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Secondary Progressive MS: Recognition and Management


Activity Info

A patient with MS presents in the clinical care center with worsening symptoms. Patricia Coyle, MD, and Patricia Melville, RN, MSN, review the key diagnosis criteria, treatment options, and discuss counseling options using shared decision-making with the patient. This interactive case study provides numerous resources for the learner.

Activity Title

Secondary Progressive MS: Recognition and Management


Attacking RRMS and SPMS: Employing Key Clinical and Patient Considerations

Accreditation Type

AMA PRA Category 1 Credit(s)

ANCC CE credit

ACPE pharmacy credit

Release Date


Expiration Date


Estimated Time to Complete Activity

0.5 hours


Learning Objectives

Upon completion of the activity, participants should be able to:

  • Explain MOAs and considerations and precautions surrounding new and emerging agents for RRMS and SPMS
  • Provide evidence-based rationale for initial or subsequent treatment choices, as well as their timing
  • Formulate a management plan that includes strategies and practical tools which support shared decision-making (SDM)



Patricia Coyle, MD

Professor of Neurology and Vice Chair of Clinical Affairs

Director, MS Comprehensive Care Center

Stony Brook Neurosciences Institute

Stony Brook, NY


Patricia Melville, RN, MSN, NP-C, MSCN

Clinical Instructor, Department of Neurology
SUNY at Stony Brook

Stony Brook MS Comprehensive Care Center

Stony Brook, NY


Marie Moore, MSN

Nurse Practitioner

Neurology, Carolinas Healthcare System

Charlotte, NC


Khamini Guillermo, DNP, CRNP, MSN

Family Nurse Practitioner

Ursinus College Wellness Center

Collegeville, PA


Jacci Bainbridge, PharmD, FCCP

Professor, Department of Clinical Pharmacy and Neurology

Anschutz Medical Campus, University of Colorado

Aurora, CO



Technical Requirements:

  1. There are no fees for participating in and receiving credit for this activity.
  2. Review the activity objectives and CME/CE information.
  3. Complete the CME/CE activity
  4. Complete the online posttest. A score of at least 75% is required to successfully complete this activity. The participant may take the test until successfully passed.
  5. Complete the CME/CE evaluation/attestation form, which provides each participant with the opportunity to comment on how participating in the activity will affect their professional practice, the quality of the instructional process, the perception of enhanced professional effectiveness, the perception of commercial bias, and his/her views on future educational needs.
  6. Credit documentation/reporting:
    • If you are requesting AMA PRA Category 1 Credits™, ANCC credit, or a certificate of participation—your CME/CE certificate will be available for download.
    • If you are requesting ACPE pharmacy credit—your CE credits will be submitted electronically to the CPE Monitor.


This activity is provided by The France Foundation




This activity is intended for neurologists, advanced practice providers, nurses, pharmacists, and other members of the MS care team.



Clinicians are tasked with keeping up with new developments in the understanding of MS pathology and related mechanisms of action (MOAs), as well as considerations and precautions associated with new and emerging treatment agents. Clinicians remain challenged by the need for, and timing of, optimal initial and subsequent treatment choice. While shared decision-making (SDM) in MS is widely recognized as a way to include the patient voice and facilitate patient-centered care, experts agree that it is an underutilized tool.



The France Foundation is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.




The France Foundation designates this enduring activity for a maximum of 0.50 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.



 The France Foundation is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education and will award 0.5 CEU to pharmacists who complete the activity, complete the registration and evaluation forms, and successfully pass a posttest (>75%). There is no fee to participate in this activity. This is an application-based educational activity. Your CE credits will be submitted electronically to the CPE Monitor. CE providers must upload participant information within 60 days from the date the participant completed the activity. Please submit all evaluations and credit requests no later than 30 days after you complete this activity to ensure your credit fulfillment, as CE credit cannot be awarded past 60 days from the activity date.

ACPE No. 0391-0000-19-131-H01-P.



This continuing nursing education activity was approved by Montana Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.



In accordance with the ACCME Standards for Commercial Support, The France Foundation (TFF) requires that individuals in a position to control the content of an educational activity disclose all relevant financial relationships with any commercial interest. TFF resolves all conflicts of interest to ensure independence, objectivity, balance, and scientific rigor in all its educational programs. Furthermore, TFF seeks to verify that all scientific research referred to, reported, or used in a CME/CE activity conforms to the generally accepted standards of experimental design, data collection, and analysis. TFF is committed to providing learners with high-quality CME/CE activities that promote improvements in health care and not those of a commercial interest.


Activity Staff Disclosures

The planners, reviewers, editors, staff, CME committee, or other members at The France Foundation who control content have no relevant financial relationships to disclose.


Faculty Disclosures

The faculty listed below report that they have no relevant financial relationships to disclose:
  • Khamini Guillermo, DNP, CRNP, MSN

The following faculty report that they have relevant financial relationships to disclose:

  • Jacci Bainbridge, PharmD, FCCP, serves on the advisory board for Genentech.
  • Patricia Coyle, MD, has done non-CE consulting for Accordant, Actelion, Alexion, Bayer, Biogen, Celgene, Genentech/Roche, Novartis, Sanofi Genzyme, Serono, and TG Therapeutics.  She has also done contract research for Actelion, Alkermes, Genentech/Roche, MedDay, NINDS and Novartis.
  • Patricia Melville, RN, MSN, NP-C, MSCN, has served on advisory boards for Biogen, Genentech, and Sanofi Genzyme.  She has also served on the speaker bureau for Biogen, EMD Serono, Genentech, Sanofi Genzyme, and Novartis.
  • Marie Moore, MSN, has served on advisory boards for Celgene and Genzyme and has served on the speakers bureau for Genzyme.



TFF requires CME faculty (speakers) to disclose when products or procedures being discussed are off label, unlabeled, experimental, and/or investigational, and any limitations on the information that is presented, such as data that are preliminary, or that represent ongoing research, interim analyses, and/or unsupported opinion. Faculty in this activity may discuss information about pharmaceutical agents that is outside of U. S. Food and Drug Administration approved labeling. This information is intended solely for continuing medical education and is not intended to promote off-label use of these medications. TFF does not recommend the use of any agent outside of the labeled indications. If you have questions, contact the Medical Affairs Department of the manufacturer for the most recent prescribing information.


This activity is supported by educational grants from Biogen, Celgene, and Sanofi Genzyme.


The France Foundation presents this information for educational purposes only. The content is provided solely by faculty who have been selected because of recognized expertise in their field. Participants have the professional responsibility to ensure that products are prescribed and used appropriately on the basis of their own clinical judgment and accepted standards of care. The France Foundation and the commercial supporter(s) assume no liability for the information herein.


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  • The materials are to be used solely for personal, noncommercial, informational and educational purposes. The materials are not to be modified. They are to be distributed in the format provided with the source clearly identified. The copyright information or other proprietary notices may not be removed, changed, or altered.
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Additional information regarding The France Foundation’s Privacy Policy can be viewed at


If you have questions about this CME activity, please contact The France Foundation at 860-434-1650 or





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