researchers may also contribute to this underrepresentation, as certain investigators may be better equipped to speak to certain populations. Inclusion criteria often discount those with comorbidities, and as diabetes and hypertension are more common in minority populations, this creates another barrier to inclusion. Williams stressed the need to examine these barriers from the patient perspective, in terms of cost and time, as well as on the broader, institutional level.
In the summer of 2021, a combined effort from the Magnetic Resonance Imaging in Multiple Sclerosis study group, CMSC, and North American Imaging in Multiple Sclerosis Cooperative resulted in the latest update in MRI guidelines for patients with MS. The recommendations covered changes in MRI acquisition protocols, such as the emphasis on the value of 3D-fluid-attenuated inversion recovery as the core brain pulse sequence to improve diagnostic accuracy and ability to identify new lesions to monitor treatment effectiveness, as well as for the use of gadolinium-based contrast agents.1
Additionally, the group extended the recommendations to the use of MRI for those in childhood, during pregnancy, and in the post-partum period. At CMSC 2021, one of the authors of the paper, David Li, MD, FRCPC, professor of radiology, associate member in neurology, and director, Multiple Sclerosis/MRI Research Group, University of British Columbia, spoke with NeurologyLive® on the key points.
Li specifically spoke to the use of a small, portable card that covers the needs for scans to follow the new protocol, its potential to help improve the application of these new guidelines, and how it might better inform patients and physicians about them. The Standardized MRI Protocol card can be accessed here, and the Spanish version can be accessed here.
In Case You Missed It: Can’t get enough of CMSC 2021? Be sure to browse the rest of our coverage and learn more about the latest research in MS, advances experts are excited about, as well as the impact of the ongoing COVID-19 pandemic and vaccinations. The NeurologyLive® team also continues to add coverage about the MS space—click here to learn more about ongoing developments!