VOLUME 31 · ISSUE 3 · MARCH 2017
Y O U R M O N T H LY A A N M E M B E R S H I P M A G A Z I N E
2017 Annual Meeting Scientific Program Announced The most innovative scientific research in neurology will debut at the world’s largest gathering of neurologists, from April 22 through 28 in Boston. The 2017 Annual Meeting Scientific Program will showcase more than 2,700 abstracts in a wide variety of formats: nn Seven cutting-edge plenary
sessions, one each day beginning Saturday evening nn Six daily poster and e-poster
sessions beginning Sunday
nn New Neuroscience in the
nn New Invited Science Sessions nn More
For more information, visit AAN.com/view/AM17. Continued on page 26
Want Valuable Insights into Your Practice? Complete the Neurology Compensation and Productivity Survey The AAN’s fifth annual Neurology Compensation and Productivity Survey will launch on March 28. By participating in the survey, active US members can gain free access to the Neurology Compensation and Productivity Report and results
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Webinars Help Strengthen Contract Negotiations, Solo/Small Practices There still is time to register for the AAN’s practice management webinar on what you need to consider when negotiating a contract and how the AAN’s resources—including the Academy’s upcoming 2017 Neurology Compensation and Productivity Report—can help. A second webinar later in March will help you grow your small or solo neurology practice.
Continued on page 18
THIS ISSUE 27 34 36
Registration Opens This Month for July Sports Concussion Conference in Florida Vote for Board Nominees, Bylaws Change at AAN Business Meeting Seeking Mid-career Neurologists for 2017 Transforming Leaders Program
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Table of Contents COVER 2017 Annual Meeting Scientific Program Announced Want Valuable Insights into Your Practice? Complete the Neurology Compensation and Productivity Survey Webinars Help Strengthen Contract Negotiations, Solo/Small Practices
5 Annual Meeting Science
Program Presents Innovations to Entice Clinicians
MEET YOUR LEADER
6 Meet the Nominees for the
AAN and AAN Institute Boards of Directors
16 Podcast Central 17 Quality Payment Program:
Are You Exempt from MIPS?
27 Registration Opens This Month for July Sports Concussion Conference
28 Don’t Wait! Hotels Filling Up Quickly, Registration Savings Ending
Official Publication of the American Academy of Neurology
30 Jones Recognized for Patient Advocacy
CME & MOC
32 New NeuroLearn Patient Safety Online CME Course Available Free to AAN Members
32 UCNS Announces Newly Certified and Recertified Diplomates
33 Continuum Audio Series
Addresses Outpatient Neurology
The Mission of the AAN is to promote the highest quality patient-centered neurologic care and enhance member career satisfaction. Contact Information American Academy of Neurology 201 Chicago Avenue Minneapolis, MN 55415 Phone: (800) 879-1960 (toll free) (612) 928-6000 (international) Email:
35 Synapse Online Communities
For advertising rates, contact: Eileen R. Henry Wolters Kluwer Health | Medical Research Lippincott, Williams & Wilkins
Change at AAN Business Meeting Inaugural Year Proves a Big Hit
36 Seeking Mid-career Neurologists for 2017 Transforming Leaders Program
37 AAN Staff Singled Out for
2016 Great Performers Award
CAREERS | 37 AMERICAN BRAIN FOUNDATION 38 Miller to Help Advance Foundation’s Mission
DATES AND DEADLINES | 39
The AAN responded to the recent executive order suspending some foreign entry into the United States by signing on to positions from the Association of American Medical Colleges and the Council of Medical Specialty Societies and sending a message to members and Annual Meeting attendees. The AAN is also exploring alternative methods for researchers who may be affected by immigration policy to present their scientific research at the AAN Annual Meeting. Learn more at AAN.com/january-30-2017. The AAN Medical Economics & Management Committee (MEM) approved its regulatory priorities for 2017, which include: 1) Continuing MACRA advocacy with the goal to reduce burdens on neurologists while improving the Quality Payment Program; 2) Encouraging increased flexibilities for small and solo neurology practices; 3) Advocating for more accurate and improved cognitive reimbursement; and 4) Monitoring regulatory announcements from the new administration to outline further regulatory priorities as needed and address developments. • AANnews • March 2017
The Vision of the AAN is to be indispensable to our members.
34 Vote for Board Nominees, Bylaws
29 Capitol Hill Report
AAN Executive Director Catherine M. Rydell, CAE Editor-in-Chief: John D. Hixson, MD Managing Editor: Angela Babb, CAE Editor: Tim Streeter Writers: Ryan Knoke and Sarah Parsons Designers: Siu Lee and Jim Hopwood Email: aannews@AAN.com AANnews is published monthly by the American Academy of Neurology for its 32,000 members worldwide. Access this magazine and other AAN publications online at AAN.com/go/elibrary. The American Academy of Neurology’s registered trademarks and service marks are registered in the United States and various other countries around the world. “American Brain Foundation” is a registered service mark of the American Brain Foundation and is registered in the United States.
Annual Meeting Science Program Presents Innovations to Entice Clinicians One of the exciting things about holding this April’s Annual Meeting in Boston is that this city has long been a major hub of science and research, of tradition and change. This challenges us to be better than our best when we present the latest cutting-edge research in neurology. I think we will accomplish this thanks to the leadership of AAN Board Member Dr. Lisa M. DeAngelis, who chairs the Science Committee, and the great efforts of hundreds of volunteer members and our staff.
I presume you have plenty of new features for this year’s Science Program. We certainly do. We’re constantly thinking about not only how we can attract the best abstracts—we have over 2,700—but how can we present them in a way that enhances the attendees’ experience. We strive to have the broadest array of neurology topics and still enable attendees to have a personal experience interacting with presenters and colleagues. For example, our poster sessions have always been very popular, but this year we are grouping topic-related posters together in “neighborhoods.” Not only will this be more convenient, but it will help spur discussions and exchange of ideas. And the chance for interaction with leading researchers continues in our “Best of” sessions, which are four abstract presentations followed by a
panel discussion, and ending with a “meet the investigator” breakout.
The Experiential Learning Area was a hit last year in Vancouver, and it will be bigger and better in Boston. How will science be represented? At the Research Corner: Moving Neurology Forward, Terrence L. Cascino, Lisa M. DeAngelis, MD, FAAN MD, FAAN attendees can enjoy informative presentations responded with two fresh programs and helpful mentoring sessions on that should provide real value. Our research careers, grant proposals, innovative Neuroscience in the Clinic funding, and more. The platform and Clinical Discussions sessions will sessions in the Research Corner on offer entirely new ways of engaging History, Autonomic Disorders, Pain, scientists and clinicians in important Neurorehabilitation, and Global Health discussions about scientific application will be appreciated by those seeking to the clinical setting. These sessions more insights on those topics. will offer a new twist by merging This will also be an exciting new scientists, who will provide abstracts venue for award recipients. The 2017 and discussion regarding the Scientific Award recipients will be underlying research and how it applies recognized and celebrated in the to our clinical problems followed by Research Corner, which will feature a a Q&A with the audience. The new display wall with recipient names and Clinical Discussions will incorporate photos, and a private lounge space for invited discussants at the platform award winners to enjoy. sessions to provide clinical context for the research that was presented.
I understand there are new neuroscience programs directed at clinicians. Attendees have asked for more integration of scientific research with clinical application, so we have
A highlight for me each year are the plenary sessions. Perhaps more so this year since you will be presenting the Presidential Lecture? Continued on page 15
AANnews • March 2017
Meet Your Leader
Meet the Nominees for the AAN and AAN Institute Boards of Directors AAN members who attend the Annual Meeting on Saturday, April 22, in Boston will be able to vote on nominees for the 2017–2019 AAN and AAN Institute Boards of Directors at the Business Meeting. The Academy is comprised of two legal entities, the AAN and the AAN Institute. Several AAN and AAN Institute Board members serve ex officio based on their positions as chairs of major committees. Most of the elected members of the AAN Board of Directors also serve ex officio on the Board of Directors of the AAN Institute, which includes an independent secretary-treasurer and additional members who serve in ex officio capacities. For informational purposes only, the biographies below include both AAN and AAN Institute proposed Board members as well as those who serve ex officio pursuant to the AAN and AAN Institute bylaws. Ralph L. Sacco, MD, MS, FAHA, FAAN, will serve as the president of the AAN based on his 2015 election as president elect, and Terrence L. Cascino, MD, FAAN, will serve as immediate past president based on his current service as president.
President—Ralph L. Sacco, MD, MS, FAHA, FAAN
Immediate Past President— Terrence L. Cascino, MD, FAAN
Ralph L. Sacco, MD, MS, FAHA, FAAN, is the chairman of neurology; Olemberg Family Chair in Neurological Disorders; Miller Professor of Neurology Public Health Sciences, Human Genetics, and Neurosurgery; executive director of the Evelyn McKnight Brain Institute; Senior Associate Dean for Clinical and Translational Science, University of Miami, Miller School of Medicine; and chief of the neurology service at Jackson Memorial Hospital. A graduate of Cornell University and a cum laude graduate of Boston University School of Medicine, he also holds a master’s in epidemiology from Columbia University, School of Public Health. Sacco completed his neurology residency training and postdoctoral training in stroke and epidemiology at Columbia Presbyterian in New York. He was previously professor of neurology, chief of Stroke and Critical Care Division, and associate chairman at Columbia University before taking his current position in 2007.
Terrence L. Cascino, MD, FAAN, is currently a professor of neurology, Mayo Clinic College of Medicine, at Mayo Clinic in Rochester. He has served as vice chair of the department of neurology and has been a leader in clinical practice at Mayo Clinic serving as the chair of the Clinical Practice Committee. He has served as the Juanita Kious Waugh Executive Dean for Education, Mayo Clinic, completing his tenure in October 2012. Cascino has chaired numerous committees in the American Academy of Neurology, including the Graduate Medical Education Committee and Education Committee, as well as having served as the AAN treasurer and AEI Board chair. He currently serves as president of the AAN.
Sacco is an international expert in stroke epidemiology and health disparities. He is the principal investigator of the Northern Manhattan Study, the Florida Puerto Rico Collaboration to Reduce Stroke Disparities, AHA/ASA Bugher Center of Excellence, as well as co-investigator of multiple other NIH grants. Sacco has published extensively with over 600 peer-reviewed articles (h-index 101) in the areas of stroke prevention, treatment, epidemiology, risk factors, vascular cognitive impairment, human genetics, and outcomes.
He has been the recipient of numerous awards, including the AAN Wartenberg Lecture, AHA Feinberg Award of Excellence in Clinical Stroke, the WSO Global Stroke Leadership Award, AHA Gold Heart Award, the NINDS Javits Award in neuroscience, and numerous named lectures. Sacco is a fellow of both the Stroke and Epidemiology Councils of the American Heart Association, a Fellow of the ANA, and an elected member of the American Association of Physicians. He was the first neurologist to serve as the president of the American Heart Association from 2010 to 2011.
AANnews • March 2017
2017–2019 AAN Board of Directors Nominees *Denotes new board nominees
President Elect—Lisa M. DeAngelis, MD, FAAN Lisa M. DeAngelis, MD, FAAN, is chair of the department of neurology at Memorial Sloan Kettering Cancer Center. She holds the Lillian Rojtman Berkman Chair in honor of Dr. Jerome Posner. She has published extensively on a wide variety of topics in neuro-oncology and is particularly known for developing the current standard regimen to treat primary CNS lymphoma, the first brain tumor to be treated with chemotherapy exclusively. DeAngelis is a Fellow of the American Academy of Neurology and of the American Neurological Association. She is a prior member
of the AAN Board of Directors, vice chair of the Board, and current chair of the Science Committee. She is a member of the editorial boards of Neurology ®, Neuro-oncology, and Journal of Neuro-Oncology. DeAngelis was elected to the Institute of Medicine of the National Academies.
Vice President—James C. Stevens, MD, FAAN James C. Stevens MD, FAAN, has been a private practicing neurologist and specialist in sleep disorders medicine at the Fort Wayne Neurological Center for the past 29 years. He received his medical degree from the Indiana University School of Medicine (IUSM), where he graduated at the top of his class, receiving AOA honors his junior year. He completed his neurology resident training at Indiana University, where he was a multiyear recipient of the Alexander Ross Award for outstanding neurologic research. He currently serves as a professor of neurology for the IUSM. Stevens has been a participant, co-author, and/or principal investigator in over 80 clinical trials dealing with a wide variety of neurologic diseases. He has also been involved with the development, authorship and/or reviewer for over 80 clinical practice guidelines submitted by the AAN. He has held many leadership positions within the Academy, serving as the chair of the Practice Committee, member of the Quality Standards Subcommittee, and the Therapeutics and Technology Subcommittee, as well as serving on numerous work groups and task forces, including the Health Reform Task Force, the Solo and Small Group Task Force, and is currently serving as vice president of the AAN and chair of the AAN Board Planning Committee. Stevens is a graduate of the Palatucci Advocacy Leadership Forum, has been a special advisor to the NINDS clinical research consortium, and is a pastpresident of the Indiana Neurological Society. He also served on the executive committee for the Lutheran Hospital of Indiana, and serves as chair of the board of directors for Physicians Health Plan of Indiana. He has been recognized annually as one the “Best Doctors in America,” and has been a recipient of the “Patients Choice Award” since 2008 as one of the outstanding physicians in the United States, and has received multi-year recognition as the “Top Doc” in neurology by the Fort Wayne Journal Gazette.
Secretary—Carlayne E. Jackson, MD, FAAN Carlayne E. Jackson, MD, FAAN, is currently professor of neurology and otolaryngology at the University of Texas Health Science Center San Antonio (UTHSCSA). She also serves as chief medical officer of UT Medicine and as assistant dean of ambulatory services for the School of Medicine. Jackson is a graduate of Texas A&M University, where she received a bachelor’s of science degree in chemical engineering. She obtained her medical degree at UTHSCSA, where she subsequently completed her neurology residency training and clinical neurophysiology fellowship. She has obtained board subspecialty certification in both clinical neurophysiology and neuromuscular medicine. She is a graduate of the Executive Leadership in Academic Medicine (ELAM) program sponsored by Drexel University College of Medicine. Jackson serves as medical director for the South Texas ALSA Center of Excellence and the MDA ALS Research Center. She is a member of the Western ALS Study Group, Northeast ALS Research Group, and the Muscle Study Group. She has participated in over 60 multi-center clinical trials in the areas of ALS, muscular dystrophy, and myasthenia gravis and has published over 200 abstracts, journal articles, and book chapters. Jackson has served the AAN as a member of the Science Committee, Meeting Management Committee, Leadership Development Committee, and the Board of Directors. She has been a member of the Continuum ® editorial board since 2007. She co-chaired the ALS Measurement Development Panel and co-authored the ALS Practice Parameters. She has actively participated on the Education Subcommittee and more recently on the Neuromuscular Topic Work Group. Jackson participated in the Palatucci Advocacy Leadership Forum in 2013, and has been a delegate to Neurology on the Hill. She has served as a mentor in the Emerging Leaders Forum for the past three years and the Diversity Leaders Program since its inception.
Continued on page 8
Meet Your Leader
Meet the Nominees for the AAN and AAN Institute Boards of Directors Continued from page 7
Treasurer—Janis M. Miyasaki, MD, MEd, FRCPC, FAAN
Janis M. Miyasaki, MD, MEd, FRCPC, FAAN, is a graduate of the University of Toronto Medical Faculty, neurology residency program, and a movement disorders fellowship. From 1994 to 1998, she was a community neurologist seeing general neurology patients and providing in-hospital care at a regional cancer and dialysis hospital. In 1999, she joined the faculty of medicine at the University of Toronto as full-time faculty, assuming the roles for various periods of director of education for neurology for four hospitals, ward chief, member of the Board of Trustees for the University Health Network, president of the Medical Staff Association, president of the Canadian Movement Disorders Group, deputy physician-in-chief at Toronto Western Hospital, and associate clinical director of the Movement Disorders Centre at Toronto Western Hospital from 2001 to 2013. Her practice consisted of movement disorders, clinical trials, and the development of an interdisciplinary Palliative Care Program for Parkinson’s Disease and Related Disorders, the first of its kind in the world.
Brenda Banwell, MD, FAAN, currently serves as the chief of child neurology and professor of neurology and pediatrics at The Children’s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania. Banwell’s clinical and research focus is in the area of pediatric multiple sclerosis and she leads a 24-site North American prospective study of clinical outcomes, genetics, immunology, and neuroimaging features of MS in children. Banwell also serves as the research chair of the International Pediatric Multiple Sclerosis Study Group.
Since 2014, Miyasaki has been a member of the division of neurology at the University of Alberta and active in local and provincial initiatives in palliative care for neurologic patients. Her AAN activities began in 2000 with writing a guideline on Parkinson’s disease. Since that time, she has worked on many AAN committees, including the Practice Committee, Technology and Therapeutics Subcommittee, Practice Improvement Subcommittee, Patient Safety Subcommittee, and co-chaired the Technology and Therapeutics Subcommittee (now the Guideline Development Subcommittee) and Education Committee. Between producing educational content, committees, working groups and meetings, she estimates since 2000 spending one day per month to a half-day per week on AAN work. It has been rewarding and energizing work.
