An estimated 2.3 million people live with multiple sclerosis worldwide. This disease of the central nervous system is unpredictable and is often first diagnosed between the ages of 20 and 50, disrupting the lives of otherwise healthy people. Learn how your Rotary club can work with the Rotarian Action Group for Multiple Sclerosis Awareness and local MS societies to fund research and to support individuals living with the illness.

1. 2016 ROTARY INTERNATIONAL CONVENTION
RAGMSA
Rotarian Action Group of
Multiple Sclerosis Awareness
www.rotary-rfmsa.org

2. • The protective covering or insulation of
the nerve fibres (mylin) in the central
nervous system is damaged and thus nerve
impulses to the brain, spine and optic
nerve are short circuited.
What is MS

3. • Over 2 million people worldwide are
diagnosed with MS
• Multiple Sclerosis can be observed as early
as 2 years of age and becomes more
frequent after age of 10 years.
How Many People does MS affect?

4. • Ratio 3:1 women/men
• Mainly young women & men 17/40 years
• The further North & South of equator
higher incidence
Who Does MS Affect

5. • Rotarians support in many ways
• MS Fundraisers
• Bike Rides, Mega Swims, Walks, Golf, etc
• MS Research PhD Scholarships
• Health Fair participation
• rotary-msawareness@yahoo groups.com
How Do Rotarians Help?

6. Rotarians organizing events to Raise MS Awareness and Funds

7. Rotarians organising Events- MS Global Dinner

8. Rotarians Joining in MS Walks and Runs

9. Rotarians Cooking for MS Bike Rides, Walks, Runs

10. Rotarians organising Bike Rides

11. Rotarians at RAGMSA Booth

12. • Recent advances in Clinical Management
of Multiple Sclerosis
Introduce Ms Sun-Hyun Kim

13. 2016 ROTARY INTERNATIONAL CONVENTION
Recent advances in management
of multiple sclerosis
Dr Su-Hyun Kim
Department of Neurology, National Cancer Center

14. What is multiple sclerosis?

15. Global prevalence of MS in 2013
Paul Browne et al. Neurology 2014;83:1022-1024
~2.5 Million people in the world
1,500~2,000
people in
Korea

16. • 2,3X more females are
diagnosed with MS
• MS is not contagious
or inherited
• Most people are
diagnosed between
the ages of 20 and 50.
What gets MS?
20 40 50 60301051

17. What causes MS?
• Immunologic factors
• Environmental factors
Vitamin D, smoking
• Infectious factors
EBV infection
• Genetic factors
HLA-DRB1501, HLA-DRB0901 genotype

18. Symptoms of MS
Anxiety
Cognitive impairment
Visual disturbance
Vertigo
Sleep disorders
Depression
Double vision
Fatigue Pain
Impaired speech
Sexual problems
Poor balance
Bladder problems
Tremor
Stiffness
Clumsiness
Bowel problems
Weakness
Numbness

19. Clinical course of MS
Nat Rev Neurosci 2012;13:507-14

20. How is MS diagnosed?
Since there is no single test for MS, MS can be difficult to
diagnose.
Thoughtful
clinical
evaluation
Complete
Assessment for
excluding other MS
mimic diseases
Proper
interpretation of
MRI
Diagnosis of MS

21. History of diagnostic criteria for MS

22. Other conditions to rule out
NMOMS

23. Proportion of NMO/MS
Western Asia
MS
NMO NMOMS
1:0.8~3
1:0.06~0.006
Curr Opin Neurol 2016;29:372-380

24. 24
Why early?
Treatment initiated at different stages of MS can affect
outcomes
Disability
Time
Preclinical CIS RRMS SPMS
Clinical Threshold
Treatment of
RRMS
Treatment after a first event
Treatment of SPMS
OPTIMAL
THERA-
PEUTIC
WINDOW

25. • Treating exacerbation
• Modifying disease course
• Managing symptoms
• Promoting function through rehabilitation
Treating MS

26. 19901960 2000 2010
Corticosteroids
for acute
treatment
IFNβ-1b
(Betaseron®)
IFNβ-1a
(Rebif®)
Glatiramer
acetate
(Copaxone®)
IFNβ-1a
(Avonex®)
FDA
1993
FDA
2002
FDA
1996
FDA
1996
Mitoxantrone
(Novantrone®)
FDA
2000
Natalizumab
(Tisabri®)
FDA
2006
Fingolimod
(Gilenya®)
Dimethyl
fumarate
(TAC )
Teriflunomide
(Aubagio®)
FDA
2013
FDA
2010
FDA
2012
Aelmtuzumab
(Lemtrada®)
FDA
2014
PegIFN β-1a
(Plegridy®)
FDA
2014
11 Licensed Treatments for people with MS

27. Therapeutic options in Korea
Burden of Therapy
(Convenience, monitoring, tolerability, and safety)
Diseaseactivity
IFN
GA
Teriflun
omide
Fingolimod
BG-12
Nataliz
umab Mitoxa
ntrone
Alemtu
zumab

28. Korean society of MS (From 2005)

29. Healthcare costs of people with MS
in Korea
 Average annual direct
medical cost for person
with MS in Korea
Journal of MS 2015;6:9-13
0%
10%
20%
30%
40%
50%
60%
70%
EDSS <4 4≤EDSS<6.5 EDSS≥6.5
$0
$10,000
$20,000
$30,000
$40,000
$50,000
EDSS <4 4≤EDSS<6.5 EDSS≥6.5
Employment rate according to
The level of disability
Medical costs according to the
level of disability

30. • Awareness about MS among general public
is still fairly low
• Insufficient eligible/certified neurologists,
physiatrists or nurses in specialized clinical care of
MS.
• Lack of social care services, educational program,
financial assistance program
Unmet needs of people with MS and their cares
in Korea

31. Take home message
• There is no cure, but MS is treatable disease.
• Our aims is to ensure that people living with MS
in Korea have the best quality of evidence based
care and treatment that health and social care
systems
• To get the best results and benefits for people
with MS, it is important for health and social care
providers, research and industry to work together

32. Thank you!
herena20@ncc.re.kr

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