UBC PiMS Research Group
Pharmacoepidemiology in Multiple Sclerosis Research Group

Afsaneh Shirani

Current Academic Status: Neuroimmunology/Multiple Sclerosis Fellow, Washington University School of Medicine, St Louis, MO, USA

Previous Academic Training:

• Neurology Resident, University of Texas Southwestern Medical Center, Dallas, TX, USA
• Internship, University of Texas Southwestern Medical Center, Dallas, TX, USA
• Postdoctoral Research Fellowship in Pharmacoepidemiology of Multiple Sclerosis, University of British Columbia, Vancouver, BC, Canada
• Medical School, Tehran University of Medical Sciences, Tehran, Iran

Projects with PiMS group:

• Long-term benefits and adverse effects of beta-interferon for multiple sclerosis
• Temporal trends of disability progression in patients with multiple sclerosis
• Temporal patterns of demographic changes in patients with multiple sclerosis
• Clinical profile and impact of treatment in older adults with multiple sclerosis

Email: ashirani@wustl.edu, ashirani@gmail.com

Awards Received:

• Outstanding Citizenship Award, Clinical Research Training Center, Washington University School of Medicine, St Louis, MO
• Clinician Scientist Development Award, National Multiple Sclerosis Society
• Clinical Research Training Scholarship, American Academy of Neurology
• Fred Baskin Young Investigator Award, University of Texas Southwestern Medical Center, Dallas, TX
• Rivera-Weisberg Manuscript Award, University of Texas Southwestern Medical Center, Dallas, TX
• Postdoctoral Fellowship Award, Multiple Sclerosis Society of Canada
• Scholarship Award, Consortium of Multiple Sclerosis Centers
• Travel Awards, Americas Committee for Treatment and Research in Multiple Sclerosis
• Travel Awards, European Committee for Treatment and Research in Multiple Sclerosis
• Travel Awards, endMS Research and Training Network, Canada
• Jacqueline Du Pre Award, Multiple Sclerosis International Federation, UK

Publications:

1. Shirani A, Wu GF, Giannini C, Cross AH. A case report of oligodendroglioma and multiple sclerosis: Occam’s razor or Hickam’s dictum? BMJ Case Reports (in press).

2. Shirani A, Sun P, Schmidt R, Trinkaus K, Naismith R, Song SK, Cross AH. Histopathological correlation of diffusion basis spectrum imaging metrics of a biopsy-proven inflammatory demyelinating brain lesion: a brief report.
Mult Scler (in press).

3. Shirani A, Newton BD, Okuda DT. Finger tapping impairments are highly sensitive for identifying upper motor neuron lesions related to multiple sclerosis. BMC Neurol 2017;17(1):55.

4. Shirani A, Stuve O. Natalizumab for multiple sclerosis: a case in point for the impact of translational neuroimmunology. J Immunol 2017 198(4):1381-6.

5. De Jong HJ, Kingwell E, Shirani A, Cohen Tervaert JW, Hupperts R, Zhao Y, et al. Evaluating the safety of β- interferons in MS: A series of nested case-control studies. Neurology 2017;88(24):2310-20.

6. Menon S, Zhu F, Shirani A, Oger J, Freedman MS, Tremlett H. Disability progression in aggressive multiple sclerosis. Mult Scler 2017;23(3):456-463.

7. Shirani A, Okuda DT, Stuve O. Therapeutic advances and future prospects in progressive forms of multiple sclerosis. Neurotherapeutics 2016;13(1):58-69.

8. Menon S, Zhu F, Shirani A, Oger J, Freedman MS, Tremlett H. Disability progression in aggressive multiple sclerosis. Mult Scler 2017;23(3):456-463.

