Precision in Practice: Individualizing MS Therapy Across the Patient Lifespan
Neurology1.00 AMA PRA Category 1 Credit(s) ™
October 08, 2026
October 08, 2027
Primary Audience:
Relevant Terms:
Mary Ann Picone, MD, FAAN, FACP
Medical Director
Holy Name Multiple Sclerosis Comprehensive Care Center
Clinical Professor
Dept. of Medicine at Rowan-Virtua SOM
Dr. Mary Ann Picone has been Medical Director of the Holy Name MS Comprehensive Care Center since 1993. She is widely recognized for her clinical expertise, research acumen and comprehensive approach to patient care. She is Clinical Professor at Rowan University of Osteopathic Medicine. She earned her undergraduate Bachelors of Arts degree from New York University and her medical degree from University of Medicine and Dentistry of New Jersey, now Rutgers Medical School. She completed a fellowship in Neurophysiology at Robert Wood Johnson Hospital in New Brunswick, NJ.
Dr. Picone is a member of the Clinical Advisory Board of the NJ Metro Chapter of the National MS Society. She is a Castle Connolly Top Doctor and is a Fellow of the American College of Physicians and American Academy of Neurology. She has been principal investigator for numerous clinical research studies, involving novel disease modifying therapies, symptom management, psychosocial interventions and use of wearable technology to monitor disease worsening. She has particular interest in gait and balance disorders in MS and is involved in collaborative research with the Hospital for Special Surgery and New York Presbyterian Hospital. She has been an editor of the two recent textbooks Multiple Sclerosis for the Non Neurologist and Foot and Ankle Pain Management. She is also interested in wearable technologies to monitor disease progression in MS. She has been featured on CBS NY, ABC NY, Fox 5 News, The Bergen Record and Star Ledger, on topics related to Multiple Sclerosis, and was named a NJ Healthcare Hero by NJ Biz.
Leorah Freeman, MD, PhD
Associate Professor of Neurology and Diagnostic Medicine
Medical Director, MS and Neuroimmunology Center
Dell Medical School, The University of Texas at Austin
Austin, Texas
Dr. Leorah Freeman is an Associate Professor of Neurology and the medical director of the Multiple Sclerosis and Neuroimmunology Center at Dell Medical School, The University of Texas at Austin. She also serves as director of the MS and Neuroimmunology fellowship program and leads the MS Imaging and Outcomes Research Laboratory. Her research focuses on the development of data-driven approaches to predict and improve the long-term outcomes of people with MS. She is passionate about eliminating disparities in MS care and research. She is the founder of the Texas MS Consortium and serves as principal investigator of the MS Implementation Network, a nationwide practice-based research network focused on bringing innovations to routine care.
| 1. | DESCRIBE the role of B cells, microglial activation, and compartmentalized CNS inflammation in the pathogenesis of MS. | 2. | DIFFERENTIATE MS progression from relapse-related worsening and other non-MS causes of decline using a structured history and interval assessment. |
| 3. | COMPARE the efficacy and safety data of current and emerging high-efficacy disease-modifying therapies (DMTs) for both relapsing and progressive MS. | 4. | ASSESS patient-specific risks/benefits of anti-CD20 therapy and consider viable alternative therapies. |
| 1. | DESCRIBE the role of B cells, microglial activation, and compartmentalized CNS inflammation in the pathogenesis of MS. |
| 2. | DIFFERENTIATE MS progression from relapse-related worsening and other non-MS causes of decline using a structured history and interval assessment. |
| 3. | COMPARE the efficacy and safety data of current and emerging high-efficacy disease-modifying therapies (DMTs) for both relapsing and progressive MS. |
| 4. | ASSESS patient-specific risks/benefits of anti-CD20 therapy and consider viable alternative therapies. |
TITLE
Precision in Practice: Individualizing MS Therapy Across the Patient Lifespan
PROGRAM PARTNERS
This activity is jointly provided by Albert Einstein College of Medicine-Montefiore Medical, RealCME, and the Multiple Sclerosis Association of America.
