HowtoS.E.A.R.C.H.™forthe

RightMSTherapyforYou!

G

LiveWebinar

October19,2016

presents

HowtoS.E.A.R.C.H.

™

forthe RightMSTherapyforYou!

GuestPresenter

CarrieM.Hersh,DO,MS

MSNeurologist

ClevelandClinicLouRuvoCenterforBrainHealth

LasVegas,NV

Acknowledgements

MSAAwouldliketotakethisopportunitytothankthesupportersofthisprogram.

Thiswebinar,alongwiththerecentlyrevisedS.E.A.R.C.H.™bookletandpatientworkbook,havebeenmadepossiblewiththesupportofEMDSeronoandSanofiGenzyme.

MSAAissolelyresponsibleforthedevelopmentofS.E.A.R.C.H.™anditscontent.

Programs and Services

Providing Information . . .

• Toll-free Helpline at (800) 532-7667 • Online response forums via Chat feature and email option at MSquestions@mymsaa.org • Free mobile phone application - My MS Manager™

Easing Daily Life . . . • Equipment distribution • Cooling program • MRI Access Fund

Finding Answers . . .

• Comprehensive website: mymsaa.org

• Award-winning publications, videos, and webinars

• S.E.A.R.C.H.™ initiative

Staying Connected . . .

• In-person educational events

• New online peer community – My MSAA Community

•Social media presence via Facebook, Twitter, YouTube, etc.

HowtoS.E.A.R.C.H.™fortheRightMSTherapyforYou!WebinarObjectives

• ExplorethechanginglandscapeofMS,lookingatcurrentandfuturetreatments

• Emphasizetheimportanceoftreatmentadherenceandcompliance

• Lookattoday’sdoctor-patientrelationshipandhowbothsidescanworktogether

• LearnaboutMSAA’sS.E.A.R.C.H.™program–whichcanhelpyourdecisiontochoosetherightMStherapyforYOU!!!

TheChangingLandscapeofMS

Priorto1993,theMSlandscapelookedfairlybarren

• TherewerenoFDA-approvedtreatmentsforMS

• Limitedapproachtotreatingsymptomsandmanagingthedisease

• Noconsistentuseofrehabilitationservices

TheChangingLandscapeofMS

Becauseofsuchlimitedoptionsatthetime,adviceto

manyMSpatientsincludedstatementssuchas...

• Gohomeandrest–trynottodotoomuch

• Don’tgetexposedtotheheat

• Youmaywanttoconsidernothavingchildren

TheChangingLandscapeofMS

Since1993,thisbarrendeserthasbeentransformedintoafertile,growinglandscapeflourishingwith...

• MorethanadozenFDA-approvedtreatmentsforMSwithmoreunderdevelopment

• Amorecomprehensiveapproachtotreatingandmanagingthedisease,withanincreasedfocusonrehabilitationandwellness

TheChangingLandscapeofMS

CurrentFDA-ApprovedMSDiseaseModifyingTherapies(DMTs)

Self-InjectedMedications InfusedMedications OralMedications

Avonex® Lemtrada® Aubagio®

Betaseron® Novantrone® Gilenya®

Copaxone® Tysabri® Tecfidera®

Extavia®

Glatopa®

Plegridy®

Rebif®

Zinbryta®

TheChangingLandscapeofMS

NewLong-TermTreatmentsontheHorizon

Ocrelizumab-ahumanizedmonoclonalantibodythatfunctionssimilarlytoanothertherapycommonlyusedforautoimmuneconditions,Rituximab

-FirstdiseasemodifyingtherapyofitskindtodemonstratepositivebenefitinpatientswithprimaryprogressiveMS-Administeredviaintravenousinfusionevery6months-ClinicaltrialsshowedexcellentreductionofclinicalrelapsesandnewMRIlesionscomparedtoastandardinjectableMStherapy-Expectedtobeavailableforcommercialusein2017

TheChangingLandscapeofMS

NewLong-TermTreatmentsontheHorizon

Siponimod-anoraltreatmentstrategywithsimilarstructureandfunctionasfingolimod

-PotentialtreatmentoptionforpatientswithsecondaryprogressiveMS

-RecentlyannouncedatECTRIMS2016inLondon,EnglandtodemonstratepositivebenefitindelayingdisabilityprogressioninpatientswithsecondaryprogressiveMSinaphase3clinicaltrialcomparedwithplacebo

