Recap

Migraine attacks are classified as chronic or episodic. Chronic migraines occur at least 15 days a month, and often prove functionally debilitating. In 2018, therapies that target the calcitonin gene-related peptide (CGRP) were first introduced to help manage migraine attacks.

Dr Stephanie Nahas from Thomas Jefferson University in Philadelphia, Pennsylvania, discusses optimal approaches for incorporating these therapies, which include small molecule agents called gepants, and monoclonal antibodies. In both cases, these therapies prevent CGRP from binding to its receptor, which helps to reduce migraine symptomatology, both acutely and over time

According to Dr Nahas, the choice of therapy for an individual patient depends primarily on patient preferences. Most gepants are administered orally, and monoclonal antibodies are injected.

Dr Nahas  recommends that these therapies should be considered when a previous treatment proves insufficient to reduce disease burden to the degree that allows improved functioning and quality of life for the patient.

--

Stephanie J. Nahas-Geiger, MD, MSEd, Associate Professor, Department of Neurology, Division of Headache Medicine, Thomas Jefferson University; Assistant Director, Headache Medicine Fellowship Program, Jefferson Headache Center, Philadelphia, Pennsylvania

Stephanie J. Nahas-Geiger, MD, MSEd, has disclosed the following relevant financial relationships:
Serve(d) as a consultant for: AbbVie; Eli Lilly; Lundbeck; Pfizer; Theranica; Tonix (no relationships are active)

Migraine attacks are classified as chronic or episodic. Chronic migraines occur at least 15 days a month, and often prove functionally debilitating. In 2018, therapies that target the calcitonin gene-related peptide (CGRP) were first introduced to help manage migraine attacks.

Dr Stephanie Nahas from Thomas Jefferson University in Philadelphia, Pennsylvania, discusses optimal approaches for incorporating these therapies, which include small molecule agents called gepants, and monoclonal antibodies. In both cases, these therapies prevent CGRP from binding to its receptor, which helps to reduce migraine symptomatology, both acutely and over time

According to Dr Nahas, the choice of therapy for an individual patient depends primarily on patient preferences. Most gepants are administered orally, and monoclonal antibodies are injected.

Dr Nahas  recommends that these therapies should be considered when a previous treatment proves insufficient to reduce disease burden to the degree that allows improved functioning and quality of life for the patient.

--

Stephanie J. Nahas-Geiger, MD, MSEd, Associate Professor, Department of Neurology, Division of Headache Medicine, Thomas Jefferson University; Assistant Director, Headache Medicine Fellowship Program, Jefferson Headache Center, Philadelphia, Pennsylvania

Stephanie J. Nahas-Geiger, MD, MSEd, has disclosed the following relevant financial relationships:
Serve(d) as a consultant for: AbbVie; Eli Lilly; Lundbeck; Pfizer; Theranica; Tonix (no relationships are active)

Migraine attacks are classified as chronic or episodic. Chronic migraines occur at least 15 days a month, and often prove functionally debilitating. In 2018, therapies that target the calcitonin gene-related peptide (CGRP) were first introduced to help manage migraine attacks.

Dr Stephanie Nahas from Thomas Jefferson University in Philadelphia, Pennsylvania, discusses optimal approaches for incorporating these therapies, which include small molecule agents called gepants, and monoclonal antibodies. In both cases, these therapies prevent CGRP from binding to its receptor, which helps to reduce migraine symptomatology, both acutely and over time

According to Dr Nahas, the choice of therapy for an individual patient depends primarily on patient preferences. Most gepants are administered orally, and monoclonal antibodies are injected.

Dr Nahas  recommends that these therapies should be considered when a previous treatment proves insufficient to reduce disease burden to the degree that allows improved functioning and quality of life for the patient.

--

Stephanie J. Nahas-Geiger, MD, MSEd, Associate Professor, Department of Neurology, Division of Headache Medicine, Thomas Jefferson University; Assistant Director, Headache Medicine Fellowship Program, Jefferson Headache Center, Philadelphia, Pennsylvania

Stephanie J. Nahas-Geiger, MD, MSEd, has disclosed the following relevant financial relationships:
Serve(d) as a consultant for: AbbVie; Eli Lilly; Lundbeck; Pfizer; Theranica; Tonix (no relationships are active)

Episodic migraine occurs fewer than 15 days per month but can become chronic if poorly controlled. It is estimated that preventive therapy is indicated in over one third of patients with episodic migraine. Dr Barbara Nye from Wake Forest University in Winston-Salem, North Carolina, discusses optimal approaches for managing episodic migraine. According to Dr Nye, several factors, including patient preference, clinical evidence, and insurance coverage, will help inform which treatments can be offered.

She mentions that currently approved treatments include nonspecific therapeutics such as antiseizure, antidepressant, and blood pressure medications. Newer therapies known as gepants and injectable monoclonal antibodies are also available to manage and prevent episodic migraine.

Dr Nye concludes that the appropriate therapeutic goal is a reduction in headache frequency, reduction in headache severity, and improved response to medications, as well as decreasing the level of disability that patients are experiencing.

--

Barbara L. Nye, MD, Associate Professor of Neurology, Wake Forest University; Director, Headache Fellowship, Department of Neurology, Atrium Health Wake Forest Baptist, Winston-Salem, North Carolina

Barbara L. Nye, MD, has disclosed no relevant financial relationships.

Episodic migraine occurs fewer than 15 days per month but can become chronic if poorly controlled. It is estimated that preventive therapy is indicated in over one third of patients with episodic migraine. Dr Barbara Nye from Wake Forest University in Winston-Salem, North Carolina, discusses optimal approaches for managing episodic migraine. According to Dr Nye, several factors, including patient preference, clinical evidence, and insurance coverage, will help inform which treatments can be offered.