AANnews • March 2017
Brenda Banwell, MD, FAAN*
Banwell studied medicine at the University of Western Ontario, followed by residencies in pediatrics at the University of Western Ontario and Child Neurology at the University of Toronto. She then pursued a Neuromuscular Fellowship at the Mayo Clinic, Rochester, MN. Banwell was appointed as an assistant professor of pediatrics and neurology at The Hospital for Sick Children, University of Toronto in 1999, and rose to the rank of full professor at the University of Toronto prior to relocating to The Children’s Hospital of Philadelphia in 2012. Banwell remains as adjunct senior scientist in the Research Institute at The Hospital for Sick Children. Banwell has been a member of the AAN since 1996, and has attended every Annual Meeting since joining the Academy. She served on the Science Committee from 2005 to 2011, and is an active member of the AAN Meeting Management Committee. Banwell was a selected attendee at the Leadership Development Program in 2007 and 2008, and has more recently served as a mentor in the Emerging Leader Program of the AAN. She serves on the Brain Health Fair Committee and has been an active participant in Brain Health Fair activities annually.
Sarah M. Benish, MD, FAAN Sarah M. Benish, MD, FAAN, is currently a partner at Minneapolis Clinic of Neurology (MCN), one of the largest physician-owned, single-specialty neurology clinics in the country. She is a general neurologist who spends most of her days evaluating outpatient and inpatient neurology patients in Edina, MN. She is also a member of the board of MCN and has enjoyed
her time learning about the “business of medicine” and the challenges of remaining as an independent physicianowned clinic in the current health care environment. She joined the clinic in 2007 after completing the neurology residency training program at Mayo Clinic in Rochester, MN, and medical school at Indiana University School of Medicine. She began her involvement with the American Academy of Neurology as a member of the inaugural class of the Emerging Leaders Forum. Subsequently, she has been a member of the Practice Committee and the Registry Committee.
Charles C. Flippen II, MD, FAAN Charles C. Flippen II, MD, FAAN, is a faculty member of the Headache Research and Treatment Program at the Ronald Reagan UCLA Medical Center, attending neurologist at the Olive View-UCLA Medical Center, and professor of neurology and director the residency program in clinical neurology at the Geffen School of Medicine at UCLA. Flippen is a diplomate of adult neurology of the American Board of Psychiatry and Neurology (ABPN) and of headache medicine of the United Council of Neurologic Subspecialties. He is a member of the American Headache Society, International Headache Society, Fellow of the American Neurological Association, and Fellow of the American Academy of Neurology, where he is active in headache education, having directed several courses, and as chair of the Headache Topic Work Group of the Education Committee. He also serves on the Quality and Safety Subcommittee, the AAN Institute Minority Scholars Subcommittee, and served on the AAN Nomination Committee. In addition to his activity on the AAN Education Committee, Flippen represents the ABPN on the Neurology Residency Review Committee of the Accreditation Council of Graduate Medical Education, is conducting education research funded by the ABPN Faculty Fellowship award, and serves on several intramural committees charged with curricular innovation in the Geffen School of Medicine. Flippen is also active within the general Los Angeles community through his service as a former trustee of the Carlthorp School, board member of 100 Black Men of Los Angeles, assistant scoutmaster and Merit Badge counselor for Troop 223 (Pacific Palisades) of the Boy Scouts of America, West Region Health and Wellness committee member for Alpha Phi Alpha Fraternity Inc., and member of Sigma Pi Phi Fraternity, Inc.
Charlene Gamaldo, MD, FAAN* Charlene Gamaldo, MD, FAAN, has been a faculty member of the Johns Hopkins School of Medicine neurology department since 2004, with joint appointments in the department of psychiatry, nursing, anesthesiology, and schools of public health. She is currently the medical director of the Johns Hopkins Center for Sleep and the vice chair for faculty development for the neurology department. Gamaldo’s research interest is studying the impact of sleep on manifestation and progression of neurologic diseases. Her research activities have relied heavily on the interdisciplinary and inter-professional collaborative model for conducting sleep research using the efforts of a diverse group of collaborators and, as a result, have led to ongoing and evolving research projects that now include a growing list of collaborators at Johns Hopkins in neurology, psychiatry, urology, biomedical engineering, Schools of Nursing and Public Health, along with the National Institute on Aging. In addition, upon considering the projected shortage of sleep practitioners, she has developed programs to involve and expose undergraduates (sleep learning module), medical students (sleep learning module), graduate students, post-docs, and residents to the sleep medicine field in order to attract the best and the brightest early on in their career. Gamaldo has served as co-chair for the AAN Sleep Section presentations, served as the Johns Hopkins School of Medicine neurology clerkship co-director for six years, and has recently been appointed to the AAN Sleep Section Leadership Committee, as well as the AAN Medical Student Pipeline Committee, the Undergraduate Education Subcommittee, and the Minority Scholars Subcommittee.
Jonathan P. Hosey, MD, FAAN Jonathan P. Hosey, MD, FAAN, is currently the chairman of neuroscience for the St. Luke’s University Health Network in Bethlehem, PA, which is composed of seven hospitals in two states. He has been involved with the development of neurology residency programs at the Madigan Army Medical Center in Tacoma in 1990, and as the founding director of the Geisinger Health System program in 2010. He is a professor of neurology at the Lewis Katz School of Medicine at Temple University, and has served on numerous American Academy of Neurology subcommittees and committees. He is most proud of being in the inaugural class of the Palatucci Advocacy Leadership Forum. Continued on page 10
Meet Your Leader
Meet the Nominees for the AAN and AAN Institute Boards of Directors Continued from page 9
Hosey is active in his community, having served as a past president of the American Heart Association/American Stroke Association (AHA/ASA) of Pennsylvania/Delaware chapter. He has served on many boards, including the Three Rivers Affiliate of the AHA/ASA, Geisinger Health Plan, Pennsylvania Rural Stroke Institute, and was a longserving trustee of Wyoming Seminary Preparatory School of Pennsylvania, where he was awarded the Joseph Donchess Lifetime Achievement Award for his service. He currently serves on the Board of King’s College in Wilkes-Barre, PA, of which he is an alumnus. He is married to Linda M. Famiglio, MD, FAAP, a pediatric neurologist, and has two children.
Elaine C. Jones, MD, FAAN Elaine C. Jones, MD, FAAN, has been in solo, private practice in Bristol, RI, since 2005, and enjoys doing general neurology in her community and her state. She received her undergraduate degree from Smith College in Northampton, MA, and her medical degree from the Medical University of South Carolina in Charleston. She completed her internship in internal medicine at Tufts University Baystate Medical Center in Springfield, MA, followed by a residency in neurology and a fellowship in neurophysiology at Brown University, Rhode Island Hospital in Providence. Early in her career, Jones attended the American Academy of Neurology Palatucci Advocacy Leadership Forum, where she became involved in both federal and state legislation and policy. She chaired the AAN’s Government Relations Committee and the Payment Policy Subcommittee, and has served on the BrainPAC Executive Committee, Payment Advisory Taskforce, Burnout Taskforce, and the Gender Disparities Taskforce. She currently serves on the AAN Board of Directors. In her own state, she served as president of the Rhode Island Medical Society and as president of the Rhode Island Neurological Society. She served on many state taskforces, including the Health Care Leaders Advisory Committee, Health Source RI Advisory Board for the State Exchange, and the Alzheimer’s Disease Planning Committee. Jones is a diplomate in the American Board of Psychiatry and Neurology with a neurology certification. She is a Fellow of the American Academy of Neurology. Honors and awards include the 2016 AAN Palatucci Advocacy Award for advocacy work done in the US and in Haiti, and Rhode Island Monthly Top Docs in 2008–2016.
AANnews • March 2017
Brett M. Kissela, MD, MS, FAAN* Brett M. Kissela, MD, MS, FAAN, is professor and chair of the Department of Neurology and Rehabilitation Medicine at the University of Cincinnati College of Medicine. Since 2008, he has been co-director of the Stroke Recovery Center at Drake and a member of the University of Cincinnati Stroke team since 2000. He is fellowship-trained in vascular neurology and has extensive clinical trial experience in acute stroke treatment, prevention, and recovery trials. He is an internationally recognized expert on causes, outcomes, and recovery of stroke, with a special interest in the impact of diabetes on stroke and factors that influence stroke outcomes. He also participates in a variety of stroke recovery projects which look to improve recovery with the use of innovative techniques and devices. Honors and awards include the Cincinnati Business Courier’s Forty Under 40 Award, Michael S. Pessin Stroke Leadership Prize from the American Academy of Neurology, Alpha Omega Alpha membership, National Medical Honor Society, Phi Beta Kappa, UC Faculty Senate Award, and has continuously been named as one of the Best Doctors in America (national surveys from Woodward-White and Best Doctors, Inc.).
John C. Morris, MD, FAAN John C. Morris, MD, FAAN, is a leading researcher in the fight against Alzheimer’s disease. Morris is the Harvey A. and Dorismae Hacker Friedman Distinguished Professor of Neurology; Professor of Pathology and Immunology, Physical Therapy, and Occupational Therapy; and director and principal investigator of the Charles F. and Joanne Knight Alzheimer’s Disease Research Center at Washington University School of Medicine. Morris earned his medical degree from the University of Rochester School of Medicine and Dentistry in Rochester, NY. He completed residencies in internal medicine at Akron General Medical Center and in neurology at the Cleveland Metropolitan General Hospital, both in Ohio, and a postdoctoral fellowship in neuropharmacology at Washington University School of Medicine. The focus of Morris’ research and practice is Alzheimer’s disease and other neurologic disorders associated with aging. He is a former member of
the Alzheimer’s Association National Board of Directors and its Medical Scientific Advisory Council. He currently is a member of the Board of Directors for the American Academy of Neurology. Morris has authored four books and more than 520 published articles (current h-index 118). He is a member of several professional societies and serves on numerous scientific and community advisory boards. He has received many honors and awards, including the MetLife Award for Medical Research in Alzheimer’s Disease (2004); the Potamkin Prize for Research in Pick’s, Alzheimer’s, and Related Dementias (2005); Peter H. Raven Lifetime Achievement Award from the Academy of Science of St. Louis (2013); the Carl and Gerty Cori Faculty Achievement Award, Washington University (2010); the Washington University School of Medicine Second Century Award; and the 2013 Medical and Scientific Honoree from the Alzheimer’s Association. He is ranked in the top one percent of investigators in the field of neuroscience and behavior by Essential Science Indicators database.
Thomas R. Vidic, MD, FAAN
Vidic was introduced to AAN leadership through the Palatucci Advocacy Leadership Forum and has been active in both advocacy and member issues. He has been a member of AAN committees such as State Affairs, Legislative Affairs, BrainPAC, and as an alternate delegate to the AMA. He has chaired the Membership Committee and currently chairs the Member Research Subcommittee. He was co-author of “Supply and Demand Analysis of the Current and Future US Neurology Work Force” and is a co-author of the Neurology ® article on neurologist burnout. Vidic believes in the importance of neurologists in the medical community and the need to support neurologists through the AAN. He has developed an interdisciplinary skillset to analyze medical/political issues and the interpersonal skills to implement effective strategies. He is excited about continuing to serve the AAN on its board.
Ex Officio (voting) Nicholas E. Johnson, MD Chair, Government Relations Committee
Thomas R. Vidic, MD, FAAN, has dedicated his professional life to patient care, advocacy, teaching, and clinical research. He is a practicing general neurologist at the Elkhart Clinic in Indiana, the director of the regional MDA clinic, and co-director of the rehabilitation unit at Elkhart General Hospital. Vidic established Indiana Medical Research and is its medical director. He is past chair of the Elkhart Clinic, past chief of staff of Elkhart General Hospital, and chair of the bylaws committee.
Nicholas E. Johnson, MD, is an assistant professor of neurology, pediatrics, and pathology at the University of Utah with a focus in inherited neuromuscular disorders. He received his undergraduate degree in molecular and cellular biology and psychology at the University of Arizona. He then obtained his medical degree at the University of Arizona. He completed his neurology residency and combined fellowship in neuromuscular medicine and experimental therapeutics at the University of Rochester.
Advocacy has been a passion for Vidic. He is a member of the Indiana Neurological Society and has served many roles, including president. He has worked with the Indiana State Medical Association on legislative advocacy and has served as speaker, president, and current chair of the PAC. He currently represents Indiana as an alternate delegate to the AMA.
His laboratory is focused on identifying the pathogenesis of myotonic dystrophy and facioscapulohumeral muscular dystrophy and identifying appropriate clinical endpoints for these conditions. Johnson conducts therapeutic trials in many other inherited nerve and muscle disorders. He also serves as deputy editor of Neurology ® Genetics.
Vidic is a clinical associate professor at the Indiana School of Medicine/South Bend and co-teaches the third-year clerkship in neurology. He is on the Medical Foundation Board, which has helped develop and finance the transition of a regional campus to a four-year program.
Johnson serves as chair of the Government Relations Committee for the American Academy of Neurology. He is also a member of the American Academy of Neurology’s delegation to the American Medical Association. In these roles, Johnson advocates for improving the practice of neurology for neurologists and their patients.
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Meet Your Leader
Meet the Nominees for the AAN and AAN Institute Boards of Directors Continued from page 11
Orly Avitzur, MD, MBA, FAAN, Chair, Medical Economics and Management Committee Orly Avitzur, MD, MBA, FAAN, chairs the American Academy of Neurology Medical Economics and Management Committee. She is a medical writer and the editor-inchief of Neurology Now ®, the AAN patient magazine. She has been writing for Neurology Today ®, reporting on trends in the practice of neurology, since 2001, and is an associate editor for the publication. She is also the editor of the American Brain Foundation newsletter and the former editor-in-chief of AAN.com. She is Consumer Report’s medical director, writes the Proactive Patient column for Consumer Reports on Health, and has been a frequent contributor to the Washington Post. She writes and speaks frequently about consumer health and wellness, medical economics, and medical practice management and has been the recipient of several APEX writing awards and the 2009 AAN Journalism Fellowship award. A graduate of Pennsylvania State University School of Medicine, Avitzur is a clinical instructor at Yale University School of Medicine in New Haven, CT, where she completed her neurology residency, and a clinical assistant professor at New York Medical College in Valhalla, NY. She is a practicing neurologist in Tarrytown, NY, and a medical consultant to the New York Rangers.
Gregory D. Cascino, MD, FAAN, Chair, Member Engagement Committee Gregory D. Cascino, MD, FAAN, is the Whitney MacMillan, Jr. Professor of Neuroscience at the Mayo Clinic College of Medicine and the Enterprise Director of Epilepsy at Mayo Clinic, Rochester, MN. He attended Northwestern University and received his degree in medicine from Rush Medical College in Chicago, IL. Cascino completed an internal medicine residency at Duke University in Durham, NC, and a neurology residency and clinical neurophysiology fellowship at the Massachusetts General Hospital in Boston, MA. In 1988, Cascino joined the staff of the Mayo Clinic. His interests have included the identification of surgically remediable epileptic syndromes and advanced neuroimaging in patients with
AANnews • March 2017
drug-resistant focal epilepsy. He has published over 200 peer-reviewed articles and presented approximately 400 invited lectures. Cascino has participated in the training of over 75 epilepsy-EEG fellows. He is currently an associate editor of Neurology ®, chair of the AAN Member Engagement Committee, and an ex officio member of the AAN Board of Directors. He previously served on the American Epilepsy Society (AES) Board of Directors, the Council of the American Clinical Neurophysiology Society, and the Professional Advisory Board Executive Committee of the Epilepsy Foundation of America, and is past-chair of the AAN’s Epilepsy Section. Cascino was the recipient of the J. Kiffin Penry Excellence in Epilepsy Care Award presented by the AES in 2013. He is married to Teresa Griffin Cascino and has two sons (Dr. Matthew and Dr. Gregory Joseph), one daughter (Mary), two daughters-in-law (Dr. Missy Haehn and Sarah), and two terrific grandkids (Ira and Charles).
Robert A. Gross, MD, PhD, FANA, FAAN, Editor-in-Chief of Neurology Robert A. Gross, MD, PhD, FANA, FAAN, graduated from Harvard College in 1975 with an AB in biology, summa cum laude, and from Washington University, MD and PhD (pharmacology) in 1981. After internship at the Jewish Hospital in St. Louis, he completed neurology residency at the Massachusetts General Hospital, where he served as chief resident. Faculty positions followed at the University of Michigan and the University of Minnesota, followed by the University of Rochester Medical Center (1994). Research interests have centered on various aspects of cellular neuropharmacology and, collaboratively, on mechanisms of excitotoxicity and chemobrain. He participated in clinical trials of novel anticonvulsants and served on a multicenter task force to design trials to compare brand to generic AEDs. He was the recipient of the S. Weir Mitchell Award of the American Academy of Neurology (AAN) in 1988. He sees patients in the Strong Epilepsy Center, and is the associate chair for academic affairs in neurology. Gross’ educational efforts are diverse. He founded and directs the Academic Research Track; funded by URMC’s Clinical and Translational Science Award, this supports medical students for a year-out mentored experience in medical research. He helps direct and lectures (neuropharmacology) in the medical student course “Mind, Brain and Behavior.” He directs a novel basic science course for fourth-year medical students, “Process of Discovery,” in which students design cutting-
edge research programs to address gaps in clinical care. He also teaches in AAN Annual Meeting courses, including the Career Development symposium.
