Waddell Center for Multiple Sclerosis

A CASE FOR SUPPORT Waddell Center for Multiple Sclerosis

“The Waddell Center is a leading MS care hub in the Tristate region, with four National MS Society-certified comprehensive center locations. Built through philanthropy, it brings together a multidisciplinary team committed to treating the whole patient— not just MS—and transforming lives.”

ARAM ZABETI, MD Director & Endowed Chair Waddell Center for Multiple Sclerosise

Dear Friend, With skilled physicians across several specialties, the Waddell Center for Multiple Sclerosis at the University of Cincinnati Gardner Neuroscience Institute offers unmatched crossdisciplinary care. Our MS-trained care team is uniquely equipped to address the timely diagnosis and treatment of this challenging yet common neurological disease.

Our strengths: • UC Health is among the most experienced infusion therapy providers in the U.S and participated in the first clinical trial for MS-infusion drug Ocrevus (Ocrelizumab).

We continue to seek the latest infusion therapy treatments for MS including Frexalimab for both relapsing and progressive MS through clinical trials.

• Our clinic consists of 11 multidisciplinary providers who are focused on neuroimmunology, neuro-rehabilitation, neuro-ophthalmology, psychology, urology and integrative medicine. Patients have access to a robust care team that understands the level of coordination needed for treatment and care, incorporating expert nurses and specialists.

• We embrace cutting-edge research and the latest advancements offering 10+ clinical trials annually plus training and mentoring for future neurologists specializing in MS. Our current clinical trial portfolio includes all major therapeutic approaches, ranging from cell therapy to BTK inhibitors and Frexalimab.

• To identify early signs of progression, we use advanced biomarkers—including AI-assisted quantitative MRI, Optical Coherence Tomography, and serum biomarkers.

This is important for patients who experience gradual progression, or “smoldering MS,” which can be difficult to detect in routine clinical practice.

• Patients have access to a variety of support and care services including free integrative medicine and wellness programs, a dietician, a social worker, mental health counselor and a clinical pharmacist.

We strive to continue our specialized care approach so that our patients can maintain the best quality of life. Thank you for your thoughtful consideration and interest in partnering with our team to improve the lives in our region and beyond.

Aram Zabeti, MD Professor of Neurology Director and Endowed Chair Waddell Center for Multiple Sclerosis WADDELL CENTER FOR MULTIPLE SCLEROSIS 3

RESEARCH Growing and retaining top talent At the UC Gardner Neuroscience Institute, our faculty leaders bring an evidence-based focus to everything we do. To attract rising-star researchers and expand our quests for discovery, we must evolve our resources to maintain the fast pace required for continual health care innovation.

Endowed chairs for clinical leadership and research faculty Historically, endowed chairs were a want-to-have luxury; today they are a need-to-have tool in order for UC to be competitive with other nationally ranked academic medical centers.

Chairs are essential to our ability to recruit and retain top talent among a competitive field of other neuroscience institutes. Establishing new chairs builds permanency and sustainability in our areas of excellence: Clinical leadership in subspecialty areas of complex neuroimmunological or neuroinflammatory disease like autoimmune encephalitides or those deriving from cancer diagnosis (paraneoplastic syndromes).

Neuroscience research chairs expand clinical trials and basic neuroscience research, to enable the discovery of new medications and treatments, and protect time for physicianscientists to balance patient care with research and teaching. An endowed research chair allows us to recruit new thought leaders or retain vital faculty and ensures continuity of important research efforts at the university.

Paired with our advanced facilities and research operations, endowed chairs will attract nationally and globally recognized faculty to the UC Gardner Neuroscience Institute.

This accelerates the research and development of new treatments, all to directly benefit more patients.

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Expanding research for improved outcomes

MRI research technology MRI scans are now a key component of clinical research trials at the neuroscience institute— including in Parkinson’s disease, MS, stroke, epilepsy, memory and mood disorders.

Neuroimaging research allows a physician or researcher to evaluate a patient’s baseline or see how they respond to new medications or therapies. To support our robust research efforts, the institute is in need of a dedicated research scanner.

