Clinical Insights on When and How to Switch DMT in Patients With a Suboptimal Treatment Response

Edward Fox, MD, PhD, FAAN, is Director of the Multiple Sclerosis (MS) Clinic of Central Texas and the founding partner of Central Texas Neurology Consultants in Round Rock, Texas. Dr Fox also has an appointment as Clinical Associate Professor of Neurology at the University of Texas Dell Medical School in Austin, Texas. After receiving a bachelor’s degree at Washington University in St. Louis, Missouri, he was enrolled in the Medical Scientist Training Program at Baylor College of Medicine in Houston, Texas, where he earned a dual medical degree and a doctorate in immunology for the thesis, “Growth Requirements of Human Suppressor T Lymphocytes.”

Since starting a private neurology practice in the Austin area in 1992, Dr Fox has been involved in numerous MS research protocols and is an international speaker on topics related to neuroimmunology. He is a Fellow of the American Academy of Neurology and his clinic has been designated a Center for Comprehensive MS Care by the National MS Society. Dr Fox is a longstanding member of the Consortium of MS Centers and is President-Elect of the Texas Neurological Society.

Stephanie A. Agrella is the Director of Clinical Services at the Multiple Sclerosis Clinic of Central Texas, in Round Rock, Texas, where she specializes in the assessment, diagnosis, and management of multiple sclerosis (MS). She graduated with Cum Laude honors from Kent State University College of Nursing in Kent, Ohio, with Bachelor of Science in Nursing and Master of Science in Nursing degrees. Ms Agrella is a PhD candidate in the nursing program at Saint Louis University, St. Louis, Missouri, and is currently working on her dissertation involving vitamin D and its impact on magnetic resonance imaging (MRI) activity in adults who have recently been diagnosed with MS. She is a board certified Adult Nurse Practitioner specializing in primary care, and has been working directly with patients living with MS since the early 2000s.

Ms Agrella is licensed by the International Organization of Multiple Sclerosis Nurses (IOMSN) Certification Board as an MS Certified Nurse (MSCN). In addition, she currently serves as Co-Chair of the organization’s Education Committee and previously served 2 terms as an IOMSN board member. She has served on the Awards and Nominations Committee, as the Liaison for the Multiple Sclerosis Nursing International Certification Board (MSNICB), and as the MSNICB nomination chair.
 
Stephanie is dedicated to working in the field of MS and spends the majority of her time providing direct healthcare to patients living with MS; she specializes in all aspects of patient care, with an emphasis on disease-modifying therapy and symptom management. Ms Agrella is also involved in research and has served as a sub-investigator on numerous MS-related clinical trials. She has presented on MS at many continuing medical education symposia, peer-to-peer presentations, journal clubs, professional conferences, and community-based patient gatherings, both within the community, nationally, and internationally. She has also published in several peer-reviewed journals on all aspects related to MS.

Jacquelyn L. Bainbridge, BSPharm, PharmD, FCCP, MSCS, FAES, is a Professor at the University of Colorado Anschutz Medical Campus, where she holds joint appointments in the Skaggs School of Pharmacy and Pharmaceutical Sciences, Department of Clinical Pharmacy, and the Department of Neurology in the School of Medicine. Dr Bainbridge received her doctorate in pharmacy from the University of Colorado in Denver, where she subsequently completed a specialty residency in neurology.

Dr Bainbridge is a Multiple Sclerosis Certified Specialist (MSCS) and is actively involved in clinical research in many areas of neurology, including epilepsy, multiple sclerosis (MS), Parkinson’s disease (PD), back pain, and cannabis. Currently, she is working on 2 clinical trials investigating cannabis for the treatment of back pain and PD sponsored by the Colorado Department of Public Health and Environment (CDPHE), as well as a synthetic cannabidiol (CBD) study involving patients with Fragile X syndrome. Dr Bainbridge is involved in 2 additional clinical trials sponsored by the CDPHE: one for back pain in patients not on opiates or on opiates with a dose reduction and cannabis treatment, and another study in patients with autism being treated with CBD for behavioral issues. Dr Bainbridge also continues to study the safety and efficacy of antiepileptic drugs in older adults. She was previously an investigator for several National Institutes of Health (NIH)-funded trials researching drugs that may be neuroprotective in PD. Dr Bainbridge has completed a clinical trial using a synthetic CBD product in patients with scleroderma.

She has published several articles in professional journals, including Epilepsia, Pharmacotherapy, and the American Journal of Health-System Pharmacy. She has reviewed and written several book chapters on MS, epilepsy, migraine, chronic pain, women’s issues, pharmacokinetics, and the practice of pharmacy. Dr Bainbridge is a frequent lecturer on topics of neurologic and pharmacologic interest, including chronic pain disorders, epilepsy, migraines, movement disorders, MS, neuroprotection, restless legs syndrome, and the administration of cannabis for therapeutic intent.

Dr Bainbridge is a member of numerous professional organizations, including the Epilepsy Foundation of Colorado, the American Academy of Neurology, the American Epilepsy Society, the Epilepsy Foundation of America, the American College of Clinical Pharmacy, the American Association of Colleges of Pharmacy, the Colorado Pharmacists Society, and the American Society of Health-System Pharmacists. She is the past president of the board of directors for the Restless Legs Syndrome Foundation and is a member of the Epilepsy Foundation of Colorado professional advisory board. Dr Bainbridge was elected as a Fellow of the American College of Clinical Pharmacy (FCCP) and a Fellow of the American Epilepsy Society (FAES), and has won several student preceptor and teaching awards.