ACKNOWLEDGEMENT OF FINANCIAL SUPPORT
Supported by an educational grant from Genentech, a member of the Roche Group
Release Date: October 8, 2026
Expiration Date: October 8, 2027
STATEMENT OF NEED
Despite significant advances in our understanding of multiple sclerosis (MS) pathophysiology, many clinicians continue to rely on older, relapse-centric management models. This approach underestimates the critical roles of B-cells, microglial activation, and compartmentalized central nervous system (CNS) inflammation in driving continuous neurodegeneration. Consequently, progression independent of relapse activity (PIRA) is frequently under-recognized and under-monitored in routine practice. By underutilizing standardized clinical assessments and advanced imaging to detect insidious decline, clinicians often miss the optimal therapeutic window for initiating high-efficacy therapies, leading to faster long-term disability accumulation for their patients.
Furthermore, the rapidly expanding landscape of MS pharmacotherapies complicates treatment selection and long-term management. While high-efficacy disease-modifying therapies (DMTs), such as anti-CD20 agents, offer robust disease control, they present long-term safety challenges—including hypogammaglobulinemia, cumulative infection risks, and immune senescence—that require rigorous, protocol-driven monitoring. Additionally, clinicians often lack familiarity with how emerging therapies, such as brain-penetrant BTK inhibitors, differ mechanistically in targeting compartmentalized inflammation. To optimize outcomes, providers require education on bridging contemporary MS immunobiology with individualized, shared decision-making that accounts for age, comorbidities, genetic variability, and social determinants of health across the patient's lifespan.
EDUCATIONAL OBJECTIVES
-
DESCRIBE the role of B cells, microglial activation, and compartmentalized CNS inflammation in the pathogenesis of MS.
-
DIFFERENTIATE MS progression from relapse-related worsening and other non-MS causes of decline using a structured history and interval assessment.
-
COMPARE the efficacy and safety data of current and emerging high-efficacy disease-modifying therapies (DMTs) for both relapsing and progressive MS.
-
ASSESS patient-specific risks/benefits of anti-CD20 therapy and consider viable alternative therapies.
TARGET AUDIENCE
This educational initiative is intended for Neurology clinicians (MD’s and APP’s) with a focus on those in Community-based practices.
FACULTY
 | Mary Ann Picone, MD, FAAN, FACP Medical Director Holy Name Multiple Sclerosis Comprehensive Care Center Clinical Professor Dept. of Medicine at Rowan-Virtua SOM |
| Disclosure(s): | Received honorarium from Genentech, TG Therapeutics, Biogen and Vanda Pharmaceuticals for serving as a speaker. |
 | Leorah Freeman, MD, PhD Associate Professor of Neurology and Diagnostic Medicine Medical Director, MS and Neuroimmunology Center Dell Medical School, The University of Texas at Austin Austin, Texas |
| Disclosure(s): | Received consultant fees from Roche/Genentech, EMD Serono, Sanofi, Amgen, TG Therapeutics, Immunic, Neurocast USA, and Octave Bioscience for serving as a consultant; received honorarium from Roche/Genentech, Sanofi, Octave Bioscience, and Merck for serving as a speaker; received research funding paid to his institution from Genentech, TG Therapeutics, Sanofi, EMD Serono, Setpoint Medical and Novartis for research work. Roche/Genentech, EMD Serono, Merck, Sanofi, TG Therapeutics, Immunic, Neurocast USA, and Octave Bioscience business line and/or products are related to Dr. Freeman’s presentation. |
CONTENT REVIEWERS
David Kaufman, MD
Professor of Neurology and Psychiatry
Albert Einstein College of Medicine
Montefiore Medical Center
Bronx, NY
David Kaufman, MD, has no relevant financial relationships with ACCME-defined ineligible companies during the past 24 months.
Elizabeth Daphne Verter, MD
Montefiore Multiple Sclerosis Center
Montefiore Medical Center
Assistant Professor of Neurology
Albert Einstein College of Medicine
Bronx, NY
Elizabeth Daphne Verter, MD, has no relevant financial relationships with ACCME-defined ineligible companies during the past 24 months.
PLANNERS
Steven Haimowitz, MD
RealCME
Steven Haimowitz, MD, has no relevant financial relationships with ACCME-defined ineligible companies during the past 24 months.
Anne Jacobson
Medical Writer
Anne Jacobson, has no relevant financial relationships with ACCME-defined ineligible companies during the past 24 months.