TheChangingLandscapeofMS

NewLong-TermTreatmentsontheHorizon

Ofatumumab-afullyhumanmonoclonalantibodythatfunctionssimilarlytoRituximabandOcrelizumab

-Expectedtobewelltoleratedgivenitshumanstructure

-Inphase2clinicaltrials,OfatumumabdemonstratedsignificantreductioninnumberofrelapsesandnewMRIlesions,andnounexpectedsafetyfindingswerereported

-Ofatumumab,administeredasaoncemonthlyinjectionunderneaththeskin,isenteringaphase3clinicaltrialthatwillbeinvestigatingitsefficacyandsafetyinalargerpopulationofpatientswithrelapsingformsofMS

ImportanceofAdherence

SIMPLEFACT:

ResearchhasproventhatmostMSpatientswith

relapsingformsofMSwhostartandcontinueusinga

DMTtreatmentaccumulatelessdisabilityovertime,

andataslowerratethanpatientswhoare

non-compliant.

HavingaGoodDoctor-PatientRelationship

“Yourappointmentwiththedoctorisat

11:15,buthisappointmentwithyouis

at12:15.”

“Giveittomestraight,Doc.HowlongdoIhavetoignoreyouradvice?”

The Cartoon Bank/Condé Nast Publications Inc.

HavingaGoodDoctor-PatientRelationship

• GiventhecomplexityofMS,thedoctorandpatientmustworktogethertounderstandtheproblemsandfindsuccessfulsolutions

• Establishingopenandhonestdoctor-patientcommunicationwillhelpfoster: -mutualtrust

-enhancedaccuracyofdiagnosisandtreatment

-improvedadherenceandcompliance

-increasedpatientsatisfaction,reducedcomplaints

-thebestpossiblehealthandoverallqualityoflife

WaystoHelp

• Beproactiveandtakechargeofyourhealthcare -UsecredibleInternetsitestoresearchinformation -KeepajournaloruseMSAA’smobilephoneapp

(MyMSManager™) -Maintainotherhealthcareneedsandappointments

• Understandthereducedtimedoctorshavetospendwiththeirpatientsandcomeprepared

• UseMSAA’sS.E.A.R.C.H.™modeltodiscussyourMStreatmentoptionsandmakeaninformeddecision

WhatisS.E.A.R.C.H.™

MSAA’sS.E.A.R.C.H.™

• Aneasyacronymthathelpsyouremember,organize,andprioritizeimportantquestionstodiscusswithyourdoctororhealthcareteam

• Eachletterrepresentskeyareasthatneedtobeconsideredwhen“searching”forthemostappropriateMStreatment

S.E.A.R.C.H.™standsfor:

SAFETYEFFECTIVENESSACCESSRISKSCONVENIENCEHEALTHOUTCOMES(overallwellnessandqualityoflife)

MSAA’sS.E.A.R.C.H.™

Safety

SuggestedQuestions:

SpecifictotheMStherapiesyouareconsidering...

• Whatarethelong-termsafetyprofilesoftheseFDA-approvedDMTs?

• WhattestsarerequiredpriortotakingorwhilereceivingcertainDMTs?

• HowwillDMTsinteractwithmycurrentmedicaltreatments,othermedicalconditions,andanycomplementaryandalternativemedicines?

• WhataretheconcernsaboutpregnancyorbreastfeedingwhiletakingoneoftheseDMTs?

MSAA’sS.E.A.R.C.H.™

Effectiveness

SuggestedQuestions:

SpecifictotheMStherapiesyouareconsidering...

• HoweffectivearetheseDMTsinreducingMSrelapses,disability,andMRIactivity?

• WhataremyrealisticexpectationsregardingtheeffectivenessoftheseDMTs?

• HowcanItellifmyDMTisworking?

• WhenshouldIconsiderusingadifferentDMT?

MSAA’sS.E.A.R.C.H.™

Access

AccesstoDMTsandtheabilitytoswitchtherapiescanvary

greatlydependingonyourinsuranceprovider,coveragelevelsand

otherrestrictions.MSAAhasacomprehensivewebsitesectiontitled,

MyHealthInsuranceGuide,tohelppeoplebetterunderstandandutilizetheirhealthinsurance.