She mentions that currently approved treatments include nonspecific therapeutics such as antiseizure, antidepressant, and blood pressure medications. Newer therapies known as gepants and injectable monoclonal antibodies are also available to manage and prevent episodic migraine.

Dr Nye concludes that the appropriate therapeutic goal is a reduction in headache frequency, reduction in headache severity, and improved response to medications, as well as decreasing the level of disability that patients are experiencing.

--

Barbara L. Nye, MD, Associate Professor of Neurology, Wake Forest University; Director, Headache Fellowship, Department of Neurology, Atrium Health Wake Forest Baptist, Winston-Salem, North Carolina

Barbara L. Nye, MD, has disclosed no relevant financial relationships.

Episodic migraine occurs fewer than 15 days per month but can become chronic if poorly controlled. It is estimated that preventive therapy is indicated in over one third of patients with episodic migraine. Dr Barbara Nye from Wake Forest University in Winston-Salem, North Carolina, discusses optimal approaches for managing episodic migraine. According to Dr Nye, several factors, including patient preference, clinical evidence, and insurance coverage, will help inform which treatments can be offered.

She mentions that currently approved treatments include nonspecific therapeutics such as antiseizure, antidepressant, and blood pressure medications. Newer therapies known as gepants and injectable monoclonal antibodies are also available to manage and prevent episodic migraine.

Dr Nye concludes that the appropriate therapeutic goal is a reduction in headache frequency, reduction in headache severity, and improved response to medications, as well as decreasing the level of disability that patients are experiencing.

--

Barbara L. Nye, MD, Associate Professor of Neurology, Wake Forest University; Director, Headache Fellowship, Department of Neurology, Atrium Health Wake Forest Baptist, Winston-Salem, North Carolina

Barbara L. Nye, MD, has disclosed no relevant financial relationships.

Migraine can be divided into two broad categories: episodic, in which attacks occur between two and four times a month; and chronic, in which individuals suffer from headaches for at least half the month and experience at least eight attacks.

Acute treatment is fundamental to reducing the immediate disability of migraine attack in both types, and several effective migraine-specific therapies have been approved.

Dr Jessica Ailani, director of the Headache Center at Medstar Georgetown University Hospital, Washington, DC, discusses the benefits, potential side effects, and optimal use of migraine-specific therapies available for acute migraine, including how they can be used to build an effective treatment plan for an individual patient.

These include triptans (5-HT1B/1D receptor agonists), ergotamines (dihydroergotamine), neuromodulation devices, ditans (5-HT1F agonists), and gepants (CGRP antagonists).

--

Jessica Ailani, MD, Professor of Clinical Neurology, Director, Headache Center, Medstar Georgetown University Hospital, Washington, DC

Jessica Ailani, MD, has disclosed the following relevant financial relationships:

Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: AbbVie; Aeon; electroCore; Dr. Reddy; Eli-Lilly; GlaxoSmithKline (2023); Lundbeck; Linpharma; Ipsen; Merz; Miravo; Pfizer; Neurolief; Gore; Satsuma; Scilex; Theranica; Tonix

Received research grant from: Parema; Ipsen; Lundbeck

Migraine can be divided into two broad categories: episodic, in which attacks occur between two and four times a month; and chronic, in which individuals suffer from headaches for at least half the month and experience at least eight attacks.

Acute treatment is fundamental to reducing the immediate disability of migraine attack in both types, and several effective migraine-specific therapies have been approved.

Dr Jessica Ailani, director of the Headache Center at Medstar Georgetown University Hospital, Washington, DC, discusses the benefits, potential side effects, and optimal use of migraine-specific therapies available for acute migraine, including how they can be used to build an effective treatment plan for an individual patient.

These include triptans (5-HT1B/1D receptor agonists), ergotamines (dihydroergotamine), neuromodulation devices, ditans (5-HT1F agonists), and gepants (CGRP antagonists).

--

Jessica Ailani, MD, Professor of Clinical Neurology, Director, Headache Center, Medstar Georgetown University Hospital, Washington, DC

Jessica Ailani, MD, has disclosed the following relevant financial relationships:

Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: AbbVie; Aeon; electroCore; Dr. Reddy; Eli-Lilly; GlaxoSmithKline (2023); Lundbeck; Linpharma; Ipsen; Merz; Miravo; Pfizer; Neurolief; Gore; Satsuma; Scilex; Theranica; Tonix

Received research grant from: Parema; Ipsen; Lundbeck

Migraine can be divided into two broad categories: episodic, in which attacks occur between two and four times a month; and chronic, in which individuals suffer from headaches for at least half the month and experience at least eight attacks.

Acute treatment is fundamental to reducing the immediate disability of migraine attack in both types, and several effective migraine-specific therapies have been approved.

Dr Jessica Ailani, director of the Headache Center at Medstar Georgetown University Hospital, Washington, DC, discusses the benefits, potential side effects, and optimal use of migraine-specific therapies available for acute migraine, including how they can be used to build an effective treatment plan for an individual patient.

These include triptans (5-HT1B/1D receptor agonists), ergotamines (dihydroergotamine), neuromodulation devices, ditans (5-HT1F agonists), and gepants (CGRP antagonists).

--

Jessica Ailani, MD, Professor of Clinical Neurology, Director, Headache Center, Medstar Georgetown University Hospital, Washington, DC

Jessica Ailani, MD, has disclosed the following relevant financial relationships:

Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: AbbVie; Aeon; electroCore; Dr. Reddy; Eli-Lilly; GlaxoSmithKline (2023); Lundbeck; Linpharma; Ipsen; Merz; Miravo; Pfizer; Neurolief; Gore; Satsuma; Scilex; Theranica; Tonix

Received research grant from: Parema; Ipsen; Lundbeck

Migraine can be divided into two broad categories: episodic, in which attacks occur between two and four times a month; and chronic, in which individuals suffer from headaches for at least half the month and experience at least eight attacks.

