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Evolving Expectations in the Management of Relapsing-Remitting Multiple Sclerosis:  The Role of Sphingosine 1-Phosphate Receptor Modulators

Evolving Expectations in the Management of Relapsing-Remitting Multiple Sclerosis: The Role of Sphingosine 1-Phosphate Receptor Modulators


Patient Case Study

Time to Complete

1 hour


October 31, 2017


December 31, 2018
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Maximum Credits

1.00 / AMA PRA Category 1 CreditTM

Accredited Provider

Provided by Haymarket Medical Education

Commercial Supporter

Supported by an educational grant from Celgene Corporation

Program Description

Incomplete recovery from relapses in individuals with relapsing-remitting multiple sclerosis (RRMS) contributes to stepwise disability worsening, underscoring the importance of early, effective intervention. After many years in which first-line disease-modifying therapies (eg, glatiramer acetate, interferon-β) were the principal treatment options, a plethora of new agents for MS treatment—including next-generation sphingosine-1-phosphate (S1P) receptor modulators—are now approved or under investigation. These emerging options are raising the bar from the current therapeutic goals of achieving minimal evidence of disease activity to the potential, albeit ambitious, goal of achieving no evidence of disease activity—meaning no relapses, no disability worsening, and no new or enlarging lesions on magnetic resonance imaging.

Intended Audience

Neurologists and other clinicians who manage patients with MS

Educational Objectives

At the conclusion of this activity, participants should be better able to:

  • Analyze the disease course of relapsing-remitting multiple sclerosis (RRMS) and the impact of early diagnosis
  • Describe how the introduction of disease-modifying therapy—including oral sphingosine 1-phosphate (S1P) receptor modulators—has transformed expectations for reducing inflammatory lesion activity in patients with RRMS
  • Explain the mechanisms of action of S1P receptor modulators and their rationale for treatment for patients with RRMS
  • Interpret the efficacy and safety of current and emerging S1P receptor agents, including their benefit/risk profiles and effects on cardiac health
  • Utilize shared decision-making with patients when discussing a new treatment and/or a change in therapeutic regimen
  • Address nonmotor symptoms of MS such as depression and fatigue

Conflict Of Interest Disclosure Policy

In accordance with the ACCME Standards for Commercial Support, HME requires that individuals in a position to control the content of an educational activity disclose all relevant financial relationships with any commercial interest. HME resolves all conflicts of interest to ensure independence, objectivity, balance, and scientific rigor in all its educational activities.


Patricia K. Coyle, MD
Professor and Vice Chair, Clinical Affairs
Department of Neurology
Director, Multiple Sclerosis Comprehensive Care Center
Stony Brook University Medical Center
Stony Brook, NY

Dr. Coyle receives consulting fees from Accordant, Acorda, Bayer, Biogen, Celgene, Genentech/Roche, Novartis, Sanofi Genzyme, and Serono and is a primary investigator for Actelion, Alkermes, Genentech/Roche, MedDay, National Institute of Neurological Disorders and Stroke (NINDS), and Novartis.

Accredited Provider Disclosures

Haymarket Medical Education staff involved in the planning and content review of this activity have no relevant financial relationships to disclose.




AMA PRA Category 1 Credit(s)TM

Accreditation Statement

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

Designation Statement

Haymarket Medical Education designates this enduring material for a maximum of 1.00 AMA PRA Category 1 CreditTM  . Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Disclosure of Unlabeled Use

This CME activity may or may not discuss investigational, unapproved, or off-label use of drugs. Participants are advised to consult prescribing information for any products discussed. The information provided in this CME activity is for continuing medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options for a specific patient’s medical condition.


The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of Haymarket Medical Education or Celgene Corporation. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.


To obtain credit, a score of 70% or better on the post-test is required. This activity is offered at no cost to participants. Please proceed with the activity until you have successfully completed this program, answered all test questions, completed the post-test and evaluation, and have received a digital copy of your credit certificate. Your online certificate will be saved on myCME within your Profile/CME History, which you can access at any time.

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