2017–2019 AAN Institute Board of Directors Nominees
He served as an associate editor of Neurology for eight years, two of which were as deputy editor, and is the current editor-in-chief of the Neurology journals.
The following are additional members of the AAN Institute Board of Directors who do not serve on the AAN Board of Directors.
Gross is a fellow of the AAN and American Neurological Association, and a member of the American Epilepsy Society. He has appeared on the PBS program “Second Opinion” and on local radio shows on the topic of epilepsy.
Ex Officio (non-voting) Catherine M. Rydell, CAE, Executive Director/CEO Catherine M. Rydell, CAE, has been the American Academy of Neurology’s executive director and chief executive officer since 1999. Along with her executive team, she oversees 185 staff. Under Rydell’s leadership, AAN membership has grown from 16,000 to 32,000 members. Since joining the AAN, Rydell has focused on strengthening advocacy and coalition-building efforts, increasing staff development, improving communication with members, and implementing its strategic plan. Under her leadership, the Academy increased educational offerings and established a companion organization to help support new member services and advocacy. Rydell also has been instrumental in expanding the influence and reach of the AAN by creating entities and initiatives to promote and advance the specialty of neurology. Rydell is a Certified Association Executive (CAE), the highest professional credential in the association industry. Less than five percent of all association professionals have earned a CAE designation. Rydell serves on the Board of Directors of the American Brain Foundation and as a member of the American Medical Association CEO Advisory Committee and the Specialty Society CEO Coalition. She serves as an ex officio member of the Neurology Residency Review Committee and the United Council of Neurologic Subspecialties (UCNS). She also serves on the Board of the University of North Dakota Foundation and Alumni Association. Prior to joining the AAN, Rydell served as executive director of the North Dakota Medical Association. From 1984 through 1996, Rydell served as a state representative in the North Dakota State Legislature, where she chaired the House Human Services Committee and the House Education Committee.
Ann H. Tilton, MD, FAAN, Secretary-Treasurer Ann H. Tilton, MD, FAAN, is a professor of neurology and pediatrics and section chair of child neurology at Louisiana State Health Science Center in New Orleans, LA. She is director of the Rehabilitation Center at Children’s Hospital of New Orleans and director of the Comprehensive Spasticity Program. Special interests include neurorehabilitation, neuromuscular disorders, and clinical applications and research in novel uses of botulinum toxin and intrathecal baclofen in the care of children and young adults with abnormal tone. Tilton has been involved on the executive committee of the Professors of Child Neurology and active in the national Child Neurology Society as a councilor, secretary/treasurer, and served as president of the organization. She is currently the president-elect of the Child Neurology Foundation. She is actively involved in the AAN Board of Directors, where she serves as the treasurer of the AAN Institute. Residency education is one of her priorities and she served as a member and vice chair of the ACGME Neurology Residency Review Committee. She is just completing her role as the chair of the American Board of Psychiatry and Neurology. Tilton’s interest in children with disabilities extends to the American Academy of Pediatrics where she served on the national Council for Children with Developmental Disabilities. Additionally, she is a certified member of the American Society of Neurorehabilitation and has been active on the executive committee. Tilton has been board certified by the American Board of Pediatrics, the American Board of Psychiatry and Neurology with special qualifications in child neurology, and the American Board of Psychiatry and Neurology in clinical neurophysiology. She has published on numerous topics and has spoken nationally and internationally on child neurology, rehabilitation, and spasticity management. Continued on page 14
Meet Your Leader
Meet the Nominees for the AAN and AAN Institute Boards of Directors Continued from page 13
Ex Officio (voting) Natalia S. Rost, MD, MPH, FAAN, FAHA, Chair, Science Committee Natalia S. Rost, MD, MPH, FAAN, FAHA, is director of the Acute Stroke Services at Massachusetts General Hospital and associate professor of neurology at Harvard Medical School. A cum laude graduate of Boston University School of Medicine, she also holds a master’s degree from Harvard School of Public Health. Rost trained in neurology and vascular neurology at Partners (Massachusetts General Hospital/Brigham and Women’s Hospital) residency and fellowship programs. As clinician-scientist, Rost dedicated her career to care of patients with stroke and reducing the burden of poststroke disability through excellence and innovation in care and neurological science. Rost has an established line of research aiming to unravel the role of pre-existing burden of cerebrovascular disease on susceptibility of brain tissue to acute ischemia, which has been continuously supported by the National Institutes of Health and foundations including National Stroke Association, Bugher Foundation of the American Heart/Stroke Association, and the NIH Career Development Award (K23). As the principal investigator of the SALVO (NINDS R01NS082285) and MRI-GENIE (NINDS R01NS0869050) studies, she is broadly recognized as expert in neuroimaging markers of cerebrovascular disease, genetics of stroke, and post-stroke outcome prediction. Rost also serves as co-investigator on the multiple multidisciplinary, multi-center collaborations involving the US-based NINDS StrokeNET clinical trials network and the International Stroke Genetics Consortium, where she serves as chair of the Neuroimaging Working Group. Rost is an author of numerous peer-reviewed publications, book chapters, and co-author of the Massachusetts General Hospital Handbook of Neurology. She serves as assistant editor of the journal STROKE, and she recently completed her tenure as president of the Boston Board of the American Heart/Stroke Association. Among her professional accomplishments, Rost is particularly proud of her career-long involvement with the American Academy of Neurology, where she currently serves as vice chair of the Science Committee.
AANnews • March 2017
Heidi B. Schwarz, MD, FAAN, Chair, Practice Committee Heidi B. Schwarz, MD, FAAN, is currently professor of clinical neurology at the University of Rochester Medical Center (URMC). Schwarz graduated from Mount Holyoke College magna cum laude with an AB in chemistry. She obtained her medical degree from University of Rochester School of Medicine and Dentistry. She did a two-year residency in internal medicine and three-year residency in neurology at the University of Rochester, followed by a fellowship in movement disorders and inherited metabolic diseases (MIND unit). She is board certified in neurology from the ABPN and headache medicine from United Council for Neurologic Subspecialties. Schwarz was in private practice of general neurology for 13 years, where she also served on the board of directors of a medical management company. She returned to URMC, where she became an associate chair of community relations and director of an affiliated stroke center, which achieved NYS certification. She also has worked as an employed neurologist at Unity Health System, where she was involved in creating the only regional headache center. She has been actively involved in teaching mindfulness in medicine for the last eight years. Currently, she is chair of the AAN Practice Committee (overseeing the development of guidelines, quality measures, integration of advanced practice providers, advancing telemedicine, and stroke systems), ex officio member of the AAN Institute Board of Directors, co-chair of the Burnout Work Group, and member of Meeting Management Committee and Conference Subcommittee. She is collaborating on developing a Leadership Program for Well-being and Resilience to help address the crisis of physician burnout.
A. Gordon Smith, MD, FAAN, Chair, Education Committee A. Gordon Smith, MD, FAAN, is professor of neurology and vice chair for research at the University of Utah, where he also serves as chief of the division of neuromuscular medicine and director of the Jack H. Petajan EMG Laboratory. Smith is a graduate of the University of Virginia and the Mayo Medical School. He completed neurology residency and a neuromuscular fellowship at the University of Michigan. Smith’s research team focuses on peripheral neuropathy in diabetes and obesity. He has a particular interest in biomarker development and novel clinical trial design in peripheral neuropathy and longstanding and ongoing NIH and major foundation funding. He is principal investigator of the Utah Regional site in the NINDSfunded Network for Excellence in Neuroscience Clinical Trials. He has led or participated in numerous clinical trials in neuromuscular disorders. Smith serves as chair of the Education Committee and is a member of the American Brain Foundation Board of Trustees. He previously chaired the Distance Learning Subcommittee and was the Education Editor of AAN.com. He also serves as editor for NeuroLearnSM. Smith is active in the Peripheral Nerve Society, where he is a former member of the board of directors. •
Annual Meeting Science Program Presents Innovations to Entice Clinicians Continued from page 5 No, in spite of that! I’m excited and pleased to see my colleague from the Mayo Clinic, Dr. Ronald Petersen, will be the keynote speaker on Sunday. Dr. Petersen is one of the leading research experts on dementia and Alzheimer’s disease and I’m sure his talk will be heavily attended like all of the others. We are presenting plenary sessions daily, beginning on Saturday evening. But again, we have a new approach. Immediately preceding each plenary session will be a scientific platform session that will bring together the top four abstracts in each discipline that were rated as being the most important research by our reviewers; these are our new Best of Science Sessions.
It sounds like you and your team have really come up with a very engaging science program this year and I want to thank you all for the tremendous effort you’ve put into it. It’s not that difficult when neuroscience is our passion. We hope that attendees will share our enthusiasm and that clinicians, in particular, enjoy a week of “Aha!” moments as we strengthen the connection between the laboratory bench and the exam room. If you’ve been on the fence about attending this year’s Annual Meeting, I hope these tantalizing changes will nudge you closer to registration. Be aware that the big savings for early registration end on March 30. Even earlier than that is the March 8 hotel reservation deadline to take advantage of discounted rates in the 28 Boston hotels with which the AAN has arrangements. Visit AAN.com/view/AM17 for more information on the meeting and how to book your travel and hotel accommodations. •
Terrence L. Cascino, MD, FAAN President, American Academy of Neurology email@example.com
AANnews • March 2017
Your Guide to New and Recent AAN Podcasts
11 mi ll Ov an ion d er d g ow row nlo ing ads ! ...
Neurology ® Podcasts Visit Neurology.org to listen to Neurology podcasts and earn 0.5 AMA PRA Category 1 CME Credits™ by answering the multiple-choice questions in the online podcast quiz. Interviews based on articles from Neurology ® Clinical Practice, Neurology ® Genetics, and Neurology ® Neuroimmunology & Neuroinflammation are excluded from the CME program.
Available by March 1 nn Neurology: Dystonia Treatment: Patterns of Medication Use in an International Cohort Jeffrey B. Ratliff, MD, and Sarah Elizabeth Pirio Richardson, MD nn Neurology: Prognosis of Carotid Dissecting Aneurysms: Results from CADISS and a Systematic Review Andrew M. Southerland, MD, MSc, and Hugh S. Markus, DM, FRCP nn Neurology: Symptoms from Repeated Intentional and Unintentional Head Impact in Soccer Players Ted M. Burns, MD, and Michael L. Lipton, MD, PhD nn Neurology: Neuroimmunology & Neuroinflammation: Microarray Screening of Guillain-Barré Syndrome Sera
for Antibodies to Glycolipid Complexes
Ted M. Burns, MD, and Hugh J. Willison, MBBS, PhD
nn Neurology: Neuroimmunology & Neuroinflammation: Next-generation Sequencing in Neuropathological
Diagnosis of Infections of the Nervous System Heather D. Harle, MD, and Carlos A. Pardo, MD
Pre-order now and save $800 or more! Members save an additional $300. Features of Annual Meeting On Demand include: • Online access: Quickly and conveniently access any presentation in your comprehensive library of 500 hours1 from any computer, tablet, or mobile phone! • Syllabi: Syllabi are available for 200+ programs for an even quicker review. • PDFs and MP3 files: To enhance mobility, you can download and print PDFs as well as load MP3 files onto your favorite MP3 player. • Online CME testing: Instantly test and claim CME right from your On Demand player. • Portable hard drive²: Included with your order, this hard drive allows you to access presentations when an internet connection is not convenient or available. 1
Specific presentations within a session may not be available or may be audio only if the presenter has confidential patient information or otherwise declines to be recorded. Hard Drive does not include all the functionality available online, such as Advanced Search, PDF/MP3 Downloads, Bookmarks, Recently Viewed, and CME testing.
Order by April 28, 2017, to secure your savings. Online: AANonDemand.com/ad Phone: (800) 501-2303 (US Only) or (818) 844-3299 For even greater savings, register to attend the Annual Meeting at AAN.com/view/register and select Gold Registration.
Quality Payment Program: Are You Exempt from MIPS? The new Quality Payment Program (QPP) from the Centers for Medicare & Medicaid Services puts into practice— literally—the changes in physician reimbursement mandated by MACRA. Under the QPP, CMS will reimburse, reward, or penalize physicians through either the Merit-based Incentive Payment System (MIPS) or the Alternative Payment Models (APM). MIPS will provide physician payment penalties or bonuses beginning in 2019 based on 2017 performance data. So it is important to understand if you must participate and begin reporting data, or if you are exempt. Are you exempt from MIPS? CMS has estimated that about a quarter of US neurologists may not need to participate in MIPS in 2017 according to the following exemptions: New to Medicare (approximately 832 neurologists, or 4.8 percent): Defined by CMS as being in their first year of Medicare participation. These neurologists should continue to be aware of QPP and prepare to participate in 2018. Low volume (approximately 3,215 neurologists, or 18.5 percent): Defined as 100 or fewer Medicare patients or annual Medicare billing less than, or equal to, $30,000. CMS will calculate this based on data from September 1, 2015, to August 31, 2016, and inform practices that fall under this threshold. By learning early if they are excluded, neurologists can save themselves unnecessary work.
If you want to avoid MIPS in 2018, consider monitoring the number of Medicare patients and charges to stay under the threshold. What is the impact of individual vs. group reporting? CMS applies the low volume threshold at the individual clinician (NPI/TIN) level for those reporting individually, and the group practice (TIN) level for group reporting. If you, as an individual, are excluded, but your practice chooses to report as a group, you will be eligible for MIPS and have to report as part of that group. If your practice decides everyone will report individually, you don’t have to report anything. For more information on MIPS, visit AAN.com/view/MACRA or contact firstname.lastname@example.org. •
APM participant (approximately 275, or 1.6 percent): This applies if neurologists meet the requirements for participating in an advanced APM and have a sufficient amount of patients or charges associated with that APM. Neurologists would be excluded from MIPS and receive a 5-percent bonus payment in 2019. What could make you eligible for MIPS in 2018? It is important to be mindful of the future and how your eligibility may change, such as: nn No longer being a first-year
participant in Medicare
nn No longer participating in APM nn Increasing your Medicare
AANnews • March 2017
Webinars Help Strengthen Contract Negotiations, Solo/Small Practices Continued from cover Getting What You Deserve—A Primer on Contracting
Thriving in Small and Solo Neurology Practices
March 8, 2017 12:00 p.m.–1:00 p.m. ET
March 28, 2017 12:00 p.m.–1:00 p.m. ET
Register by March 7
Register by March 27
Directors: Brad C. Klein, MD, MBA, FAAN, and David A. Evans, MBA
Director: Elaine C. Jones, MD, FAAN Upon completion, you should be able to: nn Implement tips to help you
balance patient visits while maintaining a thriving practice
nn Maximize use of technology in
your practice to boost revenue
Elaine C. Jones, MD, FAAN
nn Discover best practices for working effectively with
Medicare and private payers
Brad C. Klein, MD, MBA, FAAN
David A. Evans, MBA
Upon completion, you should be able to: nn Use benchmarking data to negotiate your next contract nn Identify key aspects of contracts to watch out for nn Explore where to find vital data within your practice
AAN practice management webinars provide the valuable insights and tools you need to navigate through the everchanging health care landscape. Single webinars are $99 but AAN members get the greatest value with the $189 subscription to all 10 live one-hour webinars. All webinars include access to presentation slides and recordings if you miss the live event. Physicians receive 1 AMA PRA Category 1 Credit™ per webinar; non-physicians receive a certificate of completion. Visit AAN.com/view/pmw17 to learn more and register. •
Want Valuable Insights into Your Practice? Complete the Neurology Compensation and Productivity Survey Continued from cover dashboard (a $600 value). The survey will be open until May 6, and the report will be available in the summer. The AAN’s Neurology Compensation and Productivity Report is the only survey and report dedicated solely to neurology. The survey results are kept confidential and secure and are reported only in aggregate. By completing the survey and accessing the free report and results dashboard, members will be able to benchmark their compensation and productivity against national benchmarks to make smart business decisions. The report and customizable dashboard empowers members to:
nn Compare and customize your
individual practice-related data with your colleagues at local and national levels
nn Determine if you are being
compensated fairly relative to your peers
nn Use the data in demonstrating your
value to payers and to delivering quality patient care
nn Discover fair market value based
on your subspecialty, region, and practice type
nn Create charts and graphs and
download them right to your desktop
nn Assess patient and practice
management principles and implement efficiencies that ultimately can help improve the quality of patient care
Nearly 1,400 members completed the survey in 2016, double the number of members who completed it in 2013. More than a third of the participants in the past three years have completed the survey two or more times during that period. Repeating the survey can help members measure the results of changes they have made in their practices due to the data produced by the surveys. For more information or to begin the survey, visit AAN.com/view/benchmark or contact email@example.com. •
AANnews • March 2017
QUIETING MS Quietly for your patients with relapsing MS
*AUBAGIO is effective across key measures of disease activity: sustained disability progression (14 mg only), annualized relapse rate, and MRI activity. Overall discontinuation rates due to adverse events were 12.5% with AUBAGIO 14 mg, 11.2% with AUBAGIO 7 mg, and 7.5% with placebo, and treatment discontinuation rates due to common adverse events were ≤3.3% in the pooled clinical trials.1,2
INDICATION AUBAGIO® (teriflunomide) is indicated for the treatment of patients with relapsing forms of multiple sclerosis. IMPORTANT SAFETY INFORMATION WARNING: HEPATOTOXICITY AND RISK OF TERATOGENICITY • Severe liver injury including fatal liver failure has been reported in patients treated with leflunomide, which is indicated for rheumatoid arthritis. A similar risk would be expected for teriflunomide because recommended doses of teriflunomide and leflunomide result in a similar range of plasma concentrations of teriflunomide. Concomitant use of AUBAGIO with other potentially hepatotoxic drugs may increase the risk of severe liver injury. • Obtain transaminase and bilirubin levels within 6 months before initiation of AUBAGIO therapy. Monitor ALT levels at least monthly for 6 months after starting AUBAGIO. If drug-induced liver injury is suspected, discontinue AUBAGIO and start an accelerated elimination procedure with cholestyramine or activated charcoal. AUBAGIO is contraindicated in patients with severe hepatic impairment. Patients with pre-existing liver disease may be at increased risk of developing elevated serum transaminases when taking AUBAGIO. • AUBAGIO is contraindicated for use in pregnant women and in women of reproductive potential who are not using effective contraception because of the potential for fetal harm. Teratogenicity and embryolethality occurred in animals at plasma teriflunomide exposure lower than that in humans. Exclude pregnancy before the start of treatment with AUBAGIO in females of reproductive potential. Advise females of reproductive potential to use effective contraception during AUBAGIO treatment and during an accelerated drug elimination procedure after AUBAGIO treatment. Stop AUBAGIO and use an accelerated drug elimination procedure if the patient becomes pregnant. Please see additional Important Safety Information and Brief Summary of Full Prescribing Information, including boxed WARNING, on the following pages.