Acute treatment is fundamental to reducing the immediate disability of migraine attack in both types, and several effective migraine-specific therapies have been approved.

Dr Jessica Ailani, director of the Headache Center at Medstar Georgetown University Hospital, Washington, DC, discusses the benefits, potential side effects, and optimal use of migraine-specific therapies available for acute migraine, including how they can be used to build an effective treatment plan for an individual patient.

These include triptans (5-HT1B/1D receptor agonists), ergotamines (dihydroergotamine), neuromodulation devices, ditans (5-HT1F agonists), and gepants (CGRP antagonists).

--

Jessica Ailani, MD, Professor of Clinical Neurology, Director, Headache Center, Medstar Georgetown University Hospital, Washington, DC

Jessica Ailani, MD, has disclosed the following relevant financial relationships:

Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: AbbVie; Aeon; electroCore; Dr. Reddy; Eli-Lilly; GlaxoSmithKline (2023); Lundbeck; Linpharma; Ipsen; Merz; Miravo; Pfizer; Neurolief; Gore; Satsuma; Scilex; Theranica; Tonix

Received research grant from: Parema; Ipsen; Lundbeck

Migraine can be divided into two broad categories: episodic, in which attacks occur between two and four times a month; and chronic, in which individuals suffer from headaches for at least half the month and experience at least eight attacks.

Acute treatment is fundamental to reducing the immediate disability of migraine attack in both types, and several effective migraine-specific therapies have been approved.

Dr Jessica Ailani, director of the Headache Center at Medstar Georgetown University Hospital, Washington, DC, discusses the benefits, potential side effects, and optimal use of migraine-specific therapies available for acute migraine, including how they can be used to build an effective treatment plan for an individual patient.

These include triptans (5-HT1B/1D receptor agonists), ergotamines (dihydroergotamine), neuromodulation devices, ditans (5-HT1F agonists), and gepants (CGRP antagonists).

--

Jessica Ailani, MD, Professor of Clinical Neurology, Director, Headache Center, Medstar Georgetown University Hospital, Washington, DC

Jessica Ailani, MD, has disclosed the following relevant financial relationships:

Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: AbbVie; Aeon; electroCore; Dr. Reddy; Eli-Lilly; GlaxoSmithKline (2023); Lundbeck; Linpharma; Ipsen; Merz; Miravo; Pfizer; Neurolief; Gore; Satsuma; Scilex; Theranica; Tonix

Received research grant from: Parema; Ipsen; Lundbeck

Migraine can be divided into two broad categories: episodic, in which attacks occur between two and four times a month; and chronic, in which individuals suffer from headaches for at least half the month and experience at least eight attacks.

Acute treatment is fundamental to reducing the immediate disability of migraine attack in both types, and several effective migraine-specific therapies have been approved.

Dr Jessica Ailani, director of the Headache Center at Medstar Georgetown University Hospital, Washington, DC, discusses the benefits, potential side effects, and optimal use of migraine-specific therapies available for acute migraine, including how they can be used to build an effective treatment plan for an individual patient.

These include triptans (5-HT1B/1D receptor agonists), ergotamines (dihydroergotamine), neuromodulation devices, ditans (5-HT1F agonists), and gepants (CGRP antagonists).

--

Jessica Ailani, MD, Professor of Clinical Neurology, Director, Headache Center, Medstar Georgetown University Hospital, Washington, DC

Jessica Ailani, MD, has disclosed the following relevant financial relationships:

Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: AbbVie; Aeon; electroCore; Dr. Reddy; Eli-Lilly; GlaxoSmithKline (2023); Lundbeck; Linpharma; Ipsen; Merz; Miravo; Pfizer; Neurolief; Gore; Satsuma; Scilex; Theranica; Tonix

Received research grant from: Parema; Ipsen; Lundbeck

Over the past two decades, the therapeutic landscape for psoriatic arthritis (PsA) has been transformed by the introduction of more than a dozen targeted therapies.

For most patients with active PsA, a tumor necrosis factor (TNF) inhibitor is recommended as the first-line biologic therapy. But some patients do not achieve an adequate response to TNF inhibitors or are intolerant to these therapies.

Choosing the right treatment after failure of the first biologic requires that clinicians consider several factors. Dr Atul Deodhar, of Oregon Health & Science University, discusses guidelines from the American College of Rheumatology/National Psoriasis Foundation and the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) for appropriate treatment strategies.

He also discusses factors critical to the optimal choice of the next therapy, such as the domains of disease activity, patient comorbidities, and whether the biologic's failure was primary or secondary.

Aside from choosing a new biologic, Dr Deodhar notes that there are other options to intensify the effect of the initial biologic. He says the clinician and patient may consider increasing the dose and frequency of the initial biologic medication or moving to a combination therapy by adding another drug, such as methotrexate.

--

Atul A. Deodhar, MD, Professor of Medicine, Division of Arthritis and Rheumatic Diseases, School of Medicine, Oregon Health & Science University; Medical Director, Rheumatology Clinics, OHSU Hospital, Portland, Oregon

Atul A. Deodhar, MD, has disclosed the following relevant financial relationships:

Serve(d) as a consultant, for: Bristol Myers Squibb; Eli Lilly; Janssen; MoonLake; Novartis; Pfizer; UCB

Serve(d) as a speaker for: Eli Lilly; Novartis; Pfizer; UCB

Received research grant from: AbbVie; Bristol Myers Squibb; Celgene; Janssen; MoonLake; Novartis; Pfizer; UCB

Received income in an amount equal to or greater than $250 from: Bristol Myers Squibb; Eli Lilly; Janssen; Novartis; Pfizer; Samsung Bioepis; UCB

Over the past two decades, the therapeutic landscape for psoriatic arthritis (PsA) has been transformed by the introduction of more than a dozen targeted therapies.