An MRI focused entirely on research, with staff trained in neuroinformatics and the latest imaging techniques, will broaden our discovery efforts across all specialty areas. The outpatient facility that opened in 2019 was built to accommodate an additional MRI with researcher staffing space.

Research endowment fund Neuroscience is the most prolific research area throughout the academic health center and the entire university. Creating a substantial research endowment will encourage further cross-disciplinary projects across departments and centers and can spark “high-risk/highreward” ideas that are less likely to find support through conventional grant funding.

Pilot grants are the mustard seeds of research. Their results lead to much larger grants from the National Institutes of Health and other external foundations.

For example, $925,000 in pilot grant funding from 2014 to 2020 resulted in $16,236,369 in monies from the government and external foundations—a 17 to 1 return on investment.

A research endowment fund is critical to progress and will allow investigators to pursue more novel, long-term and untested research projects, giving them the security to take the risks that will yield breakthrough discoveries right here in Cincinnati.

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Cell therapies for advanced treatment options Multiple sclerosis has varying forms of symptoms and levels of disease progression, which makes specialized care and treatment of the utmost importance. While current options for treatment are improving, some patients with more aggressive MS do not respond well to available treatments.

One of the most promising new options at the Waddell Center is the exploration of cell therapies, including CAR T-cell therapy and autologous hematopoietic stem cell transplant (aHSCT).

CAR T-cell therapy is a Phase I clinical trial available for all forms of relapsing and progressive MS. Unlike traditional MS treatments, which mainly target immune cells in the bloodstream, CAR T-cells are engineered to eliminate harmful immune cells throughout the central nervous system—reaching areas monoclonal antibodies cannot. This approach offers a novel and more precise way to address the drivers of disease progression.

We are also proud to offer aHSCT through the NIH-sponsored BEAT-MS trial. This national study investigates whether resetting the immune system using stem cell transplant can delay or prevent future relapses in relapsing MS. The protocol uses an intermediateintensity chemotherapy regimen, aiming to strike a balance between effectiveness and reduced side effects compared to high-intensity approaches.

Together, these trials represent our commitment to advancing treatment options for people with MS and bringing the next generation of therapies to our patients.

On the right: Optical coherence tomography, or OCT, is a noninvasive retinal imaging test that measures nerve layer thickness to detect and monitor optic nerve damage and neurodegeneration in MS patients.

Global collaboration for MS research The way we compile MS research is changing, and the Waddell Center is at the forefront of enhancing our knowledge of the disease.

With the help of large research volunteer teams, we are actively building an MS registry by collecting retrospective clinical data from our patients. This includes volumetric MRI, OCT (see below) and MS serum and CSF biomarkers.

This initiative provides valuable insights into patient care trends, treatment outcomes and areas for improvement. It also enhances our understanding of MS progression and improves our clinical approach to treat patients for optimal health outcomes.

Our vision is to take the next step in elevating our position as a leading MS institution by joining MSBase.org and collaborating with researchers globally through prospective data collection. By joining this global registry, we can contribute to and patients can benefit from research done all over the world. This collaboration also opens new opportunities to advance MS care locally and internationally. To further invest in this project, a dedicated research assistant would coordinate our collection efforts across the four UC Health clinic sites in the Greater Cincinnati area.

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Piloting new biomarker research As the neuroscience institute advances personalized, precision medicine in all areas of brain health and neurological disease, we are piloting new ways in which the collection and assessment of biomarkers can further help us define diagnosis, care and treatment of multiple sclerosis.

The diagnosis and monitoring of MS are complex due to subtle physical changes, hidden cognitive impairment and fatigue. Yearly surveillance MRIs alone are not sensitive enough to capture all aspects of disease progression. To address this, patients require frequent comprehensive evaluations and additional biomarkers, including AI-enhanced quantitative MRI, optical coherence tomography (OCT) and blood serum biomarkers. Collecting this data alongside clinical assessments of gait, mobility and dexterity, our expert teams can compile comprehensive data assessments to evaluate treatment responses across our patient populations.

These data collections can lead to new research studies that advance personalized medicine.

To support these endeavors would require two post-doctoral researchers or research fellows to analyze and publish data.