THINK BEYOND RELAPSES IN THE MANAGEMENT OF RMS
MAKE AN IMPACT ON DISABILITY PROGRESSION NOW TRE
IMPORTANT SAFETY INFORMATION (continued) CONTRAINDICATIONS • Patients with severe hepatic impairment. • Pregnant women and females of reproductive potential not using effective contraception. • Patients with a history of hypersensitivity reaction to teriflunomide, leflunomide, or to any of the inactive ingredients in AUBAGIO. • Co-administration with leflunomide. WARNINGS AND PRECAUTIONS • Hepatotoxicity: Patients with pre-existing acute or chronic liver disease, or those with serum ALT >2 times the upper limit of normal (ULN) before initiating treatment, should not normally be treated with AUBAGIO. In clinical trials, if ALT elevation was >3 times the ULN on 2 consecutive tests, patients discontinued AUBAGIO and underwent accelerated elimination. Consider additional monitoring if co-administering AUBAGIO with other potentially hepatotoxic drugs; monitor patients who develop symptoms suggestive of hepatic dysfunction (eg, unexplained nausea, vomiting, abdominal pain, fatigue, anorexia, or jaundice and/or dark urine). • Teratogenicity: AUBAGIO may cause fetal harm when administered in pregnant women. Teratogenicity and embryo-fetal lethality occurred in animal reproduction studies in multiple animal species at plasma teriflunomide exposures similar to or lower than that in humans at the maximum human recommended dose of 14 mg/day. AUBAGIO is contraindicated for use in pregnant women and females of reproductive potential not using effective contraception. Women who become pregnant while taking AUBAGIO may enroll in the AUBAGIO pregnancy registry by calling 1-800-745-4447, option 2. • Procedure for Accelerated Elimination of Teriflunomide: Teriflunomide is eliminated slowly from the plasma—it takes an average of 8 months, or up to 2 years, to reach plasma concentrations <0.02 mcg/mL. Elimination may be accelerated by administration of cholestyramine or activated charcoal, but this may cause disease activity to return in patients who were responding to AUBAGIO.
Please see additional Important Safety Information and Brief Summary of Full Prescribing Information, including boxed WARNING regarding hepatotoxicity and use in pregnancy, on the following pages.
Start or switch to AUBAGIO (teriflunomide) 14 mg—the only oral DMT with a proven impact on disability progression in 2 Phase III trials ®
The majority of patients remained free from disability progression* with AUBAGIO 14 mg1
80 84 AN ESTIMATED
OVER 108 WEEKS (P =0.03)1†
OVER 108 WEEKS (P <0.05)1†
DMT=disease-modifying therapy; EDSS=Expanded Disability Status Scale; RMS=relapsing forms of MS. *Disability progression was a secondary endpoint in TEMSO and TOWER.6,7 † Based on Kaplan-Meier estimates.1 TEMSO: A double-blind, placebo-controlled trial in patients with relapsing forms of MS (N=1088). Patients were randomized to receive AUBAGIO 14 mg (n=359), AUBAGIO 7 mg (n=366), or placebo (n=363) once daily for 108 weeks.6 TOWER: A double-blind, placebo-controlled trial in patients with relapsing forms of MS (N=1169). Patients were randomized to receive AUBAGIO 14 mg (n=372), AUBAGIO 7 mg (n=408), or placebo (n=389) once daily with results for up to 40 months of treatment.7
• The estimated proportion of patients with sustained disability progression: —TEMSO: 20.2%, 21.7%, and 27.3% with AUBAGIO 14 mg, AUBAGIO 7 mg, and placebo, respectively1 —TOWER: 15.8%, 21.1%, and 19.7% with AUBAGIO 14 mg, AUBAGIO 7 mg, and placebo, respectively1 • AUBAGIO 7 mg did not achieve a statistically significant reduction in risk of sustained disability progression versus placebo in either trial1 • Sustained disability progression was defined as at least a 1-point increase from baseline EDSS score ≤5.5 (or at least a 0.5-point increase for those with a baseline EDSS score >5.5) sustained for at least 12 weeks1 • AUBAGIO 14 mg and 7 mg achieved a significant relative reduction in risk of relapse in TEMSO (31% for both doses; P<0.05) and TOWER (36% and 22%, respectively; P<0.05)1
• Bone Marrow Effects/Immunosuppression Potential/Infections: Decreases in white blood cell counts, mainly of neutrophils and lymphocytes, and platelets have been reported with AUBAGIO. Thrombocytopenia, including rare cases with platelet counts less than 50,000/mm3, has been reported in the postmarketing setting. Obtain a complete blood cell count within 6 months before starting treatment, with further monitoring based on signs and symptoms of bone marrow suppression. AUBAGIO is not recommended for patients with severe immunodeficiency, bone marrow disease, or severe uncontrolled infections. Tuberculosis (TB) has been observed in clinical studies of AUBAGIO. Before starting treatment, screen patients for latent TB infection with a tuberculin test. Treatment in patients with acute or chronic infections should not be started until the infection(s) is resolved. Administration of live vaccines is not recommended. The risk of malignancy, particularly lymphoproliferative disorders, or infection may be increased with the use of some medications with immunosuppressive potential, including teriflunomide. • Hypersensitivity and Serious Skin Reactions: AUBAGIO can cause anaphylaxis and severe allergic reactions. Signs and symptoms have included dyspnea, urticaria, and angioedema including lips, eyes, throat, and tongue. Cases of serious skin reactions, including Stevens-Johnson syndrome and a fatal case of toxic epidermal necrolysis, have been reported with AUBAGIO. Very rare cases of Drug Reaction with Eosinophilia and Systemic Symptoms have also been reported with leflunomide. If a severe skin reaction develops with AUBAGIO, stop treatment and begin accelerated elimination. In such cases, patients should not be re-exposed to teriflunomide. • Peripheral Neuropathy: Peripheral neuropathy, including polyneuropathy and mononeuropathy, has been reported with AUBAGIO. Age >60 years, concomitant neurotoxic medications, and diabetes may increase the risk. If peripheral neuropathy is suspected, consider discontinuing treatment and performing accelerated elimination. • Increased Blood Pressure: Blood pressure increases and hypertension have occurred with AUBAGIO. Measure blood pressure at treatment initiation and manage any elevations during treatment. • Respiratory Effects: Interstitial lung disease (ILD), including acute interstitial pneumonitis, has been reported with AUBAGIO. ILD may be fatal and may occur acutely at any time during therapy with a variable clinical presentation. If discontinuation of the drug is necessary, consider initiation of an accelerated elimination procedure. (continued on back)
MAKE AN IMPACT ON DISABILITY PROGRESSION—START OR SWITCH TO AUBAGIO 1
The only oral DMT with a proven impact on disability progression in 2 Phase III trials1,4,5 • An estimated 80% of patients in TEMSO and 84% of patients in TOWER remained free from disability progression over 108 weeks with AUBAGIO® (teriflunomide) 14 mg1 • AUBAGIO 7 mg did not achieve a statistically significant reduction in risk of sustained disability progression versus placebo in either trial1 • Sustained disability progression was defined as at least a 1-point increase from baseline EDSS score ≤5.5 (or at least a 0.5-point increase for those with a baseline EDSS score >5.5) sustained for at least 12 weeks1
AUBAGIO kept a range of RMS patients free from relapse1 • AUBAGIO 14 mg and 7 mg achieved a significant relative reduction in risk of relapse in TEMSO (31% for both doses; P<0.05) and TOWER (36% and 22%, respectively; P<0.05)
One pill, once a day, taken with or without food1 • Health care professionals should run certain tests before prescribing AUBAGIO and should monitor patient liver enzyme levels monthly for the first 6 months AUBAGIO is effective across key measures of disease activity: sustained disability progression (14 mg only), annualized relapse rate, and MRI activity. Overall discontinuation rates due to adverse events were 12.5% with AUBAGIO 14 mg, 11.2% with AUBAGIO 7 mg, and 7.5% with placebo, and treatment discontinuation rates due to common adverse events were ≤3.3% in the pooled clinical trials.1,2
IMPORTANT SAFETY INFORMATION (continued) Adverse Reactions: The most frequent adverse reactions (≥10% and ≥2% greater than placebo) with AUBAGIO 7 mg and 14 mg and placebo, respectively, were headache (18% and 16% vs 15%), ALT increased (13% and 15% vs 9%), diarrhea (13% and 14% vs 8%), alopecia (10% and 13% vs 5%), and nausea (8% and 11% vs 7%). Drug Interactions: Monitor patients when teriflunomide is coadministered with warfarin, or with drugs metabolized by CYP1A2, CYP2C8, substrates of OAT3 transporters, substrates of BCRP, or OATP1B1/1B3 transporters. Use in Specific Populations: Women who wish to become pregnant should discontinue AUBAGIO and undergo an accelerated elimination procedure. Use of effective contraception should be continued until plasma concentrations of teriflunomide are <0.02 mcg/mL. Nursing mothers should not use AUBAGIO. AUBAGIO is detected in human semen. To minimize any possible fetal risk, men not wishing to father a child and their female partners should use effective contraception. Men wishing to father a child should discontinue therapy and either undergo accelerated elimination or verify plasma teriflunomide concentration is <0.02 mcg/mL. Please see additional Important Safety Information on the previous pages and Brief Summary of Full Prescribing Information, including boxed WARNING regarding hepatotoxicity and use in pregnancy, on the following pages. References: 1. AUBAGIO (teriflunomide) [package insert]. Cambridge, MA: Genzyme Corporation; November 2016. 2. Data on file, Sanofi/Genzyme. Summary of safety HMR1726teriflunomide. December 5, 2013. 3. Ziemssen T, De Stefano N, Pia Sormani M, Van Wijmeersch B, Wiendl H, Kieseier BC. Optimizing therapy early in multiple sclerosis: An evidence-based view. Mult Scler Relat Disord. 2015;4(5):460-469. 4. Tecfidera (dimethyl fumarate) [package insert]. Cambridge, MA: Biogen Inc.; February 2016. 5. Gilenya (fingolimod) [package insert]. East Hanover, NJ: Novartis Pharmaceuticals Corporation; February 2016. 6. O’Connor P, Wolinsky JS, Confavreux C, et al; for the TEMSO Trial Group. Randomized trial of oral teriflunomide for relapsing multiple sclerosis. N Engl J Med. 2011;365(14):1293-1303. 7. Confavreux C, O’Connor P, Comi G, et al; for the TOWER Trial Group. Oral teriflunomide for patients with relapsing multiple sclerosis (TOWER): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Neurol. 2014;13(3):247-256.
©2016 Genzyme Corporation. All rights reserved. AUBAGIO, Sanofi, and Genzyme registered in U.S. Patent and Trademark Office. GZUS.AUBA.15.01.0246(3) December 2016
AUBAGIO® (teriflunomide) tablets, for oral use
Brief Summary of Prescribing Information WARNING: HEPATOTOXICITY and RISK OF TERATOGENICITY • Hepatotoxicity Severe liver injury including fatal liver failure has been reported in patients treated with leflunomide, which is indicated for rheumatoid arthritis. A similar risk would be expected for teriflunomide because recommended doses of teriflunomide and leflunomide result in a similar range of plasma concentrations of teriflunomide. Concomitant use of AUBAGIO with other potentially hepatotoxic drugs may increase the risk of severe liver injury. Obtain transaminase and bilirubin levels within 6 months before initiation of AUBAGIO therapy. Monitor ALT levels at least monthly for six months after starting AUBAGIO [see Warnings and Precautions (5.1)]. If drug induced liver injury is suspected, discontinue AUBAGIO and start an accelerated elimination procedure with cholestyramine or charcoal [see Warnings and Precautions (5.3)]. AUBAGIO is contraindicated in patients with severe hepatic impairment [see Contraindications (4)]. Patients with pre-existing liver disease may be at increased risk of developing elevated serum transaminases when taking AUBAGIO. • Risk of Teratogenicity AUBAGIO is contraindicated for use in pregnant women and in women of reproductive potential who are not using effective contraception because of the potential for fetal harm. Teratogenicity and embryolethality occurred in animals at plasma teriflunomide exposures lower than that in humans. Exclude pregnancy before the start of treatment with AUBAGIO in females of reproductive potential. Advise females of reproductive potential to use effective contraception during AUBAGIO treatment and during an accelerated drug elimination procedure after AUBAGIO treatment. Stop AUBAGIO and use an accelerated drug elimination procedure if the patient becomes pregnant [see Contraindications (4), Warnings and Precautions (5.2, 5.3), Use in Specific Populations (8.1), and Clinical Pharmacology (12.3) in the full prescribing information].
