CMSC DAILY DIGEST
REPORTS FROM THE 2016 CONSORTIUM OF
MULTIPLE SCLEROSIS CENTERS' ANNUAL MEETING
THURSDAY, JUNE 2
CMSC Annual Meeting Opens
with Focus on Importance of Relapses
Fred D. Lublin, MD, FAAN, FANAThe 30th Consortium of Multiple Sclerosis Centers’ (CMSC) Annual Meeting began yesterday with one of the world’s leading authorities on multiple sclerosis (MS) posing a provocative question and immediately answering it in definitive fashion.
In delivering the inaugural John F. Kurtzke Memorial Lecture to open the meeting in National Harbor, MD, Fred D. Lublin, MD, FAAN, FANA, asked the question that served as the title of his address: Do relapses really matter? His very next slide responded to that query with just four words: “Of course they do.”
Dr. Lublin, the Saunders Family Professor of Neurology and Director of the Corinne Goldsmith Dickinson Center for Multiple Sclerosis at Mount Sinai Medical Center in New York City, went on to highlight several of the many questions about relapses that remain to be answered, while stressing that the importance of relapses is not in question.
Studies examining the long-term impact of relapses uniformly have documented residual disability in the wake of those events, Dr. Lublin noted, adding that both research and clinical experience also have shown that, “The earlier that disability occurs from a relapse, the longer one is in a disabled state.” It also is important to appreciate how heavily concerns about relapses weigh on patients’ minds, he said. “This is a constant worry for patients, and we can’t tell them when the next relapse will occur – next week, next month, next year, or maybe never.”
The neurologist, who has authored dozens of influential papers that have shaped MS care and who led a recent effort to re-define MS phenotypes, noted that the definition of a relapse often varies in practice and in clinical trials. Attention to the definition employed in a trial is particularly important, he added, because it can affect calculation of relapse rates, relative risk, number needed to treat, and other key statistics that inform clinical decision-making.
Dr. Lublin said that three of the most important unanswered questions concerning relapse are:
In summarizing his remarks, Dr. Lublin noted that clinicians now have the potential to reduce relapse rates to very low levels. Returning to his theme of the significance of relapses, he added that if relapses have no effect on the long-term course of MS, researchers and clinicians should continue to see high rates of disability developing independent of a reduction in relapse rates, but that this has not been the anecdotal experience thus far. He additionally stressed the need for treatments to address progression in MS.
The lecture Dr. Lublin gave is named for John F. Kurtzke, MD, a pioneer in MS research and clinical care who died last December at age 89.
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