ectrims ws pregnancy_2013_final programme

7 – 8 March 2013, London, United KingdoM

ectriMSFocused Workshop

2013

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ECTRIMS Committees

Executive Committee

B. Hemmer Munich, DE C. Lubetzki Paris, FR D. Miller London, UK Workshop Chair & ECTRIMS Secretary X. Montalban Barcelona, ES ECTRIMS Vice President T. Olsson Stockholm, SE P. Soelberg Sørensen Copenhagen, DK ECTRIMS Treasurer M. Trojano Bari, IT ECTRIMS President

Focused Workshop Organizers

F. Fazekas Graz, AT D. Miller London, UK Workshop Chair & ECTRIMS Secretary X. Montalban Barcelona, ES ECTRIMS Vice President S. Reingold Salisbury, US Workshop Advisor

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Welcome to London

Welcome to the ECTRIMS Focused Workshop

“Pregnancy and Hormonal Factors in MS”

London, 7-8 March 2013

Dear Participants

A warm welcome to you all, as participants in the first ever ECTRIMS focused workshop. The

workshop is one of several new initiatives being undertaken by ECTRIMS this year, in line with our

mission “To facilitate communication, create synergies, and promote and enhance research and

learning among professionals for the ultimate benefit of people affected by MS.”

Pregnancy in MS is of course a topic of major and increasing clinical importance, especially with an

expanding range and complexity of disease modifying treatments being used to treat patients who

may also wish to have children. There is also increasing understanding of the relationship of

hormonal factors to the course of MS. It is therefore timely to hold this workshop, which brings

together international experts in the field. The workshop proceedings will provide the basis of a

state-of-art review to be submitted for publication in an appropriate journal.

We hope that you will enjoy the scientific meeting - and being in a fascinating part of London. The

meeting venue is in the National Hospital for Neurology and Neurosurgery, Queen Square, where

there has been a 150-year-long interest in neurology and neuroscience. The workshop dinner on

Thursday evening will be held a short walk away at the Foundling Museum, whose historical origins

seem rather apt for our workshop theme.

David Miller Xavier Montalban Franz Fazekas

Workshop Chair Workshop Organizer Workshop Organizer

Stephen Reingold Maria Trojano

Workshop Advisor ECTRIMS President

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Workshop Programme

Thursday, 7 March 2013

08.30-09.40 Session 1: Meeting overview and experimental background

Chair: M. Trojano (Bari, IT)

08.30-08.35 Welcome and meeting logistics D. Miller (London, UK)

08.35-08.55 Historical background and meeting aims Overview of the understanding and management of pregnancy and hormonal factors in MS

X. Montalban (Barcelona, SP)

08.55-09.25 Hormonal factors in experimental models of MS and related disorders What do we know, what has the contribution of EAE been to the understanding of MS?

H. Offner (Portland, US)

09.25-09.40 Discussion

09.40-10.10 Coffee Break

10.10-12.05 Session 2: Preparing for Pregnancy with MS

Chair: X. Montalban (Barcelona, ES)

10.10-10.40 Risk counseling for parents with MS How to guide parents about risks of pregnancy to the mother with MS, complications of MS for child-rearing, and risk of MS in off-spring

D. Sadovnick (Vancouver, CA)

10.40-10.55 Discussion

10.55-11.15 Fertility treatments and risk of MS relapses What we know about contemporary fertility treatment and impact on MS disease course in women

K. Hellwig (Bochum, DE)

11.15-11.30 Discussion

11.30-11.50 Effect of disease modifying therapies (DMTs) on fertility of women and men with MS, effect of DMTs on foetal viability Does prior therapy with DMTs affect the development and viability of a foetus?

M. Clanet (Toulouse, FR)

11.50-12.05 Discussion

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13.00-14.55

Session 3: Impact of Pregnancy on MS Disease Course

Chair: T. Olsson (Stockholm, SE)

13.00-13.30 Short-term (relapse risk) and long-term (progression of disability) impact of pregnancy in MS Current data on change in disease relapse characteristics during pregnancy and post-partum; do single (or multiple) pregnancies have an impact on long-term outcomes?

C. Confavreux (Lyon, FR)

13.30-13.45 Discussion

13.45-14.05 MRI during pregnancy and post-partum Are changes in MS disease course during pregnancy and post-partum reflected in pathology detected by MRI?