1 INDICATIONS AND USAGE AUBAGIO® is indicated for the treatment of patients with relapsing forms of multiple sclerosis. 2 DOSAGE AND ADMINISTRATION The recommended dose of AUBAGIO is 7 mg or 14 mg orally once daily. AUBAGIO can be taken with or without food. Monitoring to assess safety • Obtain transaminase and bilirubin levels within 6 months before initiation of AUBAGIO therapy. Monitor ALT levels at least monthly for six months after starting AUBAGIO [see Warnings and Precautions (5.1)]. • Obtain a complete blood cell count (CBC) within 6 months before the initiation of treatment with AUBAGIO. Further monitoring should be based on signs and symptoms of infection [see Warnings and Precautions (5.4)]. • Prior to initiating AUBAGIO, screen patients for latent tuberculosis infection with a tuberculin skin test or blood test for mycobacterium tuberculosis infection [see Warnings and Precautions (5.4)]. • Exclude pregnancy prior to initiation of treatment with AUBAGIO in females of reproductive potential [see Warnings and Precautions (5.2)]. • Check blood pressure before start of AUBAGIO treatment and periodically thereafter [see Warnings and Precautions (5.7)]. 4 CONTRAINDICATIONS AUBAGIO is contraindicated in/with: • Patients with severe hepatic impairment [see Warnings and Precautions (5.1)]. • Pregnant women and females of reproductive potential not using effective contraception. AUBAGIO may cause fetal harm [see Warnings and Precautions (5.2 and 5.3) and Use in Specific Populations (8.1)]. • Patients with a history of a hypersensitivity reaction to teriflunomide, leflunomide, or to any of the inactive ingredients in AUBAGIO. Reactions have included anaphylaxis, angioedema, and serious skin reactions [see Warnings and Precautions (5.5)]. • Coadministration with leflunomide [see Clinical Pharmacology (12.3) in the full prescribing information]. 5 WARNINGS AND PRECAUTIONS 5.1 Hepatotoxicity Severe liver injury including fatal liver failure and dysfunction has been reported in some patients treated with leflunomide, which is indicated for rheumatoid arthritis. A similar risk would be expected for teriflunomide because recommended doses of teriflunomide and leflunomide result in a similar range of plasma concentrations of teriflunomide. Patients with pre-existing liver disease may be at increased risk of developing elevated serum transaminases when taking AUBAGIO. Patients with pre-existing acute or chronic liver disease, or those with serum alanine aminotransferase (ALT) greater than two times the upper limit of normal (ULN) before initiating treatment, should not normally be treated with AUBAGIO. AUBAGIO is contraindicated in patients with severe hepatic impairment [see Contraindications (4)]. In placebo-controlled trials, ALT greater than three times the ULN occurred in 61/1045 (5.8%) and 62/1002 (6.2%) of patients receiving AUBAGIO 7 mg and 14 mg, respectively, and 38/997 (3.8%) of patients receiving placebo, during the treatment period. These elevations occurred mostly within the first year of treatment. Half of the cases returned to normal without drug discontinuation. In clinical trials, if ALT elevation was greater than three times the ULN on two consecutive tests, AUBAGIO was discontinued and patients underwent an accelerated elimi-
nation procedure [see Warnings and Precautions (5.3)]. Of the patients who underwent discontinuation and accelerated elimination in controlled trials, half returned to normal or near normal values within 2 months. One patient in the controlled trials developed ALT 32 times the ULN and jaundice 5 months after initiation of AUBAGIO 14 mg treatment. The patient was hospitalized for 5 weeks and recovered after plasmapheresis and cholestyramine accelerated elimination procedure. AUBAGIO-induced liver injury in this patient could not be ruled out. Obtain serum transaminase and bilirubin levels within 6 months before initiation of AUBAGIO therapy. Monitor ALT levels at least monthly for six months after starting AUBAGIO. Consider additional monitoring when AUBAGIO is given with other potentially hepatotoxic drugs. Consider discontinuing AUBAGIO if serum transaminase increase (greater than three times the ULN) is confirmed. Monitor serum transaminase and bilirubin on AUBAGIO therapy, particularly in patients who develop symptoms suggestive of hepatic dysfunction, such as unexplained nausea, vomiting, abdominal pain, fatigue, anorexia, or jaundice and/or dark urine. If liver injury is suspected to be AUBAGIO-induced, discontinue AUBAGIO and start an accelerated elimination procedure [see Warnings and Precautions (5.3)] and monitor liver tests weekly until normalized. If AUBAGIO-induced liver injury is unlikely because some other probable cause has been found, resumption of AUBAGIO therapy may be considered. 5.2 Teratogenicity AUBAGIO may cause fetal harm when administered to a pregnant woman. Teratogenicity and embryo-fetal lethality occurred in animal reproduction studies in multiple animal species at plasma teriflunomide exposures similar to or lower than that in humans at the maximum human recommended dose (MHRD) of 14 mg/day [see Use in Specific Populations (8.1)]. AUBAGIO is contraindicated for use in pregnant women and females of reproductive potential not using effective contraception [see Contraindications (4) and Warnings and Precautions (5.3)]. 5.3 Procedure for Accelerated Elimination of Teriflunomide Teriflunomide is eliminated slowly from the plasma [see Clinical Pharmacology (12.3) in the full prescribing information]. Without an accelerated elimination procedure, it takes on average 8 months to reach plasma concentrations less than 0.02 mg/L, although because of individual variations in drug clearance it may take as long as 2 years. An accelerated elimination procedure could be used at any time after discontinuation of AUBAGIO. Elimination can be accelerated by either of the following procedures: • Administration of cholestyramine 8 g every 8 hours for 11 days. If cholestyramine 8 g three times a day is not well tolerated, cholestyramine 4 g three times a day can be used. • Administration of 50 g oral activated charcoal powder every 12 hours for 11 days. If either elimination procedure is poorly tolerated, treatment days do not need to be consecutive unless there is a need to lower teriflunomide plasma concentration rapidly. At the end of 11 days, both regimens successfully accelerated teriflunomide elimination, leading to more than 98% decrease in teriflunomide plasma concentrations. Use of the accelerated elimination procedure may potentially result in return of disease activity if the patient had been responding to AUBAGIO treatment. 5.4 Bone Marrow Effects/Immunosuppression Potential/Infections Bone Marrow Effects A mean decrease compared to baseline in white blood cell (WBC) count of approximately 15% (mainly neutrophils and lymphocytes) and in platelet count of approximately 10% was observed in placebo-controlled trials with 7 mg and 14 mg of AUBAGIO. The decrease in mean WBC count occurred during the first 6 weeks and WBC count remained low during treatment. In placebo-controlled studies, neutrophil count <1.5×109/L was observed in 12% and 16% of patients receiving AUBAGIO 7 mg and 14 mg, respectively, compared with 7% of patients receiving placebo; lymphocyte count <0.8× 109/L was observed in 10% and 12% of patients receiving AUBAGIO 7 mg and 14 mg, respectively, compared with 6% of patients receiving placebo. No cases of serious pancytopenia were reported in premarketing clinical trials of AUBAGIO but rare cases of pancytopenia and agranulocytosis have been reported in the postmarketing setting with leflunomide. A similar risk would be expected for AUBAGIO [see Clinical Pharmacology (12.3) in the full prescribing information]. Cases of thrombocytopenia with AUBAGIO, including rare cases with platelet counts less than 50,000/mm3, have been reported in the postmarketing setting. Obtain a complete blood cell count (CBC) within 6 months before the initiation of treatment with AUBAGIO. Further monitoring should be based on signs and symptoms suggestive of bone marrow suppression. Risk of Infection / Tuberculosis Screening Patients with active acute or chronic infections should not start treatment until the infection(s) is resolved. If a patient develops a serious infection consider suspending treatment with AUBAGIO and using an accelerated elimination procedure. Reassess the benefits and risks prior to resumption of therapy. Instruct patients receiving AUBAGIO to report symptoms of infections to a physician. AUBAGIO is not recommended for patients with severe immunodeficiency, bone marrow disease, or severe, uncontrolled infections. Medications like AUBAGIO that have immunosuppression potential may cause patients to be more susceptible to infections, including opportunistic infections. In placebo-controlled studies of AUBAGIO, no overall increase in the risk of serious infections was observed with AUBAGIO 7 mg (2.2%) or 14 mg (2.7%) compared to placebo (2.2%). However, one fatal case of klebsiella pneumonia sepsis occurred in a patient taking AUBAGIO 14 mg for 1.7 years. Fatal infections have been reported in the postmarketing setting in patients receiving leflunomide, especially Pneumocystis jiroveci pneumonia and aspergillosis. Most of the reports were confounded by concomitant immunosuppressant therapy and/or comorbid illness which, in addition to rheumatoid disease, may predispose patients to infection. In clinical studies with AUBAGIO, cytomegalovirus hepatitis reactivation has been observed. In clinical studies with AUBAGIO, cases of tuberculosis have been observed. Prior to initiating AUBAGIO, screen patients for latent tuberculosis infection with a tuberculin skin test or with a blood test for mycobacterium tuberculosis infection. AUBAGIO has not been studied in patients with a positive tuberculosis screen, and the safety of AUBAGIO in individuals with latent tuberculosis infection is unknown. For patients testing positive in tuberculosis screening, treat by standard medical practice prior to therapy with AUBAGIO.
Vaccination No clinical data are available on the efficacy and safety of live vaccinations in patients taking AUBAGIO. Vaccination with live vaccines is not recommended. The long half-life of AUBAGIO should be considered when contemplating administration of a live vaccine after stopping AUBAGIO. Malignancy The risk of malignancy, particularly lymphoproliferative disorders, is increased with the use of some immunosuppressive medications. There is a potential for immunosuppression with AUBAGIO. No apparent increase in the incidence of malignancies and lymphoproliferative disorders was reported in the AUBAGIO clinical trials, but larger and longer-term studies would be needed to determine whether there is an increased risk of malignancy or lymphoproliferative disorders with AUBAGIO. 5.5 Hypersensitivity and Serious Skin Reactions AUBAGIO can cause anaphylaxis and severe allergic reactions [see Contraindications (4)]. Signs and symptoms have included dyspnea, urticaria, and angioedema including lips, eyes, throat, and tongue. Cases of serious skin reactions, including cases of Stevens-Johnson syndrome (SJS) and a fatal case of toxic epidermal necrolysis (TEN), have been reported with AUBAGIO. In patients treated with leflunomide, the parent compound, very rare cases of Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) have also been reported. Inform patients of the signs and symptoms of anaphylaxis and angioedema and signs and symptoms that may signal a serious skin reaction. Inform patients that a fever associated with signs of other organ system involvement (e.g., rash, lymphadenopathy, or hepatic dysfunction) may be drug-related. Instruct patients to discontinue AUBAGIO and seek immediate medical care should these signs and symptoms occur. Discontinue AUBAGIO, unless the reactions are clearly not drug-related, and begin an accelerated elimination procedure immediately [see Warnings and Precautions (5.3)]. In such cases, patients should not be re-exposed to teriflunomide [see Contraindications (4)]. 5.6 Peripheral Neuropathy In placebo-controlled studies, peripheral neuropathy, including both polyneuropathy and mononeuropathy (e.g., carpal tunnel syndrome), occurred more frequently in patients taking AUBAGIO than in patients taking placebo. The incidence of peripheral neuropathy confirmed by nerve conduction studies was 1.4% (13 patients) and 1.9% (17 patients) of patients receiving 7 mg and 14 mg of AUBAGIO, respectively, compared with 0.4% receiving placebo (4 patients). Treatment was discontinued in 0.7% (8 patients) with confirmed peripheral neuropathy (3 patients receiving AUBAGIO 7 mg and 5 patients receiving AUBAGIO 14 mg). Five of them recovered following treatment discontinuation. Not all cases of peripheral neuropathy resolved with continued treatment. Peripheral neuropathy also occurred in patients receiving leflunomide. Age older than 60 years, concomitant neurotoxic medications, and diabetes may increase the risk for peripheral neuropathy. If a patient taking AUBAGIO develops symptoms consistent with peripheral neuropathy, such as bilateral numbness or tingling of hands or feet, consider discontinuing AUBAGIO therapy and performing an accelerated elimination procedure [see Warnings and Precautions (5.3)]. 5.7 Increased Blood Pressure In placebo-controlled studies, the mean change from baseline to the end of study in systolic blood pressure was +2.3 mmHg and +2.7 mmHg for AUBAGIO 7 mg and 14 mg, respectively, and -0.6 mmHg for placebo. The change from baseline in diastolic blood pressure was +1.4 mmHg and +1.9 mmHg for AUBAGIO 7 mg and 14 mg, respectively, and -0.3 mmHg for placebo. Hypertension was an adverse reaction in 3.1% and 4.3% of patients treated with 7 mg or 14 mg of AUBAGIO compared with 1.8% for placebo. Check blood pressure before start of AUBAGIO treatment and periodically thereafter. Elevated blood pressure should be appropriately managed during treatment with AUBAGIO. 5.8 Respiratory Effects Interstitial lung disease, including acute interstitial pneumonitis, has been reported with AUBAGIO in the postmarketing setting. Interstitial lung disease and worsening of pre-existing interstitial lung disease have been reported during treatment with leflunomide. Interstitial lung disease may be fatal and may occur acutely at any time during therapy with a variable clinical presentation. New onset or worsening pulmonary symptoms, such as cough and dyspnea, with or without associated fever, may be a reason for discontinuation of therapy and for further investigation as appropriate. If discontinuation of the drug is necessary, consider initiation of an accelerated elimination procedure [see Warnings and Precautions (5.3)]. 5.9 Concomitant Use with Immunosuppressive or Immunomodulating Therapies Coadministration with antineoplastic, or immunosuppressive therapies used for treatment of multiple sclerosis has not been evaluated. Safety studies in which AUBAGIO was concomitantly administered with other immune modulating therapies for up to one year (interferon beta, glatiramer acetate) did not reveal any specific safety concerns. The long term safety of these combinations in the treatment of multiple sclerosis has not been established. In any situation in which the decision is made to switch from AUBAGIO to another agent with a known potential for hematologic suppression, it would be prudent to monitor for hematologic toxicity, because there will be overlap of systemic exposure to both compounds. Use of an accelerated elimination procedure may decrease this risk, but may also potentially result in return of disease activity if the patient had been responding to AUBAGIO treatment [see Warnings and Precautions (5.3)]. 6 ADVERSE REACTIONS The following serious adverse reactions are described elsewhere in the prescribing information: • Hepatotoxicity [see Contraindications (4) and Warnings and Precautions (5.1)] • Bone Marrow Effects/Immunosuppression Potential/Infections [see Warnings and Precautions (5.4)] • Hypersensitivity and Serious Skin Reactions [see Contraindications (4) and Warnings and Precautions (5.5)] • Peripheral Neuropathy [see Warnings and Precautions (5.6)] • Increased Blood Pressure [see Warnings and Precautions (5.7)]
AUBAGIO® (teriflunomide) tablets, for oral use • Respiratory Effects [see Warnings and Precautions (5.8)] 6.1 Clinical Trials Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in clinical practice. A total of 2047 patients receiving AUBAGIO (7 mg or 14 mg once daily) constituted the safety population in the pooled analysis of placebo controlled studies in patients with relapsing forms of multiple sclerosis; of these, 71% were female. The average age was 37 years. Table 1 lists adverse reactions in placebo-controlled trials with rates that were at least 2% for AUBAGIO patients and also at least 2% above the rate in placebo patients. The most common were headache, an increase in ALT, diarrhea, alopecia, and nausea. The adverse reaction most commonly associated with discontinuation was an increase in ALT (3.3%, 2.6%, and 2.3% of all patients in the AUBAGIO 7 mg, AUBAGIO 14 mg, and placebo treatment arms, respectively). Table 1. Adverse Reactions in Pooled Placebo-Controlled Studies in Patients with Relapsing Forms of Multiple Sclerosis AUBAGIO AUBAGIO 7 mg 14 mg Placebo Adverse Reaction (N=1045) (N=1002) (N=997) Headache 18% 16% 15% Increase in Alanine aminotransferase 13% 15% 9% Diarrhea 13% 14% 8% Alopecia 10% 13% 5% Nausea 8% 11% 7% Paresthesia 8% 9% 7% Arthralgia 8% 6% 5% Neutropenia 4% 6% 2% Hypertension 3% 4% 2% Cardiovascular Deaths Four cardiovascular deaths, including three sudden deaths, and one myocardial infarction in a patient with a history of hyperlipidemia and hypertension were reported among approximately 2600 patients exposed to AUBAGIO in the premarketing database. These cardiovascular deaths occurred during uncontrolled extension studies, one to nine years after initiation of treatment. A relationship between AUBAGIO and cardiovascular death has not been established. Acute Renal Failure In placebo-controlled studies, creatinine values increased more than 100% over baseline in 8/1045 (0.8%) patients in the 7 mg AUBAGIO group and 6/1002 (0.6%) patients in the 14 mg AUBAGIO group versus 4/997 (0.4%) patients in the placebo group. These elevations were transient. Some elevations were accompanied by hyperkalemia. AUBAGIO may cause acute uric acid nephropathy with transient acute renal failure because AUBAGIO increases renal uric acid clearance. Hypophosphatemia In clinical trials, 18% of AUBAGIO-treated patients had hypophosphatemia with serum phosphorus levels of at least 0.6 mmol/L, compared to 7% of placebo-treated patients; 4% of AUBAGIO-treated patients had hypophosphatemia with serum phosphorus levels at least 0.3 mmol/L but less than 0.6 mmol/L, compared to 0.8% of placebo-treated patients. No patient in any treatment group had a serum phosphorus below 0.3 mmol/L. 6.2 Postmarketing Experience The following adverse reactions have been identified during postapproval use of AUBAGIO. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. • Hypersensitivity reactions, some of which were severe, such as anaphylaxis and angioedema [see Warnings and Precautions (5.5)] • Severe skin reactions, including toxic epidermal necrolysis and Stevens-Johnson syndrome [see Warnings and Precautions (5.5)] • Thrombocytopenia [see Warnings and Precautions (5.4)] • Interstitial lung disease [see Warnings and Precautions (5.8)] • Pancreatitis 7 DRUG INTERACTIONS Effect of AUBAGIO on CYP2C8 substrates Teriflunomide is an inhibitor of CYP2C8 in vivo. In patients taking AUBAGIO, exposure of drugs metabolized by CYP2C8 (e.g., paclitaxel, pioglitazone, repaglinide, rosiglitazone) may be increased. Monitor these patients and adjust the dose of the concomitant drug(s) metabolized by CYP2C8 as required [see Clinical Pharmacology (12.3) in the full prescribing information]. Effect of AUBAGIO on warfarin Coadministration of AUBAGIO with warfarin requires close monitoring of the international normalized ratio (INR) because AUBAGIO may decrease peak INR by approximately 25%. Effect of AUBAGIO on oral contraceptives AUBAGIO may increase the systemic exposures of ethinylestradiol and levonorgestrel. Consideration should be given to the type or dose of contraceptives used in combination with AUBAGIO [see Clinical Pharmacology (12.3) in the full prescribing information]. Effect of AUBAGIO on CYP1A2 substrates Teriflunomide may be a weak inducer of CYP1A2 in vivo. In patients taking AUBAGIO, exposure of drugs metabolized by CYP1A2 (e.g., alosetron, duloxetine, theophylline, tizanidine) may be reduced. Monitor these patients and adjust the dose of the concomitant drug(s) metabolized by CYP1A2 as required [see Clinical Pharmacology (12.3) in the full prescribing information].