9. Shirani A, Zhao Y, Karim ME, Kingwell E, Petkau J, Gustafson P, Tremlett T. Observational studies of disease modifying therapies for multiple sclerosis: methodological challenges and opportunities. BMJ 2016. Available at: http://www.bmj.com/content/354/bmj.i3518/rr-2

10. Pirvoaica M, Kingwell E, Shirani A, Zhu F, Zhao Y , Fisk J, Bhan V, Marrie RA, Carruthers R, Tremlett H. Temporal changes in multiple sclerosis onset age: importance of controlling for equal observation time. UBC Med J 2016; 8.1 (23-6).

11. Shirani A, Zhao Y, Karim ME, Petkau J, Gustafson P, Evans C, Kingwell E, van der Kop ML, Oger J, Tremlett H. Multiple sclerosis in older adults: the clinical profile and impact of interferon beta treatment. BioMed Res Int 2015:451912.

12. Tingting Z, Shirani A, Zhao Y, Karim ME, Gustafson P, Petkau J, Evans C, Kingwell E, van der Kop M, Zhu F, Oger J, Tremlett H. Beta-interferon exposure and onset of secondary progressive multiple sclerosis. Eur J Neurol 2015 Jun;22(6):990-1000.

13. Evans C, Zhu F, Kingwell E, Shirani A, van der Kop ML, Petkau J, Gustafson P, Zhao Y, Oger J, Tremlett H. Association between beta-interferon exposure and hospital events in multiple sclerosis. Pharmacoepidemiol Drug Saf 2014;23(11):1213-22.

14. Karim ME, Gustafson P, Petkau J, Zhao Y, Shirani A, Kingwell E, Evans C, van der Kop M, Oger J, Tremlett H. Marginal Structural Cox Models for Estimating the Association Between β-Interferon Exposure and Disease Progressionrn in a Multiple Sclerosis Cohort. Am J Epidemiol 2014;180(2):160-71.

15. Shirani A, Zhao Y, Karim ME, Petkau J, Gustafson P, Evans C, Kingwell E, van der Kop ML, Oger J, Tremlett H. Investigation of heterogeneity in the association between interferon beta and disability progression in multiple sclerosis: an observational study. Eur J Neurol 2014 Jun;21(6):835-44.

16. Menon S, Shirani A, Zhao Y, Oger J, Traboulsee AL, Freedman MS, Tremlett H. Characterizing Aggressive Multiple Sclerosis. J Neurol Neurosurg Psychiatry 2013; 84(11): 1192-8.

17. Lourenco P, Shirani A, Saeedi J, Oger J, Schreiber WE, Tremlett H. Oligoclonal bands and cerebrospinal fluid markers in multiple sclerosis: associations with disease course and progression. Mult Scler 2013;19(5):577-84.

18. Shirani A, Zhao Y, Karim ME, Evans C, Kingwell E, van der Kop ML, Oger J, Gustafson P, Petkau J, Tremlett H. Interferon beta and long-term disability in multiple sclerosis. JAMA Neurol 2013;70(5):651-3.

19. Shirani A, Zhao Y, Karim ME, Evans C, Kingwell E, van der Kop ML, Oger J, Gustafson P, Petkau J, Tremlett H. Association between use of beta-interferon and progression of disability in patients with relapsing-remitting multiple sclerosis. JAMA 2012; 18;308(3): 247-56.

20. Shirani A, Petkau J, Tremlett H. Authors’ reply to: Treatment with interferon beta for multiple sclerosis. JAMA 2012;308(16):1627-8.
21. Shirani A, Zhao Y, Kingwell E, Rieckmann P, Tremlett H. Temporal trends of disability progression in multiple sclerosis: findings from British Columbia, Canada (1975-2009). Mult Scler 2012; 18(4): 442-50.

22. Kingwell E, van der Kop M, Zhao Y, Shirani A, Zhu F, Oger J, Tremlett H. Relative mortality and survival in multiple sclerosis: Findings from British Columbia, Canada. J Neurol Neurosurg Psychiatry 2012; 83(1): 61-6.

23. Shirani A, Tremlett H. The effect of smoking on the symptoms and progression of multiple sclerosis: a review. J Inflamm Res 2010,3:115-26.