For most patients with active PsA, a tumor necrosis factor (TNF) inhibitor is recommended as the first-line biologic therapy. But some patients do not achieve an adequate response to TNF inhibitors or are intolerant to these therapies.

Choosing the right treatment after failure of the first biologic requires that clinicians consider several factors. Dr Atul Deodhar, of Oregon Health & Science University, discusses guidelines from the American College of Rheumatology/National Psoriasis Foundation and the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) for appropriate treatment strategies.

He also discusses factors critical to the optimal choice of the next therapy, such as the domains of disease activity, patient comorbidities, and whether the biologic's failure was primary or secondary.

Aside from choosing a new biologic, Dr Deodhar notes that there are other options to intensify the effect of the initial biologic. He says the clinician and patient may consider increasing the dose and frequency of the initial biologic medication or moving to a combination therapy by adding another drug, such as methotrexate.

--

Atul A. Deodhar, MD, Professor of Medicine, Division of Arthritis and Rheumatic Diseases, School of Medicine, Oregon Health & Science University; Medical Director, Rheumatology Clinics, OHSU Hospital, Portland, Oregon

Atul A. Deodhar, MD, has disclosed the following relevant financial relationships:

Serve(d) as a consultant, for: Bristol Myers Squibb; Eli Lilly; Janssen; MoonLake; Novartis; Pfizer; UCB

Serve(d) as a speaker for: Eli Lilly; Novartis; Pfizer; UCB

Received research grant from: AbbVie; Bristol Myers Squibb; Celgene; Janssen; MoonLake; Novartis; Pfizer; UCB

Received income in an amount equal to or greater than $250 from: Bristol Myers Squibb; Eli Lilly; Janssen; Novartis; Pfizer; Samsung Bioepis; UCB

Over the past two decades, the therapeutic landscape for psoriatic arthritis (PsA) has been transformed by the introduction of more than a dozen targeted therapies.

For most patients with active PsA, a tumor necrosis factor (TNF) inhibitor is recommended as the first-line biologic therapy. But some patients do not achieve an adequate response to TNF inhibitors or are intolerant to these therapies.

Choosing the right treatment after failure of the first biologic requires that clinicians consider several factors. Dr Atul Deodhar, of Oregon Health & Science University, discusses guidelines from the American College of Rheumatology/National Psoriasis Foundation and the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) for appropriate treatment strategies.

He also discusses factors critical to the optimal choice of the next therapy, such as the domains of disease activity, patient comorbidities, and whether the biologic's failure was primary or secondary.

Aside from choosing a new biologic, Dr Deodhar notes that there are other options to intensify the effect of the initial biologic. He says the clinician and patient may consider increasing the dose and frequency of the initial biologic medication or moving to a combination therapy by adding another drug, such as methotrexate.

--

Atul A. Deodhar, MD, Professor of Medicine, Division of Arthritis and Rheumatic Diseases, School of Medicine, Oregon Health & Science University; Medical Director, Rheumatology Clinics, OHSU Hospital, Portland, Oregon

Atul A. Deodhar, MD, has disclosed the following relevant financial relationships:

Serve(d) as a consultant, for: Bristol Myers Squibb; Eli Lilly; Janssen; MoonLake; Novartis; Pfizer; UCB

Serve(d) as a speaker for: Eli Lilly; Novartis; Pfizer; UCB

Received research grant from: AbbVie; Bristol Myers Squibb; Celgene; Janssen; MoonLake; Novartis; Pfizer; UCB

Received income in an amount equal to or greater than $250 from: Bristol Myers Squibb; Eli Lilly; Janssen; Novartis; Pfizer; Samsung Bioepis; UCB

Bipolar 1 disorder is a chronic and disabling mental health disorder that results in cognitive, functional, and social impairments associated with an increased risk for hospitalization and premature death.

Bipolar 1 disorder is characterized by manic episodes that last for at least 7 days, or manic symptoms that are so severe that they require immediate medical care. Depressive episodes also occur.

Dr Michael Thase, from the University of Pennsylvania, explains that although ongoing treatment is essential to prevent relapse and recurrence, particularly after a hospitalization, adherence can be serious problem.

Long-acting injectable (LAI) agents can act as a bridge between oral medications initiated in hospital and ongoing prevention therapies.

Dr Thase says LAIs can help improve adherence and patient quality of life, and are effective against relapses in adults with bipolar 1 disorder.

--

Michael E. Thase, MD, Professor of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania

Michael E. Thase, MD, has disclosed the following relevant financial relationships:

Serve(d) as an advisor or consultant for: Acadia, Inc; Akili, Inc; Alkermes PLC; Allergan, Inc; Axsome Therapeutics, Inc; Biohaven, Inc; Bocemtium Consulting, SL; Boehringer Ingelheim International; CatalYm GmbH; Clexio Biosciences; Gerson Lehrman Group, Inc; H Lundbeck, A/S; Jazz Pharmaceuticals; Janssen; Johnson & Johnson; Luye Pharma Group, Ltd; Merck & Company, Inc; Otsuka Pharmaceuticals Company, Ltd; Pfizer, Inc; Sage Pharmaceuticals; Seelos Therapeutics; Sunovion Pharmaceuticals, Inc; Takeda Pharmaceutical Company, Ltd

Receive research funding from: Acadia, Inc; Allergan, Inc; AssureRx; Axsome Therapeutics, Inc; Biohaven, Inc; Intracellular, Inc; Johnson & Johnson; Otsuka Pharmaceuticals Company, Ltd; Patient-Centered Outcomes Research Institute (PCORI); Takeda Pharmaceutical Company, Ltd

Receive royalties from: American Psychiatric Foundation; Guilford Publications; Herald House; Kluwer-Wolters; W.W. Norton & Company, Inc

Bipolar 1 disorder is a chronic and disabling mental health disorder that results in cognitive, functional, and social impairments associated with an increased risk for hospitalization and premature death.