Effect of AUBAGIO on organic anion transporter 3 (OAT3) substrates Teriflunomide inhibits the activity of OAT3 in vivo. In patients taking AUBAGIO, exposure of drugs which are OAT3 substrates (e.g., cefaclor, cimetidine, ciprofloxacin, penicillin G, ketoprofen, furosemide, methotrexate, zidovudine) may be increased. Monitor these patients and adjust the dose of the concomitant drug(s) which are OAT3 substrates as required [see Clinical Pharmacology (12.3) in the full prescribing information]. Effect of AUBAGIO on BCRP and organic anion transporting polypeptide B1 and B3 (OATP1B1/ 1B3) substrates Teriflunomide inhibits the activity of BCRP and OATP1B1/1B3 in vivo. For a patient taking AUBAGIO, the dose of rosuvastatin should not exceed 10 mg once daily. For other substrates of BCRP (e.g., mitoxantrone) and drugs in the OATP family (e.g., methotrexate, rifampin), especially HMG-Co reductase inhibitors (e.g., atorvastatin, nateglinide, pravastatin, repaglinide, and simvastatin), consider reducing the dose of these drugs and monitor patients closely for signs and symptoms of increased exposures to the drugs while patients are taking AUBAGIO [see Clinical Pharmacology (12.3) in the full prescribing information]. 8 USE IN SPECIFIC POPULATIONS 8.1 Pregnancy Pregnancy Exposure Registry There is a pregnancy exposure registry that monitors pregnancy outcomes in women exposed to AUBAGIO during pregnancy. Healthcare providers and patients are encouraged to report pregnancies by calling 1-800-745-4447, option 2 Risk Summary AUBAGIO is contraindicated for use in pregnant women and females of reproductive potential not using effective contraception because of the potential for fetal harm based on animal data. Human data are not available at this time to inform the presence or absence of drug-associated risk with the use of AUBAGIO during pregnancy. In animal reproduction studies in rat and rabbits, oral administration of teriflunomide during organogenesis caused teratogenicity and embryolethality at plasma exposures (AUC) lower than that at the maximum human recommended dose (MHRD) of 14 mg/day [see Data]. In the US general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2%–4% and 15%–20%, respectively. The background risk of major birth defects and miscarriage in the indicated population is unknown. Clinical Considerations Women who wish to become pregnant should discontinue use of AUBAGIO and undergo an accelerated elimination procedure to decrease the plasma concentration of teriflunomide to less than 0.02 mg/L (0.02 mcg/mL). Effective contraception should be used until is it verified that plasma concentrations of teriflunomide are less than 0.02 mg/L (0.02 mcg/mL) [see Warnings and Precautions (5.3)]. Human plasma concentrations of teriflunomide less than 0.02 mg/L (0.02 mcg/mL) are expected to have minimal embryofetal risk [see Contraindications (4) and Warnings and Precautions (5.3)]. If the patient becomes pregnant while taking this drug, stop treatment with AUBAGIO, inform the patient of the potential risk to the fetus, and perform the accelerated drug elimination procedure to achieve plasma concentrations of less than 0.02 mg/L (0.02 mcg/mL) [see Warnings and Precautions (5.3) and Clinical Pharmacology (12.3) in the full prescribing information]. Refer the patient to an obstetrician/gynecologist, preferably experienced in reproductive toxicity, for further evaluation and counseling [see Warnings and Precautions (5.2, 5.3)]. Data Animal Data When teriflunomide (oral doses of 1, 3, or 10 mg/kg/day) was administered to pregnant rats throughout the period of organogenesis, high incidences of fetal malformation (primarily craniofacial, and axial and appendicular skeletal defects) and embryofetal death were observed at doses not associated with maternal toxicity. Adverse effects on embryofetal development were observed following dosing at various stages throughout organogenesis. Maternal plasma exposure at the no-effect level (1.0 mg/kg/day) for embryofetal developmental toxicity in rats was less than that in humans at the maximum recommended human dose (MRHD, 14 mg /day). Administration of teriflunomide (oral doses of 1, 3.5, or 12 mg/kg/day) to pregnant rabbits throughout organogenesis resulted in high incidences of fetal malformation (primarily craniofacial, and axial and appendicular skeletal defects) and embryofetal death at doses associated with minimal maternal toxicity. Maternal plasma exposure at the no-effect dose (1.0 mg/kg/day) for embryofetal developmental toxicity in rabbits was less than that in humans at the MRHD. In studies in which teriflunomide (oral doses of 0.05, 0.1, 0.3, 0.6, or 1.0 mg/kg/day) was administered to rats during gestation and lactation, decreased growth, eye and skin abnormalities, and high incidences of malformation (limb defects) and postnatal death were observed in the offspring at doses not associated with maternal toxicity. Maternal plasma exposure at the no-effect dose for pre- and postnatal developmental toxicity in rats (0.10 mg/kg/day) was less than that in humans at the MRHD. In animal reproduction studies of leflunomide, embryolethality and teratogenic effects were observed in pregnant rat and rabbit at or below clinically relevant plasma teriflunomide exposures (AUC). In published reproduction studies in pregnant mice, leflunomide was embryolethal and increased the incidence of malformations (craniofacial, axial skeletal, heart and great vessel). Supplementation with exogenous uridine reduced the teratogenic effects in pregnant mice, suggesting that the mode of action (inhibition of mitochondrial enzyme dihydroorotate dehydrogenase) is the same for therapeutic efficacy and developmental toxicity. At recommended doses in humans, teriflunomide and leflunomide result in a similar range of plasma concentrations of teriflunomide. 8.2 Lactation Risk Summary It is not known whether this drug is excreted in human milk. Teriflunomide was detected in rat milk following a single oral dose. The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for AUBAGIO and any potential adverse effects on the breastfed infant from AUBAGIO or from the underlying maternal condition.
AUBAGIO® (teriflunomide) tablets, for oral use 8.3 Females and Males of Reproductive Potential Pregnancy Testing Exclude pregnancy prior to initiation of treatment with AUBAGIO in females of reproductive potential. Advise females to notify their healthcare provider immediately if pregnancy occurs or is suspected during treatment [see Warnings and Precautions (5.2, 5.3) and Use in Specific Populations (8.1)]. Contraception Females Females of reproductive potential should use effective contraception while taking AUBAGIO. If AUBAGIO is discontinued, use of contraception should be continued until is it verified that plasma concentrations of teriflunomide are less than 0.02 mg/L (0.02 mcg/mL). Females of reproductive potential who wish to become pregnant should undergo an accelerated elimination procedure. Effective contraception should be used until it is verified that plasma concentrations of teriflunomide are less than 0.02 mg/L (0.02 mcg/mL) [see Warnings and Precautions (5.3)]. Males AUBAGIO is detected in human semen. Animal studies to specifically evaluate the risk of male-mediated fetal toxicity have not been conducted. To minimize any possible risk, men not wishing to father a child and their female partners should use effective contraception. Men wishing to father a child should discontinue use of AUBAGIO and either undergo an accelerated elimination procedure or wait until verification that the plasma teriflunomide concentration is less than 0.02 mg/L (0.02 mcg/mL) [see Warnings and Precautions (5.3)]. Infertility Administration of teriflunomide to male rats resulted in no adverse effects on fertility. However, reduced epididymal sperm count was observed [see Nonclinical Toxicology (13.1) in the full prescribing information]. Effects of AUBAGIO on fertility in humans have not been evaluated. 8.4 Pediatric Use Safety and effectiveness in pediatric patients have not been established. 8.5 Geriatric Use Clinical studies of AUBAGIO did not include patients over 65 years old. 8.6 Hepatic Impairment No dosage adjustment is necessary for patients with mild and moderate hepatic impairment. The pharmacokinetics of teriflunomide in severe hepatic impairment have not been evaluated. AUBAGIO is contraindicated in patients with severe hepatic impairment [see Contraindications (4), Warnings and Precautions (5.1), and Clinical Pharmacology (12.3) in the full prescribing information]. 8.7 Renal Impairment No dosage adjustment is necessary for patients with mild, moderate, and severe renal impairment [see Clinical Pharmacology (12.3) in the full prescribing information]. 10 OVERDOSAGE There is no experience regarding teriflunomide overdose or intoxication in humans. Teriflunomide 70 mg daily up to 14 days was well tolerated by healthy subjects. In the event of clinically significant overdose or toxicity, cholestyramine or activated charcoal is recommended to accelerate elimination [see Warnings and Precautions (5.3)]. Genzyme Corporation 500 Kendall Street Cambridge, MA 02142 A SANOFI COMPANY November 2016 TER-BPLR-SA-NOV16
2017 Annual Meeting Scientific Program Announced 2017 Scientific Program at a Glance Saturday, April 22 5:00 p.m.–6:30 p.m. Hot Topics Plenary Session
Sunday, April 23 8:00 a.m.–9:00 a.m. “Best of” Session S1: Best of: Parkinson’s Disease 8:30 a.m.–5:30 p.m. P1: Poster Session I 9:15 a.m.–12:00 p.m. Presidential Plenary Session 1:00 p.m.–3:00 p.m. Scientific Platform Sessions S2: MS and CNS Inflammatory Disease: Neuroimaging in MS S3: ALS: Disease Mechanism and Therapeutics S4: Movement Disorders: Beyond Oral Levodopa in Parkinson’s Disease S5: General Neurology: Pathogenesis, Modulation, and Biomarkers of Complex Neurological Disorders Neuroscience in the Clinic Session Neuroscience in the Clinic Session N1: Neuroscience in the Clinic: Neurobiology and Treatment of Disorders of Language and Action 3:30 p.m.–5:30 p.m. Scientific Platform Sessions S6: Research Methodology and Education: Education Research S7: Aging and Dementia: Clinical and Translational Studies in Neurodegenerative Diseases S8: Cerebrovascular Disease and Interventional Neurology: Acute Stroke Treatment Neuroscience in the Clinic Session S9: Neuro Trauma and Sports Neurology Neuroscience in the Clinic Session N2: Neuroscience in the Clinic: Child Neurology: Neurologic Disorder Through a Lifespan
Monday, April 24 8:00 a.m.–9:00 a.m. “Best of” Session S10: Best of: MS and CNS Inflammatory Disease 8:30 a.m.–7:00 p.m. P2: Poster Session II 9:15 a.m.–11:30 a.m. Contemporary Clinical Issues Plenary Session 1:00 p.m.–3:00 p.m. Scientific Platform Sessions S11: Highlights in Sleep Science S12: MS Therapeutics and MRI Outcomes S13: Motor Neuron Diseases: Biomarkers, Outcome Measures, and Therapeutics S14: Autonomic Disorders: Synucleinopathies Neuroscience in the Clinic Session N3: Neuroscience in the Clinic: Cutting Edge Concussion Data from the NCAA-DoD Grand Alliance 3:30 p.m.–5:30 p.m. Scientific Platform Sessions S15: Neuroepidemiology
AANnews • March 2017
Continued from cover
S16: MS Characterizations and Tools for Measurement S17: Movement Disorders: Ataxia and the Cerebellum S18: Behavioral and Cognitive Neurology Invited Science Session Invited Science: Headache
Tuesday, April 25 8:00 a.m.–9:00 a.m. “Best of” Session S19: Best of: Cerebrovascular Disease and Interventional Neurology 8:30 a.m.–7:00 p.m. P3: Poster Session III 9:15 a.m.–11:30 a.m. Clinical Trials Plenary Session 1:00 p.m.–3:00 p.m. Scientific Platform Sessions S20: Neuromyelitis Optica and Other Autoimmune Disorders S21: Epilepsy and Clinical Neurophysiology (EEG) I S22: Parkinson’s Disease: Observational Studies Neuroscience in the Clinic Session N4: Neuroscience in the Clinic: Zika Virus: The Global Outbreak of a Neurotropic Virus Invited Science Session Invited Science: Neuro-oncology 3:30 p.m.–5:30 p.m. Scientific Platform Sessions S23: Neurocritical Care: Neurological Intensive Care S24: MS Therapeutics and Clinical Research I S25: Cerebrovascular Disease and Interventional Neurology: Prehospital and Emergency Department Ischemic Stroke Care S26: Neuro-ophthalmology/Neuro-otology
Wednesday, April 26 8:00 a.m.–9:00 a.m. “Best of” Session S27: Best of: Neuromuscular Disease Therapeutics 8:30 a.m.–7:00 p.m. P4: Poster Session IV 9:15 a.m.–11:30 a.m. Frontiers in Neuroscience Plenary Session 1:00 p.m.–3:00 p.m. Scientific Platform Sessions S28: MS Therapeutics and Clinical Research II S29: Cerebrovascular Disease and Interventional Neurology: Critical Care and Hemorrhage S30: Infectious Disease: HIV, Syphilis, Borrelia, TB, Cysticercosis, and Other Infections S31: History of Neurology Neuroscience in the Clinic Session N5: Neuroscience in the Clinic: Stress and Neurologic Diseases: Effects Through the Neuroendocrine System 3:30 p.m.–5:30 p.m. Scientific Platform Sessions S32: Cerebrovascular Disease and Interventional Neurology: Epidemiology S33: Progressive MS Therapeutics S34: Epilepsy and Clinical Neurophysiology (EEG) II
S35: Aging and Dementia: Neuroimaging in Neurodegenerative Diseases S36: Global Health Neuroscience in the Clinic Session N6: Neuroscience in the Clinic: Functional Recovery in Neurology and Neuroscience
S47: Headache: Basic and Clinical Science S48: Exciting New Results in Neuro-rehabilitation Neuroscience in the Clinic Session N8: Neuroscience in the Clinic: Novel Therapeutic Targets in Critical Care Neurology: Intracerebral and Intraventricular Hemorrhage
Thursday, April 27
Friday, April 28
8:00 a.m.–9:00 a.m. “Best of” Session S37: Best of: Epilepsy 8:30 a.m.–7:00 p.m. P5: Poster Session V 9:15 a.m.–11:30 a.m. Controversies in Neurology Plenary Session 1:00 p.m.–3:00 p.m. Scientific Platform Sessions S38: Update in Muscular Dystrophy S39: Movement Disorders: Functional and Structural Imaging in Parkinson’s Disease S40: Infectious Disease: The Neurology of Zika, Chikungunya, and Acute Flaccid Myelitis S41: Neuro-oncology S42: Pain and Palliative Care Neuroscience in the Clinic Session N7: Neuroscience in the Clinic: Dopamine Transporter (DaT) Imaging 3:30 p.m.–5:30 p.m. Scientific Platform Sessions S43: Practice, Policy, and Ethics S44: MS Risk Factors and Modifications S45: Peripheral Nerve Disorders S46: Child Neurology: Molecular Biology to Clinical Trials
8:00 a.m.–9:00 a.m. “Best of” Session S49: Best of: Aging and Dementia 8:30 a.m.–5:30 p.m. P6: Poster Session VI 9:15 a.m.–11:30 a.m. Neurology Year in Review Plenary Session 1:00 p.m.–3:00 p.m. Scientific Platform Sessions S50: MS Novel Therapeutics and Animal Models S51: Cerebrovascular Disease and Interventional Neurology: Stroke Prevention and Translation S52: Headache: Clinical Trials and Disease Burden S53: General Neurology: Mechanisms and Diagnosis in Overlapping Medical and Neurological Diseases Neuroscience in the Clinic Session N9: Neuroscience in the Clinic: Afferent and Efferent Visual Pathway Manifestations of Neurodegenerative Diseases: Implications for Diagnosis and Treatment 3:30 p.m.–5:30 p.m. Scientific Platform Sessions S54: Motor Neuron Disease and Myopathies S55: Epilepsy and Clinical Neurophysiology (EEG) III S56: Movement Disorders: Huntington’s Disease and Drug-Induced Dyskinesias •
Registration Opens This Month for July Sports Concussion Conference 2O17
Registration opens this month for the AAN’s fourth annual Sports Concussion Conference, coming to Jacksonville, FL, July 14 through 16, 2017. Over one million athletes experience a concussion each year in the United States, with the issue attracting significant media attention in recent years. New science is emerging quickly and breakthrough therapies are helping athletes recover from injuries previously thought untreatable. The AAN Sports Concussion Conference will help you stay up-to-date, and discover the latest information on the prevention, diagnosis, and treatment of sports concussion through interactive hands-on workshops, debates, and other engaging formats. Attendees can expect to: nn Better understand the current state
of concussion pathophysiology, diagnosis, and management
nn Learn about the latest technologies
for diagnosis and management
nn Discover emerging issues in
post-concussion syndrome diagnosis and management
nn Discuss issues of long-term
sequelae from athletic brain trauma
July 14 –16 • Jacksonville, FL
New Event Location! With 1,100 miles of shoreline, abundant parks and waterways, and natural beauty surrounding a modern, vibrant city, Jacksonville is poised to be ideal destination for the Sports Concussion Conference. The city has a rich sports tradition and is home to eight pro sports teams, host to the Annual Players Championship, TaxSlayer Bowl (formerly Gator Bowl), and numerous other sporting events, including the 2005
NFL Super Bowl. More than 30 nonstop flights from major US cities and plentiful ground transportation options make traveling to, and getting around, Jacksonville quick and easy.