24. Shahzadi S, Zali AR, Mohammadi AM, Abouzari M, Shirani A, Parsa K. Brain metastases in patients with diagnosed versus undiagnosed primary tumor. Neurosciences 2008; 13 (3): 268-71.

25. Shirani A, Sahraian MA, Harirchian MH, Mohebbi MR. Multiple sclerosis in Iran and the Middle East: new incidence trends and possible links. BMJ 2006. Available at: http://www.bmj.com/rapid-response/2011/10/31/multiple-sclerosis-iran-and-middle-east-new-incidence-trends-and-possible-.

26. Amirjamshidi A, Abouzari M, Eftekhar B, Rashidi A, Rezaii J, Esfandiari K, Shirani A, Asadollahi M, Aleali H. Outcomes and recurrence rates in chronic subdural haematoma. Br J Neurosurg 2007;21(3):272-5.

27. Pakdaman H, Sahraian M, Fallah A, Pakdaman R, Ghareghozli K, Ghafarpour M, Rahimian E, Shirani A. Effect of early interferon beta-1a therapy on conversion to multiple sclerosis in Iranian patients with a first demyelinating event. Acta Neurol Scand 2007. 115:429-431.

28. Harirchian MH, Sahraian MA, Shirani A. Serum prolactin level in patients with multiple sclerosis: a case control study. Med Sci Monit 2006; 12(4): CR177-80.

29. Harirchian MH, Maghbooli M, Shirani A. A case of choreoacanthocytosis with marked weight loss: impact of orolingual dyskinesia. Neurol India 2006; 54(3):296-7.

 

Conference Presentations/Abstracts:

1. Shirani A, Wu GF, Giannini C, Cross AH. A case report of oligodendroglioma and multiple sclerosis: Occam’s razor or Hickam’s dictum? The 12th World Congress of Controversies in Neurology (CONy), Warsaw, Poland, March 22-25, 2018.

1. Shirani A, Sun P, Schmidt R, Trinkaus K, Naismith R, Song SK, Cross AH. Histopathological correlation of diffusion basis spectrum imaging in human brain biopsy tissue of an inflammatory demyelinating lesion. The 3rd Annual Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum, San Diego, CA, February 1-3, 2018, and the 8th Annual Hope Center Retreat at Washington University School of Medicine, St Louis, MO, April 10, 2018.

2. Shirani A, Sun P, Song SK, Cross AH. Predicting clinical progression in patients with multiple sclerosis using a novel imaging biomarker targeted at differentiating and quantifying the underlying pathologies: overview of an ongoing study. The 6th Tykeson Fellow Conference on Multiple Sclerosis, Denver, CO, November 8-11, 2017.

3. Shirani A, Tremlett H, Cutter G, Stuve O. Unintended pregnancies occurring during clinical trials for multiple sclerosis therapeutics. The 69th Annual Meeting of the American Academy of Neurology (AAN), Boston, MA, April 22-28, 2017.

4. Shirani A, Cutter G, Stuve O. Subgroup analyses in phase III trials of therapeutics for multiple sclerosis: a closer look. The 32nd Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS), London, UK, September 14-17, 2016.

5. De Jong H, Kingwell E, Shirani A, Cohen T, Hupperts R, Zhao Y, Zhu F, Evans C, van der Kop M.L., Traboulsee A, Gustafson P, Petkau J, Marrie RA, the British Columbia Multiple Sclerosis Clinic Neurologists, H. Tremlett. Evaluating the safety of beta-interferons in multiple sclerosis: a series of nested case-control studies. The 32nd Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS), London, UK, September 14-17, 2016.

6. Shirani A, Newton BD, Okuda DT. Impairments in finger tapping the distal thumb crease on the non-dominant side are highly sensitive for identifying upper motor neuron lesions. Neurology 2016; 86 (16 suppl): P2.252. The 68th AAN Annual Meeting, Vancouver, BC, Canada, April 15-21, 2016.