SuggestedQuestions:SpecifictotheMStherapiesyouareconsidering...

• WhichDMTsarecoveredbymyinsurancecarrier?

• WhataretheirTierLevelsandhowdoesthataffectcost?

• Arethereassistanceprogramsthroughthepharmaceuticalcompanies,governmentorcharities?

MSAA’sS.E.A.R.C.H.™

Risk

SuggestedQuestions:

SpecifictotheMStherapiesyouareconsidering...

• WhataretherisksofsideeffectswiththeseDMTs?

• Howfrequentandseverearethesideeffects?• Howsoondotheysubside?

• Canthesesideeffectsbemanaged?

• Howdoyoubalancetherisks?

MSAA’sS.E.A.R.C.H.™

Convenience

SuggestedQuestions:

SpecifictotheMStherapiesyouareconsidering...

• HowaretheDMTsadministered?

• HowoftendoItaketheseDMTs?

• MustIhaveregulartestsorvisitstootherhealthcareproviderstomonitortheeffectsofmytreatment?

MSAA’sS.E.A.R.C.H.™

HealthOutcomes

SuggestedQuestions:

SpecifictotheMStherapiesyouareconsidering...

• HowwillmygeneralhealthandqualityoflifebeaffectedbytheseDMTs?

• WhatwillmyMSlooklikeinfiveor10years?

• WilltakingaDMTlowermyimmunesystemandcauseotherproblems?

• CantheseDMTsassistwithmymobility,cognition,andotherhealthfactors?

S.E.A.R.C.H.™Tools

MSAAhasproducedavarietyofinformationaltoolstohelpmaximizeyoursuccesswith

S.E.A.R.C.H.™Currenttoolsavailableatmymsaa.orginclude:

• S.E.A.R.C.H.™BookletwithlaminatedReferenceCard

• S.E.A.R.C.H.™PatientWorkbooktowritenotesandorganizequestionsforthedoctor

• MSDiseaseModifyingTherapyChartofcurrentlyapprovedtreatments

• MSResourceGuidelistingMSorganizationsandpharmaceuticalassistanceprograms

• mymsaa.org/healthinsurancewithinformationontheAffordableCareActandMedicare

RemainingAdherent

• OnceaDMTisinitiated,evidencesuggests

thattreatmentneedstobeongoingforbenefits

topersist.Non-adherenceandgapsintreatment

havebeenassociatedwithanincreasedrateof

relapsesandprogressionindisability.

• Understandably,adherencecanpresentcertain

challengesovertime.Fortunatelymanyofthesechallengescanbemanagedto

keeppeopleoncourse.

RemainingAdherent

SomeHelpfulStrategiestoHelpBuildTowardOngoingTreatmentAdherenceinclude:

• ManagingSideEffects -Takeover-the-countermedicationstomanagetemporaryflu-like symptoms;ice-downandrotateinjectionsites;useanautoinjector

• UnderstandingExpectations -Discussrealisticexpectationswithyourdoctor;givetheDMT1yr.to haveaneffect;realizeifyoudon’t“see”resultsthenitmightbeworking

• LearningtoAdjust -Setascheduleandusecalendarremindersorstickynotestohelpremembertotakeyour medication;receivepropertrainingifneededonself-injectiontechniques; ifproblemsarise,don’tjuststoptakingyourDMT–talktoyourdoctor!

ToSummarize

Take-homemessages:

• ViewMSasanever-changinglandscapethatholdsgreatpromiseforthefuture

• RecognizethatbeingadherenttoanMSDMTwillhelpreduceattacksandlessendisabilityovertime

• Beproactiveinmanagingyourhealthcare

• Strivetohaveagooddoctor-patientrelationship

• UseS.E.A.R.C.H.™tohelpdiscussMSmedicationswithyourdoctorandselectthetherapythatisrightforYOU!

ThankYou

ThisconcludesMSAA’sWebinar:

HowtoS.E.A.R.C.H.™fortheRightMSTherapyforYou!

ThiswebinarwillbeavailablesoononMSAA’swebsite:www.mymsaa.org

MSAAwouldliketothankDr.Hershforherexcellentpresentationon

multiplesclerosisandtheS.E.A.R.C.H.™initiative,aswellassupportersEMDSeronoandSanofiGenzyme.

ThankyouforparticipatinginMSAA’swebinar.