F. Fazekas (Graz, AT)

14.05-14.20 Discussion

14.20-14.40 Pregnancy and NMO-spectrum disorders Pregnancy outcomes in NMO-spectrum disorders and whether it differs from MS

M. Leite (Oxford, UK)

14.40-14.55 Discussion

14.55-15.25 Coffee Break

15.25-17.55 Session 4: Treatment During Pregnancy

Chair: F. Fazekas (Graz, AT)

15.25-15.45 When and how to treat an MS relapse during pregnancy Best current relapse management strategies Data from clinical practice and clinical trials

P. Soelberg Sørensen (Copenhagen, DK)

15.45-16.00 Discussion

16.00-16.30 Older disease modifying treatment during pregnancy Outcomes f rom clinical trials and in clinical practice; how to manage

M. Sandberg-Wollheim (Lund, SE)

16.30-16.45 Discussion

12.05-13.00

Lunch Break

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16.45-17.05

Newer disease modifying treatments during pregnancy Outcomes from clinical trials and in clinical practice; how to manage

R. Gold (Bochum, DE)

17.05-17.20

Discussion

17.20-17.40

Symptomatic management during pregnancy Data from clinical trials and practice

M. Hutchinson (Dublin, IR)

17.40-17.55

Discussion

19.00 - 22.00

Workshop Dinner at the Foundling Museum

Friday, 8 March 2013

08.30-09.30 Session 5: Panel Discussion

Facilitator: S. Reingold (Salisbury, US)

What can we recommend as the best ways to manage MS during pregnancy, for both the health of the mother and of the foetus/new-born? What is data driven, what is speculation? What is needed to provide missing data?

Panel Members E. Havrdova (Prague, CZ) L. Kappos (Basel, CH) A. Miller (New York, US) S. Tennebaum (Buenos Aires, AR) E. Waubant (San Francisco, US)

09.30-10.50 Session 6: Delivery and Beyond

Chair: C. Lubetzki (Paris, FR)

09.30-10.00 Obstetric management for women with MS Case studies and best practices

D. Williams (London, UK)

10.00-10.15 Discussion

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10.15-10.35

Delivery and neonatal outcomes Problems associated with delivery for women with MS; considerations for neonatal health and management

H. Tremlett (Vancouver, CA)

10.35-10.50

Discussion

10.50-11.20

Coffee Break

11.20 – 12.30

Session 6 (continued) Chair: C. Lubetzki (Paris, FR)

11.20-11.40 Breast feeding and MS Impact of breast feeding on disease course; impact of MS disease modifying and symptomatic therapies on breast milk

A. Langer-Gould (California, US)

11.40-11.55 Discussion

11.55-12.15 Geographical variations in gender ratio trends over time in MS The utility of international MS registries for gender issues

M. Trojano (Bari, IT)

12.15-12.30 Discussion

12.30-13.30 Lunch Break

13.30-15.45 Session 7: Non-Pregnancy-Related Hormonal Factors and MS Disease Course

Chair: P. Soelberg Sørensen (Copenhagen, DK)

13.30-13.50 Menopause and MS Effect of menopause on MS disease course and therapeutic implications

R. Bove (Boston, US)

13.50-14.05 Discussion

14.05-14.35 Experimental basis, current status and future prospects for repurposing hormones as DMTs for MS Oestriol and testosterone clinical trials in MS

R. Voskuhl (California, US)

14.35-14.40 Discussion

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14.40-15.10

Impact of an add-on oral contraceptive to beta interferon in MS Does oral contraception affect MS?

C. Pozzilli (Rome, IT)

15.10-15.25 Discussion

15.25-15.45 Summing up What have we learned, where are we headed?

D. Miller (London, UK)

15.45 Meeting end

Information for Speakers and Chairs

Holding a presentation The lecture theatre is equipped with a lectern at which you can hold your presentation. A projector and screen are at your disposal to display your Power Point presentation. Please bring your presentation on an USB stick or external hard drive and hand it to the technician in the lecture theatre. Please note that no corrections can be made to presentations in the room. Chairing a session Please note that no chair table will be available on stage. When chairing a session, we kindly ask you to sit in the first row of the theatre and proceed to the lectern on stage when introducing the next speaker. There will be a few places reserved in the first row.

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The Foundling Museum

The official Workshop Dinner will take place at London’s Foundling Museum. The evening will commence with a light aperitif which is followed by a seated dinner in the museum’s Picture Gallery room.