7. Shirani A, Okuda DT, Stuve O. Research trends in therapeutics for progressive forms of multiple sclerosis: a review of trials in progress and future prospects. Mult Scler 2015; 21: 770-771. The 31st Congress of European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS). Barcelona, Spain. 7-10 October 2015.

8. Pirvoaica M, Shirani A, Kingwell E, Zhu F, Zhao Y, Fisk J, Marrie RA, Bhan V, Carruthers RL, Tremlett H. Temporal Changes in the Age at Multiple Sclerosis Onset: Importance of Controlling for Equal Observation Time. Int J MS Care 2015; 17(Supl 1): 24. Annual Meeting of the Consortium of Multiple Sclerosis Centers (CMSC), Indianapolis, Indiana, May 27-30, 2015.

9. De Jong H, Kingwell E, Shirani A, van Dijk L, Zhao Y, Zhu F, Evans C, Oger J, Traboulsee A, Gustafson P, Petkau J, Tremleet H. New indications for old drugs: Do statins, angiotensin converting enzyme inhibitors or proton pump inhibitors impact long-term disease progression in multiple sclerosis (MS)? In: Proceedings of the endMS Conference, Saint-Sauveur, Quebec, Canada, December 2013.

10. Shirani A, Zhao Y, Karim M, Petkau J, Gustafson P, Evans C, Kingwell E, van der Kop ML, Oger J, UBC MS Clinic Neurologists, Tremlett H. Investigation of heterogeneity in the association between interferon beta and disability progression in multiple sclerosis: an observational study from British Columbia, Canada. Mult Scler 2013; 19 (11 suppl): 259. The 29th Congress of European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS). Copenhagen, Denmark. 2-5 October 2013.

11. Karim ME, Gustafson P, Petkau J, Shirani A, Zhao Y, Kingwell E, van der Kop ML, Oger J, Tremlett H. A simulation study of methods used to reduce variability in the inverse probability of treatment weights for marginal structural Cox models. In: Proceedings of the Annual Meeting of the Statistical Society of Canada, University of Alberta, Edmonton, Alberta, May 26-29, 2013.

12. Karim ME, Gustafson P, Petkau J, Shirani A, Zhao Y, Kingwell E, Evans C, van der Kop ML, Oger J, Tremlett H. Comparing the direct and approximate approaches to implement marginal structural Cox models: An Application to Multiple Sclerosis. In: Proceedings of the Inaugural SSC Student Conference, University of Alberta, Edmonton, Alberta, May 25, 2013.

13. Karim ME, Gustafson P, Petkau J, Shirani A, Zhao Y, Kingwell E; van der Kop ML, Oger J; Tremlett H. Logrank Tests with the Inverse Probability of Treatment Weighting to Assess the Impact of Beta-Interferon Treatments in Delaying Disability Progression in Multiple Sclerosi. Joint Statistical Meeting, Montreal, Cuebec, Canada. 3-8 August 2013. Abstract #307903. In: JSM Proceedings, Statistics in Epidemiology Section. Alexandria, VA: American Statistical Association. August 2013.

14. Shirani A, Zhao Y, Oger J, BC MS Clinic Neurologists, Tremlett H. A comparison of extreme profiles of disability change in beta-interferon treated multiple sclerosis patients: findings from British Columbia, Canada. Mult Scler 2012; 18 (4 Suppl): 2-542. The 28th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS). Lyon, France. 10-13 October 2012.

15. Menon S, Zhu F, Shirani A, Oger J, Traboulsee A, Freedman M, BC MS Clinic Neurologists, Tremlett H. The natural history of aggressive multiple sclerosis: findings from British Columbia, Canada. Mult Scler 2012; 18 (4 Suppl): 2-542. The 28th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS). Lyon, France. 10-13 October 2012

16. Karim MS, Gustafson P, Petkau J, Zhao Y, Shirani A, Evans C, Kingwell E, van der Kop ML, Tremlett H. A simulation study of the performance of the prescription time-distribution matching method to address immortal time bias. Joint Statistical Meeting, San Diego, CA, 28 July – 2 August 2012. Abstract #305129. In: JSM Proceedings, Statistics in Epidemiology Section. Alexandria, VA: American Statistical Association. August 2012.