Early Registration Discount Deadline Money-saving early registration discounts end June 15, 2017. Visit AAN.com/view/ConcussionConference to secure your spot today. •
AANnews • March 2017
Don’t Wait! Hotels Filling Up Quickly, Registration Savings Ending March 8 is your last chance to save on accommodations for the upcoming Annual Meeting through the AAN’s official housing vendor, and March 30 is your last chance to take advantage of special early registration rates. The meeting’s all-inclusive registration rate is your ticket to most everything the meeting has to offer—all week long and at no additional cost to you— and the average Neurologist member will save $260 or more by registering by March 30.
See the Savings! nn Neurologist Member: Save $260 with $720 early
nn Non-neurologist Member: Save $150 with $420
early registration rate
nn Junior Member: Save $90 with $245 early
Secure your hotel room—and your savings—today by visiting AAN.com/view/register, or calling the official Annual Meeting reservation vendor CMR at (800) 676-4226 or (415) 979-2283 (international).
Guarantee Your Rates, Reservations Please be advised of unofficial solicitations to secure housing or registration for the Annual Meeting that may target you. CMR is the ONLY official housing and registration company for the AAN. Other companies offering registration or housing are not affiliated with the AAN in any way, nor are they authorized to represent the AAN and should be avoided. These companies appear to be attempting to defraud or deceive attendees through their misrepresentations and false advertising. For your own protection and to ensure your housing and registration is confirmed, please reserve housing, and register for the Annual Meeting, with CMR.
AANnews • March 2017
Attendee Contact Lists It has come to the AAN’s attention that companies are advertising the sale of “10,000+ Attendees contact lists” that may include emails for Annual Meeting attendees. The AAN has no relationship with and has not provided contact information to companies claiming to be selling these lists. The AAN only releases email addresses of Annual Meeting attendees in a very limited circumstance. Only email addresses for US attendees who have not opted-out are made available for purchase by the AAN’s registered exhibitors, industry supporters, and Industry Roundtable members for a one-time use and must be deleted immediately after use. When you register for the Annual Meeting, you will be asked whether you wish to opt-out from having your email address provided to these commercial entities participating in the Annual Meeting. You may update your opt-out choice in the registration site or by contacting CMR at (800) 676-4226 or (415) 979-2283 (international) or at aanam.cmrushelp.com. To opt out of pre-meeting materials, opt-outs must be received by March 30. To opt out of post-meeting materials, opt-outs must be received by April 28. Any other company claiming to sell contact information has no affiliation with the AAN and will be issued a cease and desist letter. •
Capitol Hill Report Capitol Hill Report presents regular updates on legislative and regulatory actions and how the Academy ensures that the voice of neurology is heard on Capitol Hill. It is emailed to US members twice monthly and is posted at AAN.com/view/HillReport. Below are some recent highlights. This Capitol Hill Report examines the process that Republicans will try to use to repeal and replace the Affordable Care Act (ACA), also known as “Obamacare,” and the defenses that Democrats might be able to employ in opposition. The main defense Democrats have is that controversial legislation almost always needs a 60-vote supermajority to pass through the Senate. Because Republicans only control 52 votes in the Senate, they cannot outright repeal and replace with an up or down vote. Recently, Mike Amery had the opportunity to speak with both Speaker Paul Ryan (R-WI) and House Majority Leader Kevin McCarthy (R-CA) about their plans. Recognizing the inherent difficulty in getting to 60 votes in the Senate, Ryan and McCarthy plan to use three separate methods for repealing and replacing the ACA. They are calling the strategy “three buckets.”
Bucket #1—Reconciliation Reconciliation is a legislative process that requires only a majority vote in the Senate, but it is restricted to proposals that change a budget deficit or surplus. Republicans passed a budget last month. This opened the door to make changes to the ACA, but only on those provisions that impact the budget. This includes sections such as the individual mandate, the medical device tax, and the Cadillac tax. This part should be easy. However, eliminating some of these provisions will likely be very expensive, which requires spending cuts in other areas or increased revenues, which would mean the unlikely prospect of raising taxes.
Bucket #2—Department of Health and Human Services (HHS) The legislation creating the ACA passed by Democrats in 2010 runs 2,700 pages. The word “secretary” appears in the ACA more than 3,000 times. This means that the secretary of HHS is given wide discretion on interpreting and implementing many of the ACA’s provisions. A perfect example of this was the ACA’s “Medicaid bump” which allowed the Center for Medicare & Medicaid Services (CMS), a division of HHS, to expand the bonus to all internal medicine subspecialties, but not neurology, psychiatry, or OB/GYNs. President Trump’s nominee for HHS secretary, Rep. Tom Price, MD, (R-GA), a former orthopedic surgeon, was confirmed by the Senate in February. His first priority is likely to begin unraveling Obamacare through the 3,000 times his office is mentioned in the ACA.
Bucket #3—Legislation Anything that doesn’t impact the budget and cannot be affected by the HHS secretary will have to pass both houses of Congress and will be subject to the Senate’s 60-vote requirement. This includes popular programs like requiring insurance to cover pre-existing conditions and allowing children to remain on their parent’s health insurance until age 26, as well as more controversial issues like insurance coverage mandates. This will require compromise and may be very difficult. The AAN has heard from many members concerned about how any repeal and replace plans might impact their patients and all Americans. In response, the AAN’s Government Relations Committee has drafted principles for AAN positions. These principles include important AAN priorities such as ensuring appropriate health care coverage for all Americans, appropriately valuing the cognitive care that neurologists provide, and reducing regulatory burdens on all physicians. The AAN Board of Directors is considering the principles now and I hope to write about the specifics in the next issue of Capitol Hill Report. Both Speaker Ryan and Majority Leader McCarthy stressed to Amery that they believe Obamacare has serious structural flaws and will collapse without changes. They say their goal is not to cause people to lose coverage, it is to create structural integrity. They are committed to “getting it right.” As they move forward, the AAN will be ready to weigh on the priorities of AAN members and the patients they serve. •
AANnews • March 2017
Jones Recognized for Patient Advocacy Elaine C. Jones, MD, FAAN, has been named the 2016 Kenneth M. Viste, Jr., MD, Patient Advocate of the Year. Jones is a member of the AAN Board of Directors and the Medical Economics and Management Committee, and chairs the Payment Policy Subcommittee. She has been a general neurologist in solo private practice in Bristol, RI, since 2005, and an AAN member since 1986.
Following her advocacy training at the 2003 forum, Jones served as an advisor to the program in 2004 and 2005, and moderator in 2010. She also has participated in several Neurology on the Hill events in Washington, DC. Jones has been involved in many committees for the AAN, as chair of the BrainPAC Executive Committee and the Government Relations Committee, and as a member of the Nominations Committee, Payment Policy Subcommittee, Leadership Task Force, Advocacy Task Force, and State Society Task Force.
“Dr. Jones has demonstrated a sustained dedication and commitment to neurology Elaine C. Jones, advocacy for over a decade,” said Glenn D. MD, FAAN Jones completed her undergraduate training at Graham, MD, PhD, FAAN, chair of the Viste Smith College in Northampton, MA, and attended Selection Subcommittee. “A graduate of the medical school at the Medical University of South Carolina first Palatucci Advocacy Leadership Forum class in 2003, in Charleston. She completed her neurology residency she has selflessly taken time away from her solo practice and neurophysiology fellowship at Brown University in to serve the neurology community by holding multiple Providence, RI. leadership positions with the AAN, participating annually in Neurology on the Hill, and as leader and driving force of She worked at Roger Williams Medical Center in the Rhode Island Neurological Society. Dr. Jones also has Providence, RI, a community academic hospital, where donated time and effort to provide neurological care to the she was involved in training medical residents from Boston underserved in Haiti. The committee was very impressed University as well as Brown University. In 2000, she took by the range of her advocacy and service work.” over as chief of neurology at Roger Williams Medical Center until 2005, when she left to open her own private Jones will receive the award at the Annual Meeting practice in Bristol, RI. in Boston during a reception for Palatucci Advocacy Leadership Forum graduates. Jones served as president of the Rhode Island Medical Society and served on many state task forces including the “I am grateful to the AAN for providing me the training and Health Care Leaders Advisory Committee, Health Source RI opportunities to get involved in advocacy work,” Jones said. Advisory Board for the State Exchange, and the Alzheimer’s “This is some of the most rewarding work that I do and now Disease Planning Committee. Jones says she is passionate it is more important than ever that we are out there fighting about the field of neurology and her patients, and is dedicated for our patients and our profession. I have learned that one to improving the practice of neurology as our health care person can make a difference, but with more people involved system changes dramatically so that patients can continue the results can be even bigger. I encourage everyone to get to have access to high-quality care and treatments. • involved wherever and however they can.”
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It’s Not Spam... It’s AANe-news! 30
AANnews • March 2017
HEADACHES. JUST ANOTHER WAY OF SAYING BAYLOR. Baylor specializes in treating complicated headache cases. So, when you need to make a referral, consider the word “experience” as one more way of referring to Baylor.
HEAD ACHE CENT ER
9101 N. Central Expressway, Suite 400, Dallas, TX 75231
Physicians provide clinical services as members of the medical staff at one of Baylor Scott & White Health’s subsidiary, community or affiliated medical centers and do not provide clinical services as employees or agents of those medical centers or Baylor Scott & White Health. ©2017 Baylor Scott & White Health. BSWNeuro_28_2017 CE 02.17
To learn more about the Baylor Neuroscience Center Call 214.820.9272 or visit BSWHealth.com/Headache AANnews • March 2017
CME & MOC
New NeuroLearn Patient Safety Online CME Course Available Free to AAN Members A new Patient Safety course is now available as part of NeuroLearnSM, the AAN’s exclusive suite of online education courses. Available free to AAN members, the Patient Safety course is designed to help neurologists within three years prior to their board certification/recertification, or in their first C-MOC block, meet the new one-time ABPN-approved patient safety course requirement for Maintenance of Certification. In addition, the course awards up to four self-assessment CME credits. The course is designed with convenience in mind, and may be taken on a computer or tablet, from virtually anywhere at your own time and pace, and completed in approximately four hours. It is comprised of 10 topics which the learner can work through in any order. Presentations include interactive multimedia, assessments, and implementation planning tools and tactics. In order to receive CME credit, you must successfully complete the course assessment and an evaluation. Course topics include: nn Increasing Patient Safety Awareness and Practice
Among Clinicians and Staff
nn Methods for Measuring Performance and
nn The Role of Health Information Technology in
nn Reducing Medication Errors nn Advancing Patient Safety Through Systems Thinking
nn Establishing a Patient Safety Culture nn Safety Enhancing Technology nn Patient Education nn Quality Improvement nn Communication
Free AAN member access to NeuroLearn is limited to one course at a time. Medical Students and Nurse Practitioner/ Physician Assistant members at the lower dues rate are not eligible for free access. Get started today by visiting AAN.com/view/NeuroLearn. The ABPN has reviewed NeuroLearn: Patient Safety and has approved this product as part of a comprehensive lifelong learning and self-assessment program, which is mandated by the American Board of Medical Specialties (ABMS) as a necessary component of Maintenance of Certification (MOC). Members should be aware that the AAN is an independent association with no control over ABPN, the American Board of Medical Specialties, or the MOC rationale and process. For more information on MOC, visit ABPN.com. •
UCNS Announces Newly Certified and Recertified Diplomates The United Council of recertification applied to Neurologic Subspecialties recertify, which clearly (UCNS) has issued its demonstrated that UCNS first recertifications to diplomates continue to find diplomates certified value in their certificates,” in 2006 and 2007 in said Matthew E. Fink, MD, Headache Medicine and FAAN, chair of the UCNS Behavioral Neurology Certification Council. & Neuropsychiatry. Recertification examinations Diplomates receiving were offered in Headache certification receive a Medicine and Behavioral time-limited certificate that Matthew E. Fink, MD, FAAN Neurology & Neuropsychiatry. is valid for 10 years. Due A total of 65 physicians were to examination schedules, recertified in Headache 2007 diplomates recertified in 2016 to Medicine, and 46 physicians avoid a future lapse in certification. recertified in Behavioral Neurology & Neuropsychiatry. “I am happy to report that a high number of physicians due for
AANnews • March 2017
Initial certification examinations were also offered in Autonomic Disorders, Headache Medicine, and Behavioral Neurology & Neuropsychiatry, resulting in 105 newly certified diplomates in 2016. Currently, there are 2,675 UCNS-certified diplomates in nine subspecialty areas. For the list of physicians who received initial certification and recertification, visit UCNS.org. •
Continuum Audio Series Addresses Outpatient Neurology Syncope, low back pain, trigeminal neuralgia, and disorders of taste and smell are among an array of topics covered in the latest Continuum® Audio series on outpatient neurology.
the forefront for many neurologists.” The first two hours of the series are currently available; the second two hours will be available in April.
nn Syncope / William P. Cheshire, Jr.,
nn Dizziness in the Outpatient Care
Setting / Terry D. Fife, MD, FAAN
“This series focuses on topics frequently seen by neurologists in the outpatient setting, including dizziness, urogenital symptoms in neurologic patients, Bell’s palsy, and common entrapment neuropathies,” said issue host S. Andrew Josephson, MD, FAAN, of the University of California, San Francisco. “Our experts also discuss the practical considerations in addressing physician burnout and mitigating MEM: 16cybersecurity Live Well Ads Ad—Half Page Horizontal> ANin risks, topics which are Placed in AANnews 8.25 x 5.25 +0.125 bleed, 4C
Zilliox, MD, MS
Hour 4: nn Disorders of Taste and Smell /
Ronald DeVere, MD, FAAN
S. Andrew Josephson, MD, FAAN
nn Neuropathic Pain / Lindsay A.
Hour 2: nn Urogenital Symptoms in Neurologic
Patients / Jalesh N. Panicker, MD, DM, FRCP
nn Bell’s Palsy / Stephen G. Reich,
nn Practical Considerations in
Addressing Physician Burnout / Anindita Deb, MD
Hour 3: nn Low Back Pain / Jinny O. Tavee, MD nn Common Entrapment Neuropathies /
nn Trigeminal Neuralgia / Giorgio
nn Mitigating Cybersecurity Risks /
Joseph S. Kass, MD, JD, FAAN
Continuum Audio is a biweekly audio CME program based on discussions with the authors of articles published in Continuum: Lifelong Learning in Neurology®, the official CME journal of the AAN. Continuum Audio is available in multiple formats, including apps for iOS and Android devices. This program may be used to meet self-assessment and CME requirements for maintenance of certification as mandated by the American Board of Psychiatry and Neurology. To learn more and subscribe, visit Audio-digest.org/Continuum. •
Charles A. Zollinger, MD, FAAN
Live Well Taking Care of Your Patients Starts with Taking Care of You
Neurologists have one of the highest rates of burnout and lowest rates of work-life balance among medical specialties. Find practical solutions to revitalize your well-being.
Vote for Board Nominees, Bylaws Change at AAN Business Meeting The AAN Nominations Committee, chaired by former AAN President Bruce Sigsbee, MD, FAAN, has announced the nominees for AAN officer and director positions for the 20172019 term. These nominees will be presented to the voting membership for approval during the AAN’s 2017 Business Meeting on Saturday, April 22, 2017, at 4:00 p.m. during the Annual Meeting in Boston. Members are encouraged to attend the business meeting and participate in this election, a vote on a proposed bylaws change, and other matters. The classes of membership entitled to vote on any matter during any business meeting of the Academy are Fellows and Neurologist Members. Honorary and Senior members who had voting privileges in their most recent previous category of membership also are eligible to vote. “On behalf of the Nominations Committee, I’d like to thank these fine members for stepping forward to volunteer to help lead the Academy and represent the needs and desires of their colleagues,” said Sigsbee. “We received a record number of applications from worthy prospects which made the selection process very difficult for the committee. From the pool of outstanding candidates, we sought balance and diversity. We are excited to have three members who are nominated for their first term on the board, and the new insights and skills
they will contribute. We would like to thank those applicants we could not accept at this time for their commitment to the AAN and their willingness to assume a leadership role in the AAN. The AAN is fortunate that so many skilled and committed individuals are willing to volunteer at a time when the energy and commitment will be critical to not only the AAN and its membership but to the specialty given the uncertainties in the environment going forward.” The Academy is comprised of two legal entities, the AAN and the AAN Institute. Several AAN and AAN Institute Board members serve ex officio based on their positions as chairs of major committees. Most of the elected members of the AAN Board of Directors also serve ex officio on the Board of Directors of the AAN Institute, which includes an independent secretary-treasurer and additional members who serve in ex officio capacities. For informational purposes only, the information below includes both AAN and AAN Institute proposed Board members including those who serve ex officio pursuant to the AAN and AAN Institute Bylaws. Ralph L. Sacco, MD, MS, FAHA, FAAN, will serve as the president of the AAN based on his 2015 election as President Elect, and Terrence L. Cascino, MD, FAAN, will serve as immediate past president based on his current service as president.
Learn more about these nominees by reading their bios on pages 6–15.