“We are one of only a few MS centers in the U.S. with on-site dedicated clinical pharmacists to help patients navigate the increasingly complex landscape of treatment options. Our roles go beyond medication management—educating patients and families, handling insurance authorizations and coordinating with manufacturers and payors to secure treatments."

KIRANPAL SANGHA, PharmD Clinical Pharmacy Specialist

CLINICAL CARE Grow our patient data infrastructure, strengthen services for our centers of excellence, creating a national destination for care

The power of big data: Improving patient outcomes To offer truly world-class care for our patients, we need to rely on not just the expertise of one doctor, but leverage the expertise of every single doctor in our institute and beyond.

We must continue to scale our approaches to personalized treatment for our patients, understanding that care is unique to each individual.

With the vast amount of health data now available, a physician has millions of data points at their fingertips. The flow of new information never stops as biomedical knowledge from new research doubles every 73 days. However, the time lag from putting new knowledge into practice currently takes more than a decade.

The UC Gardner Neuroscience Institute is building an integrated network of research, clinical data and quality improvement processes that will rapidly deliver new learnings to the bedside, vastly improving patient care and quality and longevity of life.

This network will connect all of our centers of excellence, and eventually connect us to peer neuroscience institutes like the top-ranked Weill Institute at UC San Francisco.

These connectors multiply the expertise of our institute, identifying new approaches and treatments that will improve patient outcomes not only in our region, but worldwide.

Adopting a big data approach to care Before

After

• Average 17 years from evidence to practice.

• Less than 3 years to apply new evidence to patient care.

• Lacks patient input and learned experience.

• Patient-driven research and resources.

• Disparities in practice, decision-making.

• Measures process with outcomes.

• Aligned use of best practices, efficient and accessible evidence.

• Measures real-time patient outcomes, to continuously modify care.

Leveraging big data This approach to care will measure real-world outcomes from our patients and make immediate and continuous improvements to the system as a result. Our leaders have already demonstrated how an integrated, data-driven approach can optimize patient outcomes for brain and mental health care.

At the Waddell Center, we are leveraging big data through advanced platforms such as volumetric MRI (Icometrix), optical coherence tomography (OCT), and serum biomarkers (Octave), alongside clinical assessments and patient-reported outcomes. By integrating these data streams into a unified digital dashboard, clinicians can detect early signs of disease activity or progression, enabling proactive treatment adjustments before disability accumulates. This approach supports personalized follow-up intervals and fosters shared decision-making with patients.

Over time, aggregated data from thousands of MS patients will help identify predictors of treatment response, establish best practices across our centers, and reduce variability in care—transforming every patient encounter into an opportunity for learning and continuous improvement.

“Getting to the truth of a patient’s problem and how best to cure it, requires data scientists, analysts and biostatisticians—people and tools that aren’t normally part of the healthcare model. And I think this is where philanthropy and the generosity of our community and patients can make a big impact.”

JOSEPH CHENG, MD Associate Director for UC Gardner Neuroscience Institute Frank H. Mayfield Endowed Chair & Professor of Neurosurgery

Enhanced clinical care Expanding talented, highly trained staff is crucial to provide the most comprehensive care to our patients and their caregivers. In addition to our physician leaders, these key roles include: • Nurse navigators who provide an essential core of clinical expertise for our center.

• Social workers who provide critical care and guidance to community and other resources for our patients, particularly those managing complex conditions.

• Mental health care and cognitive assessments conducted in-clinic to optimize care for our MS patient community. We are one of the first centers to offer baseline and routine cognitive assessments using the NIH Toolbox, which allows us to counsel and support patients' individual needs.

As our patient outcomes continue to excel, new technology and comprehensive services in support of the whole person will evolve across the institute. Our current priorities include: • Expanding infusion therapies at the West Chester Hospital location will improve access, enhance the patient experience and optimize our resources across specialties.

• Questionnaires and patient-reported outcomes help track changes between visits, providing insight into the patient journey and filling clinical gaps to guide more personalized care.

• Brain health longevity program to offer in-depth neurological assessments for signature world-class preventative care.

• Integrative medicine programs and clinics offered by the Osher Center for Integrative Health at UC, providing complementary therapies like classes for nutrition, exercise and mindfulness.