17. Shirani A, Zhao Y, Oger J, Tremlett H. Changes in disability status in beta-inteferon treated multiple sclerosis patients: a comparison of the extremes. Int J MS Care 2012; 14(Supl 2): 37. Annual Meeting of the Consortium of Multiple Sclerosis Centers (CMSC) and American Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS), San Diego, California, May 30 – June 2, 2012.

18. Menon S, Shirani A, Zhao Y, Sayao A-L, Tremlett T. Characterizing benign multiple sclerosis using age, disease duration and disability status in a longitudinal database. Int J MS Care 2012; 14(Supl 2): 94. Annual Meeting of the Consortium of Multiple Sclerosis Centers (CMSC) and American Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS), San Diego, California, May 30 – June 2, 2012.

19. Shirani A, Zhao Y, Kingwell E, Fisk J, Bhan V, Oger J, Tremlett H. Trends in age at onset of multiple sclerosis in two Canadian provinces: Importance of controlling for an equal observation time. In: Proceedings of the 3rd Tykeson Fellows Conference, Dallas, Texas, 1-4 November 2011.

20. Shirani A, Zhao Y, Kingwell E, Fisk J, Bhan V, Oger J, Tremlett H. Trends in age at onset of multiple sclerosis in two Canadian provinces: Importance of controlling for an equal observation time. Mult Scler 2011;17(10): S53–S276. The 5th Joint Triennial Congress of the European and Americas Committees on Treatment and Research in Multiple Sclerosis (ECTRIMS and ACTRIMS), Amsterdam, The Netherlands, 18-22 October 2011.

21. Menon S, Shirani A, Zhao Y, Oger J, Traboulsee AL, Freedman MS, Tremlett H. Characteristics of aggressive multiple sclerosis: Findings from British Columbia, Canada. Mult Scler 2011; 17: S277–S505. The 5th Joint Triennial Congress of the European and Americas Committees on Treatment and Research in Multiple Sclerosis (ECTRIMS and ACTRIMS), Amsterdam, The Netherlands, 18-22 October 2011.

22. Karim ME, Gustafson P, Petkau J, Shirani A, van der Kop M, Kingwell E, Zhao Y, Evans C, Tremlett H. Marginal Structural Models for Investigating Long- Term Effectiveness of a Time-Dependent Treatment: An Application to Multiple Sclerosis. Joint Statistical Meeting, Miami, Florida, July 30 – August 4, 2011. Abstract #302665. In: JSM Proceedings, Statistics in Epidemiology Section. Alexandria, VA: American Statistical Association. August 2011.

23. Shirani A, Zhao Y, Kingwell E, Rieckmann P, Tremlett H. Has disability progression in multiple sclerosis patients temporally changed? Can J Neurol Sci 2011; 38 (3) Suppl. 1: S26. The 46th Annual Congress of the Canadian Neurological Sciences Federation (CNSF); Vancouver, BC, Canada, June 2011.

24. Lourenco P, Shirani A, Saeedi J, Oger J, Schreiber W, Tremlett H. Oligoclonal banding and CSF markers in multiple sclerosis: associations with disease course and progression. UBC Medical Journal 2011; 2(2S): p. 16. The annual meeting of the University of British Columbia Medicine Research Forum; Vancouver, BC, Canada, March 2011.

25. Lourenco P, Saeedi J, Shirani A, Oger J, Schreiber W, Tremlett H. Oligoclonal banding and cerebrospinal fluid markers in multiple sclerosis disease course and progression. Int J MS Care 2011; 13 Sppl. 3: 8. The 25th Annual Meeting of the Consortium of Multiple Sclerosis Centers (CMSC), Montreal, QC, Canada, 1-4 June 2011.