2017-2019 AAN Board Nominees Officers President Ralph L. Sacco, MD, MS, FAHA, FAAN President Elect Lisa M. DeAngelis, MD, FAAN Vice President James C. Stevens, MD, FAAN
Jonathan P. Hosey, MD, FAAN Elaine C. Jones, MD, FAAN Brett M. Kissela, MD, MS, FAAN* John C. Morris, MD, FAAN Thomas R. Vidic, MD, FAAN The AAN slate does not include these additional directors who will serve as ex officio directors under the bylaws:
Secretary Carlayne E. Jackson, MD, FAAN
Nicholas E. Johnson, MD, Chair, Government Relations Committee
Treasurer Janis M. Miyasaki, MD, MEd, FRCPC, FAAN
Orly Avitzur, MD, MBA, FAAN, Chair, Medical Economics and Management Committee
Immediate Past President Terrence L. Cascino, MD, FAAN
Gregory D. Cascino, MD, FAAN, Chair, Member Engagement Committee
Directors Brenda Banwell, MD, FAAN* Sarah M. Benish, MD, FAAN Charles C. Flippen II, MD, FAAN Charlene Gamaldo, MD, FAAN*
Robert A. Gross, MD, PhD, FANA, FAAN, Editor-in-Chief of Neurology ® Catherine M. Rydell, CAE, Executive Director/CEO (non-voting)
All of the elected AAN directors and officers would also serve on the AAN Institute Board of Directors, with the exception of the AAN Treasurer and the chairs of the Government Relations, Membership Engagement, and Medical Economics and Management Committees. The following additional members will serve on the AAN Institute Board of Directors: Ann H. Tilton, MD, FAAN, AAN Institute Secretary-Treasurer Natalia S. Rost, MD, MPH, FAAN, FAHA, Chair, Science Committee (ex officio) Heidi B. Schwarz, MD, FAAN, Chair, Practice Committee (ex officio) A. Gordon Smith, MD, FAAN, Chair, Education Committee (ex officio) *First-term nominees
A proposed change to the AAN bylaws is also on the agenda for the Academy’s annual Business Meeting. The proposed amendment to the AAN bylaws would improve the description of what responsibilities are fulfilled by the AAN’s executive director and to confirm that the AAN president and treasurer are not “statutory employees” of the AAN. For more information, contact Karen Kasmirski at (612) 928-6118 or email@example.com. •
AANnews • March 2017
Synapse Online Communities Inaugural Year Proves a Big Hit In early 2016, the AAN launched SynapseSM Online Communities, the official communication platform for all AAN Sections. Positioned to be the global conversation for all things neurology, Synapse offered a new opportunity for members within similar areas of interest to exchange ideas for advancing neuroscience and strengthening patient care, share insights on the latest news in the world of neurology, and gain and offer perspectives and solutions for all facets and career levels of the field. The model worked. Since its debut, Synapse has grown to 37 public communities—recently adding Autoimmune Neurology, Business Administration, Neurohealth & Integrative Neurology, and LGBTQI—serving more than 9,000 member neurologists and neuroscience professionals, residents and fellows, researchers, and businesses administrators from around the world. This engagement reflects an increase of more than 700 additional section members over the past year. Through Synapse, AAN members have been able to:
Discover the Annual Meeting Everyone’s Talking About! “I LOVE the new format.” “There is energy at this meeting
I haven’t seen in many years.”
These changes enabled me to tailor my learning and get
the most out of the conference to benefit my patients!”
“The one registration
“The clientele are
AAN meeting has changed to meet
fee with freedom to move about was an to the meeting.”
changing and the the demands.”
nn Exchange insights on professional-related topics
nn Share expertise, find answers to tough questions,
and strengthen the care they provide
nn Discuss timely news and science affecting the field
nn Offer real-world solutions to practice, patient care,
academia, and other areas of the neurology profession— across all career levels
What will you say?
Register now at AAN.com/view/AM17
Early registration discounts end March 30. Hotel registration ends March 8.
nn Quickly and easily provide feedback on section-relevant
AAN programs and services
nn Download and share documents and images through
the Synapse digital library
Because Synapse is an exclusive benefit of AAN membership, only AAN members can view conversations in any of the 37 Synapse communities (or AAN Sections). However, in order to post or comment on a conversation, participants must be a member of that particular AAN section. Section members can participate at any level of interaction (read, comment, or post) within conversations that fall under their sections’ communities. Synapse members may easily join various AAN sections directly on the AAN webpage at AAN.com/synapse, or on the Synapse site, where they may also update their profile preferences to change the frequency of online community notifications. •
u. ing Yo c n a . Adv ology r u e N ncing Adva
AANnews • March 2017
Seeking Mid-career Neurologists for 2017 Transforming Leaders Program Application Deadline: June 1 Are you an experienced US AAN member neurologist 10 or more years out of residency with demonstrated leadership skills? The Transforming Leaders Program may be for you! The AAN is now accepting applications until June 1 for this unique opportunity for qualified participants to gain an in-depth, one-of-a-kind leadership experience that will help them lead at the AAN, in daily life, and in the world of neurology. Today’s challenging health care environment creates a special need for great leadership, and the AAN is committed to helping its members expand their leadership potential to take their skills to the next level, in turn further advancing the profession of neurology and the growing needs of patients. Participants of this elite, ninemonth program will:
“The Transforming Leadership Program is NOT like any leadership training I have attended before. My natural leadership abilities have helped me to achieve some successes; however, I had no idea how much more I could learn. After just a few months, I have maximized my talents while minimizing my weaknesses, I can efficiently resolve conflict with less effort, and I am more mindful in my conversations and decision-making. Somehow, I am now able to achieve more, without working harder. I am now prepared to take a more active path towards an AAN leadership position. This program is a rare opportunity for real leadership transformation. It’s been a priceless gift that I highly recommend to anyone dedicated to our great field of neurology.”
nn Hone their leadership skills
—Jennifer Bickel, MD 2016 Transforming Leaders Program participant
through customized and in-depth leadership training
nn Take advantage of networking
opportunities with AAN Board and committee members
nn Experience one-on-one coaching sessions during
the first half of the program
nn Attend four face-to-face meetings with a facilitator,
AAN staff, and fellow classmates
nn Participate in exclusive mentoring opportunities nn Work on a self-guided leadership project during the
first four months of the program and in a group project during the second half of the program, with final presentation to the AAN/AAN Institute Board at the June 2017 Board Meeting.
Visit AAN.com/view/TransformingLeaders to learn more and apply by the June 1, 2017, application deadline. •
20 Minutes Pack a Punch! Download the latest podcast at Neurology.org.
AANnews • March 2017
AAN Staff Singled Out for 2016 Great Performers Award Executive Director and CEO Catherine M. Rydell recently recognized these 10 members of the AAN staff who went above and beyond the call of duty in 2016 and merited the Academy’s first “Great Performers Award.” Front row, left to right: Jim Hopwood, Senior Graphic Designer; Becky Schierman, Director, Quality Improvement; Christi Kokaisel, Director, Membership; Wendy Vokaty, Senior Manager, Leadership Programs and Special Events; Susan Corcoran, Associate Director, Finance. Back row, left to right: Amy Schoch, Manager, Career Services; Andrew Halverson, Associate Director, Industry Sales; Lynee Koester, Project Manager/ Executive Assistant; Andrea Weiss, Executive Editor, Education and News Publications; Kevin Heinz, Director, Annual Meeting and Conferences.
AAN.com/careers Visit the AAN’s Neurology Career Center to view hundreds of additional jobs and sign up for customized, confidential notifications when positions of interest are added. Maine Central Maine Medical Group is seeking a BE/BC neurologist to join an established adult neurology practice primarily associated with Central Maine Medical Center. A focused interest in stroke, muscle disease, headache/ migraine, epilepsy, or movement disorder would be a welcome addition, but is not required. Our diagnostic capabilities include: 1.5 T MRI, CT angio, EMG, Evoked Potentials, EEG, and 24-72 Hour Ambulatory EEG. We also have an active Teleneurology service that is affiliated with Massachusetts General Hospital. Central Maine Medical Center is the flagship hospital of Central Maine Healthcare. The medical center has 250 inpatient beds and offers a broad range of services that include, among many, neurosurgery, a Level II trauma center, cardiovascular medicine, vascular and cardiac surgery, and medical and radiation oncology. The Central Maine Medical Group comprises of approximately 350 providers, approximately half of which are in primary care. The group delivers care across almost 2500 square miles at numerous outpatient sites and four hospitals. A competitive salary and attractive benefits package are enhanced by the scenic beauty and abundant outdoor adventure found in Maine. Interested candidates, please send CV to Gina Mallozzi, Central Maine Medical Center, 300 Main Street, Lewiston, ME 04240. Fax: (207) 795-5696, email: MallozGi@ cmhc.org, or call: (800) 445-7431. Not a J1 Opportunity. Clinical Neurophysiologist The Department of Neurology of Memorial Sloan Kettering (MSK) Cancer Center is presently seeking a full-time Clinical Neurophysiologist (CNP) with an emphasis in EMG. This position offers academically-oriented candidates an exciting opportunity to join an established neurophysiology program where opportunities for career development and clinical research are excellent. The position involves clinical care based at our Manhattan campus and MSK Westchester. Candidates must be BC/BE in Neurology, and CNP or American Board of Electrodiagnostic Medicine.
Rank will be commensurate with experience and qualifications. Interested candidates should send a Curriculum Vitae and the names of three references to: Dr. Edward Avila, Vice-chair, Department of Neurology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065. Email: firstname.lastname@example.org Help Build A Gateway to Better Health Help Build a Gateway for Better Health At Northwest Permanente, P.C., we want every patient we see to receive the medical care they need to live long and thrive. You’ll benefit from a comprehensive network of support services and a talented team of colleagues who share your passion for medicine and patient care within our self-governed, physician-led, multi-specialty group of over 1,500 physicians, surgeons and clinicians who care for over 540,000 members throughout Oregon and Southwest Washington. Opportunities are available for individuals with subspecialty, general neurology and inpatient hospital responsibilities. Clinical excellence and an interest in helping to pioneer new ways of providing the right neurological care at the right time for the right person will be essential to these positions. We invite you to join our 11 Neurologist department that is pioneering integrated medical practice and is leading the way to the future of medical care. Movement Disorders Neurologist, opportunity in the Pacific Northwest: Join us in the beautiful Pacific Northwest and enjoy a competitive salary in addition to an extensive benefit package which includes medical, dental, disability and life insurance; company funded/ generous retirement plans; vacation, sabbatical and educational leave; and professional liability coverage. Physicians who are Board Certified are also eligible for Senior Physician and Shareholder standing after approximately three years with the group. To apply, please visit our Web site at: http://nwp.kpphysiciancareers.com. For more information, call Tiffany Pitre at (503) 813-3527 or email Tiffany.K.Pitre@
kp.org. No J1 opportunities. We are an equal opportunity employer and value diversity within our organization. Fellowship in Neuroimaging Winchester Neurological Consultants, Inc., in conjunction with Virginia Commonwealth University and Winchester Medical Center, is offering a clinical Neuroimaging Fellowship for BC/BE neurology graduates that can be completed in one or two years. Located approximately an hour from Washington, D.C., our United Council of Neurologic Subspecialties fully accredited fellowship offers extensive training in the performance and interpretation of diagnostic inpatient and outpatient MRI, CT, Doppler, TCD, and myelography -- utilizing four state of the art MRI scanners and four multi-slice CT units. Responsibilities include supervision and interpretation of imaging, assisting with acute stroke protocols, and direct patient care. Availability: immediate. Research interests are encouraged. Salary is $60,000.00 per year plus benefits. CV’s should be emailed to email@example.com
AANnews® Classified Advertising T he AAN offers a complete package of print, online, and in-person recruitment advertising opportunities. Visit AAN.com/careers for all AAN options, rates, and deadlines.
d copy for the May 2017 print edition of AANnews A must be submitted by April 1, 2017. The same deadline applies to changes/cancellations. he American Academy of Neurology reserves the T right to decline, withdraw, or edit advertisements at its discretion. Every care is taken to avoid mistakes, but the responsibility for clerical or printer errors does not exceed the cost of the ad.
AANnews • March 2017
Miller to Help Advance Foundation’s Mission With his extensive experience in research, patient care, and philanthropy, and his singular insight into the artistic abilities that can emerge in the setting of dementia, Bruce L. Miller, MD, FAAN, of the University of California, San Francisco, brings a wealth of talent to his new role serving on the American Brain Foundation Board of Directors. “We are thrilled that Dr. Miller has agreed to share his passion and energy with the American Brain Foundation to help us reach our mission to cure brain disease,” said AAN Executive Director and CEO Catherine M. Rydell, CAE, ex officio member of the American Brain Foundation board. “His decades of involvement with the John Douglas French Alzheimer’s Foundation as scientific director will provide us with valuable knowledge as we work
AANnews • March 2017
Miller, a behavioral neurologist who directs the UCSF Memory and Aging Center, also helps lead two philanthropyfunded research consortia, the Tau Consortium “I’m very excited and the Consortium for about the work that Frontotemporal Research. the Foundation He also co-directs the does and have Global Brain Health long admired a lot Bruce L. Miller, Institute. The AAN awarded MD, FAAN of the members Miller the Potamkin Prize of the American for Research in Pick’s, Alzheimer’s, Brain Foundation Board,” said and Related Diseases in 2010 Miller. “This is a very important for his pioneering research in organization, and I believe it is frontotemporal lobar degeneration. going to have a huge impact The American Brain Foundation is on the funding and visibility of broadening its appeal of support neurological diseases. This is a very to the public, and plans to launch a important time for neurological new online neuroscience research diseases because therapies are crowdfunding platform this year. • available today that haven’t been available even within the past 10 years.” toward our goal of accelerating scientific research and speeding progress on the road toward curing diseases of the brain.”
Dates and Deadlines SUN 5
MARCH 2017 WED
APRIL 2017 WED
Deadline: Annual Meeting Hotel Reservation AAN.com/view/AM17
AAN Brain Health Fair Boston BrainHealthFair.com
Webinar: Coding for Risk: How It Impacts Payment (Register by May 1) AAN.com/view/pmw17
Webinar: Getting What You Deserve—A Primer on Contracting (Register by March 7) AAN.com/view/pmw17
AAN Business Meeting Boston AAN.com/view/AM17
Submission Deadline: 2017 Neuro Film Festival NeuroFilmFestival.com
MARCH 28 Webinar: Thriving in Small and Solo Neurology Practices (Register by March 27) AAN.com/view/pmw17
MARCH 30 Deadline: Annual Meeting Early Registration Discount AAN.com/view/AM17
APRIL 22–28 AAN Annual Meeting Boston AAN.com/view/AM17
SAVE THE DATES JULY 14–16, 2017 Sports Concussion Conference Jacksonville, FL 2O17
MAY 6 Deadline: Neurology Compensation and Productivity Survey AAN.com/view/benchmark
July 8 –10 • Chicago, IL
OCTOBER 20–22, 2017 2017 AAN Fall Conference Las Vegas, NV AAN.com/view/17FC
AANnews • March 2017
Are you seeing the whole picture?
Migraine is a common and debilitating neurological disease.1-3 Uncover its true impact on the lives of patients, and see how the neuropeptide CGRP can play a key role in migraine’s complex pathophysiology. 2,4-9 References: 1. Barbanti P, Aurilia C, Egeo G, Fofi L. Future trends in drugs for migraine prophylaxis. Neurol Sci. 2012;33(suppl 1):S137-S140. 2. Edmeads J, Findlay H, Tugwell P, Pryse-Phillips W, Nelson RF, Murray TJ. Impact of migraine and tension-type headache on life-style, consulting behaviour, and medication use: a Canadian population survey. Can J Neurol Sci. 1993;20:131-137. 3. Munakata J, Hazard E, Serrano D, et al. Economic burden of transformed migraine: results from the American Migraine Prevalence and Prevention (AMPP) Study. Headache. 2009;49:498-508. 4. Lipton RB, Bigal ME, Diamond M, et al; for AMPP Advisory Group. Migraine prevalence, disease burden, and the need for preventative therapy. Neurology. 2007;68:343-349. 5. Hu XH, Markson LE, Lipton RB, Stewart WF, Berger ML. Burden of migraine in the United States. Arch Intern Med. 1999;159:813-818. 6. Buse DC, Rupnow MFT, Lipton RB. Assessing and managing all aspects of migraine: migraine attacks, migraine-related functional impairment, common comorbidities, and quality of life. Mayo Clin Proc. 2009;84:422-435. 7. Russo AF. Calcitonin gene-related peptide (CGRP): a new target for migraine. Annu Rev Pharmacol Toxicol. 2015;55:533-552. 8. Russell FA, King R, Smillie S-J, Kodji X, Brain SD. Calcitonin gene-related peptide: physiology and pathophysiology. Physiol Rev. 2014;94:1099-1142. 9. Goadsby PJ, Edvinsson L, Ekman R. Release of vasoactive peptides in the extracerebral circulation of humans and the cat during activation of the trigeminovascular system. Ann Neurol. 1988;23:193-196.
Learn more about the impact of migraine and the science behind it at
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Published on Feb 21, 2017