Bipolar 1 disorder is characterized by manic episodes that last for at least 7 days, or manic symptoms that are so severe that they require immediate medical care. Depressive episodes also occur.

Dr Michael Thase, from the University of Pennsylvania, explains that although ongoing treatment is essential to prevent relapse and recurrence, particularly after a hospitalization, adherence can be serious problem.

Long-acting injectable (LAI) agents can act as a bridge between oral medications initiated in hospital and ongoing prevention therapies.

Dr Thase says LAIs can help improve adherence and patient quality of life, and are effective against relapses in adults with bipolar 1 disorder.

--

Michael E. Thase, MD, Professor of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania

Michael E. Thase, MD, has disclosed the following relevant financial relationships:

Serve(d) as an advisor or consultant for: Acadia, Inc; Akili, Inc; Alkermes PLC; Allergan, Inc; Axsome Therapeutics, Inc; Biohaven, Inc; Bocemtium Consulting, SL; Boehringer Ingelheim International; CatalYm GmbH; Clexio Biosciences; Gerson Lehrman Group, Inc; H Lundbeck, A/S; Jazz Pharmaceuticals; Janssen; Johnson & Johnson; Luye Pharma Group, Ltd; Merck & Company, Inc; Otsuka Pharmaceuticals Company, Ltd; Pfizer, Inc; Sage Pharmaceuticals; Seelos Therapeutics; Sunovion Pharmaceuticals, Inc; Takeda Pharmaceutical Company, Ltd

Receive research funding from: Acadia, Inc; Allergan, Inc; AssureRx; Axsome Therapeutics, Inc; Biohaven, Inc; Intracellular, Inc; Johnson & Johnson; Otsuka Pharmaceuticals Company, Ltd; Patient-Centered Outcomes Research Institute (PCORI); Takeda Pharmaceutical Company, Ltd

Receive royalties from: American Psychiatric Foundation; Guilford Publications; Herald House; Kluwer-Wolters; W.W. Norton & Company, Inc

Bipolar 1 disorder is a chronic and disabling mental health disorder that results in cognitive, functional, and social impairments associated with an increased risk for hospitalization and premature death.

Bipolar 1 disorder is characterized by manic episodes that last for at least 7 days, or manic symptoms that are so severe that they require immediate medical care. Depressive episodes also occur.

Dr Michael Thase, from the University of Pennsylvania, explains that although ongoing treatment is essential to prevent relapse and recurrence, particularly after a hospitalization, adherence can be serious problem.

Long-acting injectable (LAI) agents can act as a bridge between oral medications initiated in hospital and ongoing prevention therapies.

Dr Thase says LAIs can help improve adherence and patient quality of life, and are effective against relapses in adults with bipolar 1 disorder.

--

Michael E. Thase, MD, Professor of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania

Michael E. Thase, MD, has disclosed the following relevant financial relationships:

Serve(d) as an advisor or consultant for: Acadia, Inc; Akili, Inc; Alkermes PLC; Allergan, Inc; Axsome Therapeutics, Inc; Biohaven, Inc; Bocemtium Consulting, SL; Boehringer Ingelheim International; CatalYm GmbH; Clexio Biosciences; Gerson Lehrman Group, Inc; H Lundbeck, A/S; Jazz Pharmaceuticals; Janssen; Johnson & Johnson; Luye Pharma Group, Ltd; Merck & Company, Inc; Otsuka Pharmaceuticals Company, Ltd; Pfizer, Inc; Sage Pharmaceuticals; Seelos Therapeutics; Sunovion Pharmaceuticals, Inc; Takeda Pharmaceutical Company, Ltd

Receive research funding from: Acadia, Inc; Allergan, Inc; AssureRx; Axsome Therapeutics, Inc; Biohaven, Inc; Intracellular, Inc; Johnson & Johnson; Otsuka Pharmaceuticals Company, Ltd; Patient-Centered Outcomes Research Institute (PCORI); Takeda Pharmaceutical Company, Ltd

Receive royalties from: American Psychiatric Foundation; Guilford Publications; Herald House; Kluwer-Wolters; W.W. Norton & Company, Inc

Over the past decade, a revolution in the treatment of non–small cell lung cancer (NSCLC) has been sparked by the ongoing discovery of targetable oncogenic driver mutations. Because of the growing number of targeted therapies, comprehensive biomarker testing is essential in this patient population to determine the best individualized treatment.  

Dr Thomas Stinchcombe, of Duke Cancer Institute in Durham, North Carolina, discusses the latest standards for identifying the pathology of NSCLC patients as well as the accepted sequence of treatments informed by the presence or absence of mutations. He also reports on new immunotherapy research for this patient population.  

Molecular testing of tumor tissue is the standard of care for genotyping, but gathering and processing the results takes time. Dr Stinchcombe points out that liquid biopsies complement tissue testing by using a patient's blood to identify circulating tumor DNA (ctDNA) in the plasma, helping to determine pathologic diagnosis more quickly. 