26. Evans C, Zhao Y, Shirani A, Kingwell E, van der Kop ML, Karim ME, Gustafson P, Petkau J, Tremlett H. The BeAMS Study: Long-term benefits and adverse effects of beta-interferons for multiple sclerosis: impact on hospital services utilization. In: Proceedings of the 2nd endMS Conference, p. 38; Whistler, BC, Canada, December 2010.

27. Kingwell E, van der Kop M, Zhao Y, Shirani A, Oger J, Tremlett H. Mortality and predictors of survival in multiple sclerosis (MS): Findings from British Columbia, Canada. In: Proceedings of the 2nd endMS Conference, p. 15; Whistler, BC, Canada, December 2010.

28. Shirani A, Zhao Y, Kingwell E, Rieckmann P, Tremlett H. No evidence for temporal change in disability progression. In: Proceedings of the 7th International Multiple Sclerosis Congress of Iran, p. 27; Tehran, Iran, November 2010.

29. Shirani A, Zhao Y, Kingwell E, Rieckmann P, Tremlett H. No evidence for a temporal change in disability progression: findings from British Columbia, Canada (1975-2009). Mult Scler 2010; 16: S7-S39. The 26th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS); Gothenburg, Sweden, October 2010.

30. Kingwell E, van der Kop M, Zhao Y, Shirani A, Rieckmann P, Tremlett H. Mortality and predictors of survival in multiple sclerosis (MS): Findings from British Columbia, Canada. Mult Scler 2010; 16: S197-S352. The 26th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS); Gothenburg, Sweden, October 2010.

31. Shirani A. Soltanian-Zadeh H, Sahraian MA. Applications of artificial intelligence techniques in diagnosis and assessment of multiple sclerosis. In: Proceedings of the 5th International Multiple Sclerosis Congress of Iran, p. 63; Tehran, Iran, November 2008.

32. Pakdaman H, Fallah A, Pakdaman R, Shirani A, Sahraian M. Impacts of early interferon beta1-a therapy on conversion to clinically definite multiple sclerosis in Iranian patients with a first demyelinating event. Mult Scler 2006; 12: S1-S228. The 22nd Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS). Madrid, Spain, September 2006.

33. Harirchian MH, Sahraian MA, Shirani A. Serum prolactin level in patients with multiple sclerosis: a case control study. Eur J Neurol 2006;13(suppl 2):239. The 10th Congress of the European Federation of Neurological Societies (EFNS). Glasgow, UK. September 2006.

34. Harirchian MH, Sahraian MA, Shirani A. Multiple sclerosis and hormones. Iranian J Neurol 2003;3(6):102-3. The 10th Iranian Congress of Neurology and Electrophysiology. Tehran, Iran, May 2003.

35. Abolmaali K, Aghamohammadi A, Farhoudi A, Moein M, Pourpak Z, Rezaei N, Movahedi M, Gharagouzlou M, Mirsaeid Ghazi B, Atarod L, Ahmadi Afshar A, Abdollahpour H, Rafiei Samani F, Shirani A. The frequency of consanguinity in primary immunodeficient patients, registered in Iranian Primary Immunodeficiency Registry. In: Proceedings of the 21st Congress of the European Academy of Allergology and Clinical Immunology, p. 170; Naples, Italy, June 2002.

Published Books:

1. Shirani A, Stuve O. Natalizumab: Perspectives from the bench to bedside. In: Kuchroo V, and Weiner H. Multiple Sclerosis. Cold Spring Harb Perspect Med. 2018 Mar 2. pii: a029066. [Epub ahead of print]

2. Habibi G, Hamediseresht E, Shirani A, Heshmat R, Lotfollahi Shabestari O, Rahimi I, et al. Principles of Scientific Writing. 2007, Marz Fekr Publication, Tehran, Iran.

3. Anoushiravani AA, Abbasi A, Shirani A, Hosseini M, Aloosh M, Shahi F. First Aid Endocrinology. 2004, Teimourzadeh Medical Publication, Tehran, Iran.

4. Meysami F, Shirani A. Multiple Choice Questions in Biology. 2000, Andishesazan Publication, Tehran, Iran.

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