DISCLOSURE OF FINANCIAL RELATIONSHIPS
The “Policy on Identification, Mitigation, and Disclosure of Relevant Financial Relationships” of Albert Einstein College of Medicine-Montefiore Medical Center requires that any individual in control of content, including faculty, participating in CME activities disclose to the audience all relevant financial relationships with ineligible companies* in the past 24 months. Any individual in control of content who refuses to disclose, or whose disclosed relationships prove to create a conflict of interest, will be recused.
Individuals with the absence of relevant financial relationships with ineligible companies will be disclosed to the audience.
All financial relationships of individuals in a position to control the content of this CME activity are identified and mitigated prior to the educational activity.
*The ACCME defines an ineligible company as those whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
ACCREDITATION STATEMENT
In support of improving patient care, this activity has been planned and implemented by Albert Einstein College of Medicine-Montefiore Medical Center and RealCME, LLC. Albert Einstein College of Medicine-Montefiore Medical Center is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
CREDIT DESIGNATION STATEMENT
Albert Einstein College of Medicine-Montefiore Medical Center designates this other/blended activity for a maximum of 1.00 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Other Credits
American Nurses Credentialing Center (ANCC) accepts AMA PRA Category 1 Credit™ from organizations accredited by the ACCME.
American Academy of Nurse Practitioners National Certification Program accepts AMA PRA Category 1 Credit™ from organizations accredited by the ACCME.
American Academy of Physician Assistants (AAPA) accepts certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by ACCME or a recognized state medical society.
American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) Program
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.00 Medical Knowledge MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.
DISCLOSURE OF UNLABELED USE
This activity may or may not discuss investigational, unapproved, or off-label use of drugs. Participants are advised to consult prescribing information for any products discussed. The information provided in this CME activity is for continuing education purposes only and is not meant to substitute for the independent medical judgment of a clinician relative to diagnostic and treatment options for a specific patient’s medical condition.
DISCLAIMER
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of Albert Einstein College of Medicine-Montefiore Medical Center, RealCME, and Genentech. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
METHOD OF PARTICIPATION/INSTRUCTIONS ON HOW TO RECEIVE CREDIT
Estimated time to complete this activity: 1.00 hours
This activity is offered at no cost to participants. Please proceed with the activity until you have completed the Post-Test, and evaluation, and have received a digital copy of your credit certificate.
PRIVACY STATEMENT
Albert Einstein College of Medicine-Montefiore Medical Center, Center for Continuing Professional Development (Einstein-Montefiore) protects the privacy of personal and other information regarding participants and education collaborators. Einstein-Montefiore will not release personally identifiable information to a third party without the individual’s consent, except such information as is required for reporting to the ACCME. Einstein-Montefiore maintains physical, electronic, and procedural safeguards that comply with federal regulations to protect against the loss, misuse, or alteration of information collected from you.
COLLECTION AND USE OF YOUR PERSONAL INFORMATION
The submission of certain personally identifiable information is necessary to award and track the credits participants may earn after completing an activity. Required items include first name, last name, middle initial, degree, email address, address and phone number. These items are necessary. Participants are also required to complete an evaluation of each activity. All evaluative information submitted is collected, retained, and used by Einstein-Montefiore to continuously improve the learning experience. Einstein-Montefiore will not transfer, sell, or share personal information with outside parties or otherwise disclose personal information unless required to in a legal process. Einstein-Montefiore will retain your personal data only for the period necessary to accomplish the stated purposes and to comply with applicable laws.
CONTACT INFORMATION
For questions regarding CME credit, contact Albert Einstein College of Medicine-Montefiore Medical Center at cme@montefiore.org.
COURSE VIEWING REQUIREMENTS
| Supported Browsers: Microsoft Edge Google Chrome 60 or higher Mozilla Firefox 60 or higher Apple Safari 11.0 or higher For video, install the latest version of Quicktime. | Supported Phones & Tablets: iOS 9.3 and higher Android 7.0 (Nougat or higher) Microsoft Windows 8 Chrome OS |
| Additional Recommendations and Requirements | |
| Display Resolution & Color Depth | Resolution - 960 X 768 minimum - 1024 X 768 recommended min. Color Depth - 8 bits (256 colors) minimum - 16 bits (High colors) minimum |
| Audio | - Microphone - Speakers or headphones - Audio recording support |
| Word Processing | Software that can open, modify, and save documents in Rich Text Format (RTF). Microsoft Word and PowerPoint are recommended. |