--

Thomas E. Stinchcombe, MD, Professor, Department of Medicine, Duke Cancer Institute, Durham, North Carolina 

Thomas E. Stinchcombe, MD, has disclosed the following relevant financial relationships: 

Consulting or Advisory Role: Janssen Oncology; Genentech/Roche; Daiichi Sankyo/Astra Zeneca; Takeda; Eisai/H3 Biomedicine; G1 Therapeutics; Spectrum Pharmaceuticals; Gilead Sciences; AstraZeneca; Coherus BioSciences 

Member of the data and safety monitoring board for: GlaxoSmithKline; Genentech/Roche 

Received research grant from: AstraZeneca; Seagen; Mirati Therapeutics; Genentech/Roche 

Received income in an amount equal to or greater than $250 from: Janssen Oncology; Genentech/Roche; Daiichi Sankyo/Astra Zeneca; Takeda; Eisai/H3 Biomedicine; G1 Therapeutics; Spectrum Pharmaceuticals; Gilead Sciences; AstraZeneca; Coherus BioSciences; GlaxoSmithKline 

Over the past decade, a revolution in the treatment of non–small cell lung cancer (NSCLC) has been sparked by the ongoing discovery of targetable oncogenic driver mutations. Because of the growing number of targeted therapies, comprehensive biomarker testing is essential in this patient population to determine the best individualized treatment.  

Dr Thomas Stinchcombe, of Duke Cancer Institute in Durham, North Carolina, discusses the latest standards for identifying the pathology of NSCLC patients as well as the accepted sequence of treatments informed by the presence or absence of mutations. He also reports on new immunotherapy research for this patient population.  

Molecular testing of tumor tissue is the standard of care for genotyping, but gathering and processing the results takes time. Dr Stinchcombe points out that liquid biopsies complement tissue testing by using a patient's blood to identify circulating tumor DNA (ctDNA) in the plasma, helping to determine pathologic diagnosis more quickly. 

--

Thomas E. Stinchcombe, MD, Professor, Department of Medicine, Duke Cancer Institute, Durham, North Carolina 

Thomas E. Stinchcombe, MD, has disclosed the following relevant financial relationships: 

Consulting or Advisory Role: Janssen Oncology; Genentech/Roche; Daiichi Sankyo/Astra Zeneca; Takeda; Eisai/H3 Biomedicine; G1 Therapeutics; Spectrum Pharmaceuticals; Gilead Sciences; AstraZeneca; Coherus BioSciences 

Member of the data and safety monitoring board for: GlaxoSmithKline; Genentech/Roche 

Received research grant from: AstraZeneca; Seagen; Mirati Therapeutics; Genentech/Roche 

Received income in an amount equal to or greater than $250 from: Janssen Oncology; Genentech/Roche; Daiichi Sankyo/Astra Zeneca; Takeda; Eisai/H3 Biomedicine; G1 Therapeutics; Spectrum Pharmaceuticals; Gilead Sciences; AstraZeneca; Coherus BioSciences; GlaxoSmithKline 

Over the past decade, a revolution in the treatment of non–small cell lung cancer (NSCLC) has been sparked by the ongoing discovery of targetable oncogenic driver mutations. Because of the growing number of targeted therapies, comprehensive biomarker testing is essential in this patient population to determine the best individualized treatment.  

Dr Thomas Stinchcombe, of Duke Cancer Institute in Durham, North Carolina, discusses the latest standards for identifying the pathology of NSCLC patients as well as the accepted sequence of treatments informed by the presence or absence of mutations. He also reports on new immunotherapy research for this patient population.  

Molecular testing of tumor tissue is the standard of care for genotyping, but gathering and processing the results takes time. Dr Stinchcombe points out that liquid biopsies complement tissue testing by using a patient's blood to identify circulating tumor DNA (ctDNA) in the plasma, helping to determine pathologic diagnosis more quickly. 

--

Thomas E. Stinchcombe, MD, Professor, Department of Medicine, Duke Cancer Institute, Durham, North Carolina 

Thomas E. Stinchcombe, MD, has disclosed the following relevant financial relationships: 

Consulting or Advisory Role: Janssen Oncology; Genentech/Roche; Daiichi Sankyo/Astra Zeneca; Takeda; Eisai/H3 Biomedicine; G1 Therapeutics; Spectrum Pharmaceuticals; Gilead Sciences; AstraZeneca; Coherus BioSciences 

Member of the data and safety monitoring board for: GlaxoSmithKline; Genentech/Roche 

Received research grant from: AstraZeneca; Seagen; Mirati Therapeutics; Genentech/Roche 

Received income in an amount equal to or greater than $250 from: Janssen Oncology; Genentech/Roche; Daiichi Sankyo/Astra Zeneca; Takeda; Eisai/H3 Biomedicine; G1 Therapeutics; Spectrum Pharmaceuticals; Gilead Sciences; AstraZeneca; Coherus BioSciences; GlaxoSmithKline 

Nonradiographic axial spondyloarthritis (nr-axSpA) is a chronic, immune-mediated, inflammatory disease characterized by active inflammation of the spine and the sacroiliac joints. There is no cure for nr-axSpA, although tumor necrosis factor inhibitors (TNFi) have been established as the recommended standard treatment. Nevertheless, a considerable portion of patients either have an inadequate response to TNFi or are intolerant of the side effects of these agents. 

Dr Eric Ruderman, of Northwestern University Feinberg School of Medicine, Chicago, Illinois, discusses treatment goals for patients with active nr-axSpA, which include symptom control, preservation of function, and suppression of symptoms that interfere with daily activities. He also highlights treatment options for patients who have an inadequate response to or are intolerant of TNFi therapy. These therapies include interleukin-17 inhibitors (IL-17i), ixekizumab and secukinumab, and the Janus kinase inhibitor (JAKi) upadacitinib. 

IL-17i therapy carries a lower risk for infection compared with TNFi but is contraindicated in patients with irritable bowel disease. Dr Ruderman also notes that IL-17i are administered by subcutaneous injection while JAKi are taken orally, and these factors may influence patient preference.