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EDUCATION Building excellence in care, training, specialized staffing At the Waddell Center for Multiple Sclerosis, education is a core pillar of our mission. We are proud to serve as a training ground for the next generation of MS specialists and healthcare professionals. Our faculty actively mentor medical students and provide hands-on training for neurology residents, fostering early exposure to the field of neuroimmunology.

Fellowships Since launching our Multiple Sclerosis/Neuroimmunology Fellowship Program in 2018, we have expanded our capacity from one to two fellows per year in response to growing national demand. All our graduates have gone on to establish MS-focused practices across the country—both in academic centers and private settings—and several have remained within the UC Health system, continuing to serve our local community.

Specialized care providers In addition to physician education, we invest in training across the multidisciplinary care spectrum. We have successfully trained three nurse practitioners and two nurse navigators who now provide high-quality, specialized care to MS patients. Our post-doctoral research fellows contribute not only to cutting-edge research but also play an active role in quality improvement initiatives that directly enhance clinical care.

By cultivating a highly skilled and compassionate MS care workforce, the Waddell Center is shaping the future of MS treatment and making a lasting impact—both locally and nationally.

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Education and training programs The UC Gardner Neuroscience Institute is a magnet of talent, attracting out-of-state high school graduates and potential graduate students to Ohio with the promise of a world-class education, mentors in research and industry, and access to leading laboratory and clinical facilities. We plan expansion and support of the following areas: • Simulation lab space and training support Several of the top programs in the country use simulation-based training: realistic clinical environments that blend learning with virtual and hands-on experiences through a model of team-based patient care. At UC, leadership from across the academic health center and UC Health have articulated a high-level vision and operational model for a simulation center that will teach not only basic procedures but also complex neurological care skills.

• Student recruitment and programming The UC College of Medicine is committed to building a physician workforce that accurately reflects the community we treat. Our mission is to recruit and retain the most talented students, residents and faculty to our academic medical center and support them in pursuing neuroscience specialties.

• Continuing medical education Training programs will provide continuing medical education in our areas of excellence.

New programming will offer primary care physicians opportunities to enhance learning in often requested specialties like depression and anxiety.

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MEASURES OF SUCCESS Philanthropic support will speed our time to impact in the areas of research, patient care and training the next generation. We will track and measure our success in these areas through improved scores and metrics in:

Research Our research portfolio will grow and be measured by: the number of publications in top level journals, faculty presentations at conferences, and scores/rankings from the National Institutes of Health and Blue Ridge Rankings. Additionally, we will track membership growth in premier research networks such as StrokeNET, Mood Disorders and the Alzheimer’s Disease Research Centers (ADRCs).

Clinical Investments into personalized medicine and clinical advancements will be measured by: improving patient outcomes (relevant to a patient’s quality of life including symptoms, functionality, and physical, mental and social health), impacting key hospital metrics like decreasing mortality and re-admissions rates, and improving patient safety and satisfaction.

These will additionally support our reputation rankings in mass media outlets like U.S. News and World Report.

Education Being a destination for complex neurological care also means being a destination for the best and brightest talent—from students pursuing our residency and specialty fellowship programs to new clinicians and researchers. As demand increases for limited spots (for example, hundreds of fellowship applicants for 10 openings), so will competitiveness and the strength of applicants, along with the quality of care and research across the institute.

Professional physician networks like Doximity and professional organizations like Association of American Medical Colleges will help us measure this.

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THANK YOU We’re grateful for your thoughtful consideration of a leadership gift to UC’s Waddell Center for Multiple Sclerosis, in support of our 10-year Vision for Neuroscience.

CONTACT Heather Sherwood Director of Development University of Cincinnati Foundation Heather.Sherwood@foundation.uc.edu 859-802-1913

To learn more about how philanthropy can make a meaningful impact, scan the QR code or visit foundation.uc.edu/ucgni/multiple-sclerosis

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This is how breakthroughs happen.

Kim Francis Associate Vice President Academic Colleges and Campaign Strategy Kim.Francis@foundation.uc.edu Office: 513-558-3438 Mobile: 317-362-1995 University of Cincinnati Foundation | PO Box 19970 | Cincinnati, OH 45219-0970

foundation.uc.edu