Please find the details of the evening below:

Date: Thursday, 7 March 2013

Time: 19.00 – 22.00h

Address: The Foundling Museum 40 Brunswick Square London WC1N 1AZ

The Foundling Museum tells the story of the Foundling Hospital, Britain's first home for abandoned children. It examines the work of the Foundling Hospital's founder Thomas Coram, various artists and also illustrates how the Foundling Hospital's charity work for children still carries on today. During the evening you will be able to wander around the museum and view the entire collection.

A reservation has been made at the museum for you, if you did not notify the organizers otherwise. Should you not be able to join us, we kindly ask you to inform us. If you wish to bring an accompanying person, please contact the organizer (upon availability only). The Foundling Museum is located within 5 minutes walking distance from the Russell Hotel. Please make your own way to the museum. For details, please see the location map on page 9.

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Location Map

Accommodation Lecture Theatre

Hotel Russell UCL Institute of Neurology Russell Square 33 Queen Square London WC1B 5BE London WC1N 3BG United Kingdom United Kingdom Tel: +44 207 837 6470 Access: use main entrance, walk through the patient room and take the stairs to level -1. Workshop Dinner Administrative Secretariat

The Foundling Museum ECTRIMS Focused Workshop 40 Brunswick Square Congrex Switzerland Ltd London WC1N 1AZ Peter Merian-Strasse 80 United Kingdom 4002 Basel / Switzerland Tel: +41 61 686 7777

E-mail: ectrims@congrex.com

Hotel Russell

Lecture Theatre

Foundling Museum

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Workshop Participants

Surname Name City Country Email

Amato Maria Pia Florence IT mariapia.amato@unifi.it

Bove Riley Boston US riley_bove@post.harvard.edu

Butzkueven Helmut Melbourne AUS butz@unimelb.edu.au

Chitnis Tanuja Boston US tchitnis@rics.bwh.harvard.edu

Ciccarelli Olga London UK o.ciccarelli@ion.ucl.ac.uk

Clanet Michel Toulouse FR michel.clanet@inserm.fr

Confavreux Christian Lyon FR christian.confavreux@chu-lyon.fr

d’Hooghe Marie Melsbroek BE marie.dhooghe@mscenter.be

Dadalti Fragoso Yara Santos BR yara@bsnet.com.br

Fazekas Franz Graz AT franz.fazekas@meduni-graz.at

Gold Ralf Bochum DE Ralf.Gold@ruhr-uni-bochum.de

Havrdova Eva Prague CZ ehavr@lf1.cuni.cz

Hellwig Kerstin Bochum DE k.hellwig@klinikum-bochum.de

Hutchinson Michael Dublin IR mhutchin2@mac.com

Kappos Ludwig Basel CH lkappos@uhbs.ch

Langer-Gould Annette California US annette.m.langer-gould@kp.org

Leite Maria Isobel Oxford UK maria.leite@imm.ox.ac.uk

Lubetzki Catherine Paris FR catherine.lubetzki@psl.aphp.fr

Mason Debbie Christchurch NZ deborah.mason@cdhb.health.nz

McCombe Pamela Brisbane AUS pamela.mccombe@uq.edu.au

Miller David London UK david.h.miller@ucl.ac.uk

Miller Aaron New York US aaron.miller@mssm.edu

Montalban Xavier Barcelona ES xavier.montalban@unic-em.com

Offner Halina Portland US offnerva@ohsu.edu

Olsson Tomas Stockholm SE Tomas.Olsson@ki.se

Pozzilli Carlo Rome IT carlo.pozzilli@uniroma1.it

Reingold Stephen Salisbury US scra.llc@earthlink.net

Sadovnick Dessa Vancouver CA sadovnik@infinet.net

Sandberg-Wollheim Magnhild Lund SE Magnhild.Sandberg_Wollheim@med.lu.se

Sellebjerg Finn Copenhagen DK finn.sellebjerg@rh.regionh.dk

Soelberg Sorensen Per Copenhagen DK per.soelberg.soerensen@rh.regionh.dk

Tenembaum Silvia Buenos AiresAR silviatenembaum@gmail.com

Tintore Mar Barcelona ES mtintore@vhebron.net

Tremlett Helen Vancouver CA helen.tremlett@ubc.ca

Trojano Maria Bari IT maria.troiano@uniba.it

Voskuhl Rhonda California US rvoskuhl@ucla.edu

Waubant Emmanuelle San FranciscoUS emmanuelle.waubant@ucsf.edu

Williams David London UK david.williams@uclh.nhs.uk