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Eric M. Ruderman, MD, Professor, Department of Medicine, Division of Rheumatology, Northwestern University Feinberg School of Medicine; Associate Chief, Clinical Affairs, Department of Rheumatology, Northwestern Medical Group, Chicago, Illinois 

Eric M. Ruderman, MD, has disclosed the following relevant financial relationships: 

Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: AbbVie; Amgen; Aurinia; Bristol Myers Squibb; Exagen; Janssen; Lilly; Novartis; Selecta 

Nonradiographic axial spondyloarthritis (nr-axSpA) is a chronic, immune-mediated, inflammatory disease characterized by active inflammation of the spine and the sacroiliac joints. There is no cure for nr-axSpA, although tumor necrosis factor inhibitors (TNFi) have been established as the recommended standard treatment. Nevertheless, a considerable portion of patients either have an inadequate response to TNFi or are intolerant of the side effects of these agents. 

Dr Eric Ruderman, of Northwestern University Feinberg School of Medicine, Chicago, Illinois, discusses treatment goals for patients with active nr-axSpA, which include symptom control, preservation of function, and suppression of symptoms that interfere with daily activities. He also highlights treatment options for patients who have an inadequate response to or are intolerant of TNFi therapy. These therapies include interleukin-17 inhibitors (IL-17i), ixekizumab and secukinumab, and the Janus kinase inhibitor (JAKi) upadacitinib. 

IL-17i therapy carries a lower risk for infection compared with TNFi but is contraindicated in patients with irritable bowel disease. Dr Ruderman also notes that IL-17i are administered by subcutaneous injection while JAKi are taken orally, and these factors may influence patient preference.

--

Eric M. Ruderman, MD, Professor, Department of Medicine, Division of Rheumatology, Northwestern University Feinberg School of Medicine; Associate Chief, Clinical Affairs, Department of Rheumatology, Northwestern Medical Group, Chicago, Illinois 

Eric M. Ruderman, MD, has disclosed the following relevant financial relationships: 

Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: AbbVie; Amgen; Aurinia; Bristol Myers Squibb; Exagen; Janssen; Lilly; Novartis; Selecta 

Nonradiographic axial spondyloarthritis (nr-axSpA) is a chronic, immune-mediated, inflammatory disease characterized by active inflammation of the spine and the sacroiliac joints. There is no cure for nr-axSpA, although tumor necrosis factor inhibitors (TNFi) have been established as the recommended standard treatment. Nevertheless, a considerable portion of patients either have an inadequate response to TNFi or are intolerant of the side effects of these agents. 

Dr Eric Ruderman, of Northwestern University Feinberg School of Medicine, Chicago, Illinois, discusses treatment goals for patients with active nr-axSpA, which include symptom control, preservation of function, and suppression of symptoms that interfere with daily activities. He also highlights treatment options for patients who have an inadequate response to or are intolerant of TNFi therapy. These therapies include interleukin-17 inhibitors (IL-17i), ixekizumab and secukinumab, and the Janus kinase inhibitor (JAKi) upadacitinib. 

IL-17i therapy carries a lower risk for infection compared with TNFi but is contraindicated in patients with irritable bowel disease. Dr Ruderman also notes that IL-17i are administered by subcutaneous injection while JAKi are taken orally, and these factors may influence patient preference.

--

Eric M. Ruderman, MD, Professor, Department of Medicine, Division of Rheumatology, Northwestern University Feinberg School of Medicine; Associate Chief, Clinical Affairs, Department of Rheumatology, Northwestern Medical Group, Chicago, Illinois 

Eric M. Ruderman, MD, has disclosed the following relevant financial relationships: 

Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: AbbVie; Amgen; Aurinia; Bristol Myers Squibb; Exagen; Janssen; Lilly; Novartis; Selecta 

Incidence of C difficile infection has been increasing over the past two decades, accounting for nearly 460,000 cases of illness and 20,000 deaths annually in the United States.  

Antibiotic treatment is the standard of care for C difficile infection, but the treatment can disrupt a patient's gastrointestinal microbiome, thereby contributing to the risk for disease recurrence.  

Recurrence rates are proven to increase with each episode of C difficile, making prevention essential.  

In this ReCAP, Dr David Johnson, of Eastern Virginia Medical School, discusses treatment options to avoid recurrence. He considers multiple means of prevention, including disinfection, infusions of monoclonal antibodies, and the latest advances in fecal microbiota-based biotherapies. Dr Johnson provides data regarding the success rates of pharmaceutical-grade options for prevention of relapse of C difficile. 

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David A. Johnson, MD, Professor of Medicine, Chief of Gastroenterology, Eastern Virginia Medical School; Chief of Gastroenterology, Digestive and Liver Disease Specialists, Division of Capital Digestive Care, Norfolk, Virginia 

David A. Johnson, MD, has disclosed the following relevant financial relationships: 

 
Serve(d) on a board for: ACG Institute for Clinical Research and Education; Adjudication Board Parexel 
Serve(d) as a consultant for: Johnson & Johnson; Isothrive 
Received research grant from: ISOThrive 
Have a 5% or greater equity interest in: American College of Gastroenterology 
Received income in an amount equal to or greater than $250 from: Parexel; Johnson & Johnson 

Incidence of C difficile infection has been increasing over the past two decades, accounting for nearly 460,000 cases of illness and 20,000 deaths annually in the United States.  

Antibiotic treatment is the standard of care for C difficile infection, but the treatment can disrupt a patient's gastrointestinal microbiome, thereby contributing to the risk for disease recurrence.  

Recurrence rates are proven to increase with each episode of C difficile, making prevention essential.  

In this ReCAP, Dr David Johnson, of Eastern Virginia Medical School, discusses treatment options to avoid recurrence. He considers multiple means of prevention, including disinfection, infusions of monoclonal antibodies, and the latest advances in fecal microbiota-based biotherapies. Dr Johnson provides data regarding the success rates of pharmaceutical-grade options for prevention of relapse of C difficile. 

