D Myelinating Diseases

Question 0

MS patients treated with natalizumab are at risk for developing PML under what conditions

Answer 0

Presence of anti-– JC virus antibody’s, longer duration of treatment with natalizumab particular more than two years and prior treatment with immunosuppressant agents

Question 1

The optic neuritis treatment trial showed the risk of developing MS was what

Answer 1

MRI findings at the time of diagnosis was the strongest predictor for developing MS. The risk was 72% after 15 years among those with one of more lesions on MRI versus 25% among those with no lesions

Question 2

What is the best oral agent for MS and somebody who wishes to become pregnant and has a past cardiac conduction abnormality and a recent history of hepatitis secondary to beta-1b therapy . What oral agents would be contraindicated

Answer 2

Dimethyl fumarate
Fingolamide is contra indicated for patients with symptomatic ischemic heart disease in the past six months as well as history AV block or dick sinus syndrome . Teriflunomide has the potential for teratogenicity and is CI in pregnancy also entetohepatic re circulation of this drug long half life