--

David A. Johnson, MD, Professor of Medicine, Chief of Gastroenterology, Eastern Virginia Medical School; Chief of Gastroenterology, Digestive and Liver Disease Specialists, Division of Capital Digestive Care, Norfolk, Virginia 

David A. Johnson, MD, has disclosed the following relevant financial relationships: 

 
Serve(d) on a board for: ACG Institute for Clinical Research and Education; Adjudication Board Parexel 
Serve(d) as a consultant for: Johnson & Johnson; Isothrive 
Received research grant from: ISOThrive 
Have a 5% or greater equity interest in: American College of Gastroenterology 
Received income in an amount equal to or greater than $250 from: Parexel; Johnson & Johnson 

Incidence of C difficile infection has been increasing over the past two decades, accounting for nearly 460,000 cases of illness and 20,000 deaths annually in the United States.  

Antibiotic treatment is the standard of care for C difficile infection, but the treatment can disrupt a patient's gastrointestinal microbiome, thereby contributing to the risk for disease recurrence.  

Recurrence rates are proven to increase with each episode of C difficile, making prevention essential.  

In this ReCAP, Dr David Johnson, of Eastern Virginia Medical School, discusses treatment options to avoid recurrence. He considers multiple means of prevention, including disinfection, infusions of monoclonal antibodies, and the latest advances in fecal microbiota-based biotherapies. Dr Johnson provides data regarding the success rates of pharmaceutical-grade options for prevention of relapse of C difficile. 

--

David A. Johnson, MD, Professor of Medicine, Chief of Gastroenterology, Eastern Virginia Medical School; Chief of Gastroenterology, Digestive and Liver Disease Specialists, Division of Capital Digestive Care, Norfolk, Virginia 

David A. Johnson, MD, has disclosed the following relevant financial relationships: 

 
Serve(d) on a board for: ACG Institute for Clinical Research and Education; Adjudication Board Parexel 
Serve(d) as a consultant for: Johnson & Johnson; Isothrive 
Received research grant from: ISOThrive 
Have a 5% or greater equity interest in: American College of Gastroenterology 
Received income in an amount equal to or greater than $250 from: Parexel; Johnson & Johnson 

In recent years, many disease-modifying therapies (DMTs) have been approved for the treatment of multiple sclerosis (MS). DMTs are not a cure for MS, but they have been proven to alter the course of the disease, reduce relapses, slow its progression, and alleviate symptoms. DMTs function by surpressing immune activity. This, in turn, diminishes the intensity of the inflammatory attack responsible for driving this disorder.  

Dr Lauren Krupp, a neurologist at NYU Langone Health in New York, NY, presents an overview of the mechanisms of action (MOA) for the various DMTs and their effects on the immune system, including the potential to increase risk for infection and alter response to vaccination.  

Dr Krupp notes that DMTs can be administered orally, by injection, and by infusion, depending on the drug prescribed. She further explains that because there are now more DMT options, it is important to understand how best to tailor therapy decisions to individual patients.  

--

Lauren Krupp, MD, Professor, Department of Neurology, NYU Grossman School of Medicine; Director, NYU Langone Comprehensive Care Center, Deaprtment of Neurology, NYU Langone Health, New York, NY 

Lauren Krupp, MD, has disclosed the following relevant financial relationships: 

Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: Novartis; Biogen; Bristol-Myers Squibb 

Received research grant from: Biogen; Novartis 

In recent years, many disease-modifying therapies (DMTs) have been approved for the treatment of multiple sclerosis (MS). DMTs are not a cure for MS, but they have been proven to alter the course of the disease, reduce relapses, slow its progression, and alleviate symptoms. DMTs function by surpressing immune activity. This, in turn, diminishes the intensity of the inflammatory attack responsible for driving this disorder.  

Dr Lauren Krupp, a neurologist at NYU Langone Health in New York, NY, presents an overview of the mechanisms of action (MOA) for the various DMTs and their effects on the immune system, including the potential to increase risk for infection and alter response to vaccination.  

Dr Krupp notes that DMTs can be administered orally, by injection, and by infusion, depending on the drug prescribed. She further explains that because there are now more DMT options, it is important to understand how best to tailor therapy decisions to individual patients.  

--

Lauren Krupp, MD, Professor, Department of Neurology, NYU Grossman School of Medicine; Director, NYU Langone Comprehensive Care Center, Deaprtment of Neurology, NYU Langone Health, New York, NY 

Lauren Krupp, MD, has disclosed the following relevant financial relationships: 

Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: Novartis; Biogen; Bristol-Myers Squibb 

Received research grant from: Biogen; Novartis 

In recent years, many disease-modifying therapies (DMTs) have been approved for the treatment of multiple sclerosis (MS). DMTs are not a cure for MS, but they have been proven to alter the course of the disease, reduce relapses, slow its progression, and alleviate symptoms. DMTs function by surpressing immune activity. This, in turn, diminishes the intensity of the inflammatory attack responsible for driving this disorder.  

Dr Lauren Krupp, a neurologist at NYU Langone Health in New York, NY, presents an overview of the mechanisms of action (MOA) for the various DMTs and their effects on the immune system, including the potential to increase risk for infection and alter response to vaccination.  

Dr Krupp notes that DMTs can be administered orally, by injection, and by infusion, depending on the drug prescribed. She further explains that because there are now more DMT options, it is important to understand how best to tailor therapy decisions to individual patients.  

--

Lauren Krupp, MD, Professor, Department of Neurology, NYU Grossman School of Medicine; Director, NYU Langone Comprehensive Care Center, Deaprtment of Neurology, NYU Langone Health, New York, NY 

Lauren Krupp, MD, has disclosed the following relevant financial relationships: 

Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: Novartis; Biogen; Bristol-Myers Squibb 

Received research grant from: Biogen; Novartis