Spotlight on Pediatrics

Credits: 0.25 CME
Spinal Muscular Atrophy Expert Discussion Conference Series — What Causes SMA? Genetics, Diagnosis, and the Role of SMN
Eugenio Mercuri, MD, PhD
The France Foundation

Spinal Muscular Atrophy Expert Discussion Conference Series — What Causes SMA? Genetics, Diagnosis, and the Role of SMN

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Conference Series: Part 1 of 3

Activity Details

Free CME
0.25 AMA PRA Category 1 Credit(s)
Released: August 21, 2018
Expires: August 20, 2019
15 minutes to complete

Accredited By

Target Audience

Neurologists, pediatric neurologists, neuromuscular specialists, pediatricians, genetic counselors, and other clinicians who see patients with spinal muscular atrophy

Learning Objectives

  • Explain the genetic aspects of SMA, including its recessive nature, carriers, and recommendations for genetic screening
  • Describe criteria for SMA diagnosis

Activity Description

As new therapies emerge for spinal muscular atrophy (SMA) that include gene replacement and gene modifying therapies, clinicians need to consider the expectations for these treatments. Experts, Dr. Eugenio Mercuri, Dr. Richard Finkel, and Dr. Gyula Acsadi, recently discussed these emerging therapies and their implications on the clinical disease state at an international meeting. This activity is a recording of their roundtable discussion with informative slides broken into 3 parts. The first part discusses diagnosis, genetics, and the role of SMN in SMA. Part 2 explains the results of emerging clinical trial data. The final activity is a practical discussion about the implications of these new therapies for this lethal disease. Discussion topics include the durability of new and emerging treatments and changes to the standards of care for patients with SMA. This education is an engaging update on SMA from the leading experts in the field.

Statement of Educational Need

Many clinicians have questions regarding the genetics of spinal muscular atrophy. In addition, carrier screening is not routinely done, despite ACOG recommendations. Routine newborn testing is currently being considered in many states and internationally. Identification of the neuromotor deficits associated with SMA (and other conditions) is often inaccurate or delayed. As new therapies emerge that include gene replacement and gene modifying therapies, clinicians need to consider the expectations of these treatments. Gene replacement therapy is still a mystery to most clinicians. New therapies prompt a reevaluation of current standards of SMA care.

Agenda

  • Introduction to SMA
  • Role of SMN1 and SMN2 genes in SMA
  • Role of SMN protein in development

Faculty

Eugenio Mercuri, MD, PhD (Chair)
Professor of Pediatric Neurology
Catholic University of the Sacred Heart
Rome, Italy

Dr. Eugenio Mercuri is a consultant for AveXis, Biogen, F. Hoffmann-La Roche, and IONIS. He is a principal investigator for Biogen/IONIS and F. Hoffmann-La Roche studies.


Richard S. Finkel, MD
Division Chief of Neurology
Pediatric Neurology
Nemours Children’s Hospital
Orlando, Florida, United States

Dr. Richard Finkel is a consultant for AveXis, Biogen, Catabasis, Ionis, Mitobridge, Novartis, and Roche. He receives clinical trial support from AveXis, Biogen, Catabasis, Cytokinetics, Ionis, Lilly, MDA, NIH, ReveraGen, and Summit. Dr. Finkel owns stock in Roche. His partner holds several patents and receives patent licensing royalties from National Jewish Center and Children’s Hospital of Philadelphia.


Gyula Acsadi, MD, PhD
Division Head of Neurology and Rehabilitation
Professor of Pediatric Neurology
Connecticut Children’s Medical Center
University of Connecticut Medical School
Hartford, Connecticut, United States

Dr. Gyula Acsadi serves as a consultant for AveXis, Biogen, and Serepta. He is on the speakers bureau for Biogen and conducts contract research for Biogen, Italfarmaco, and Serepta.


Disclosure Policy

In accordance with the ACCME Standards for Commercial Support, The France Foundation (TFF) requires that individuals in a position to control the content of an educational activity disclose all relevant financial relationships with any commercial interest. TFF resolves all conflicts of interest to ensure independence, objectivity, balance, and scientific rigor in all its educational programs. Furthermore, TFF seeks to verify that all scientific research referred to, reported, or used in a CME/CE activity conforms to the generally accepted standards of experimental design, data collection, and analysis. TFF is committed to providing learners with high-quality CME/CE activities that promote improvements in health care and not those of a commercial interest

Activity Staff Disclosure

The planners, reviewers, editors, staff, CME committee, or other members at The France Foundation who control content have no relevant financial relationships to disclose.

Accreditation Statement

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

Designation of Credit

The France Foundation designates this enduring activity for a maximum of 0.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nurses who are certified by the American Nurses Credentialing Center (ANCC) may utilize activities that are certified by ACCME-accredited providers toward their requirement for certification renewal by the ANCC. A certificate of attendance will be provided by The France Foundation, an ACCME accredited provider.

Instructions for Receiving Credit

  • There are no fees for participating in and receiving credit for this activity.
  • Review the activity objectives and CME information.
  • Complete the CME activity
  • Complete the online posttest. A score of at least 75% is required to successfully complete this activity. The participant may take the test until successfully passed.
  • Complete the CME evaluation/attestation form, which provides each participant with the opportunity to comment on how participating in the activity will affect their professional practice; the quality of the instructional process; the perception of enhanced professional effectiveness; the perception of commercial bias; and his/her views on future educational needs.
  • Credit documentation/reporting:
    • If you are requesting AMA PRA Category 1 Credits™ or a certificate of participation—your CME certificate will be available for download.

Statement of Commercial Support

This activity is supported by an educational grant from AveXis, Inc.

Disclaimer Statement

The France Foundation presents this information for educational purposes only. The content is provided solely by faculty who have been selected because of recognized expertise in their field. Participants have the professional responsibility to ensure that products are prescribed and used appropriately on the basis of their own clinical judgment and accepted standards of care. The France Foundation and the commercial supporter(s) assume no liability for the information herein.

Disclosure of Unlabeled Use

TFF requires CME faculty (speakers) to disclose when products or procedures being discussed are off label, unlabeled, experimental, and/or investigational, and any limitations on the information that is presented, such as data that are preliminary, or that represent ongoing research, interim analyses, and/or unsupported opinion. Faculty in this activity may discuss information about pharmaceutical agents that is outside of US Food and Drug Administration approved labeling. This information is intended solely for continuing medical education and is not intended to promote off-label use of these medications. TFF does not recommend the use of any agent outside of the labeled indications. If you have questions, contact the Medical Affairs Department of the manufacturer for the most recent prescribing information.

Contact Information for Questions About the Activity

If you have questions about this CME activity, please contact The France Foundation at 860-434-1650 or info@francefoundation.com.

Hardware/Software Requirements

Pro-CME recommends using the latest versions of these supported browsers: Google Chrome, Microsoft Internet Explorer, Mozilla Firefox, Safari. Depending on your browser of choice, additional software, such as Adobe Reader® and Adobe® Flash® Player may be required.

Pediatrics Presentations

1.00 CME
Vindico
Chronic Idiopathic Urticaria: Improving Treatment, With a Focus on Patient Outcomes

Chronic Idiopathic Urticaria: Improving Treatment, With a Focus on Patient Outcomes

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Activity Details

Free CME
1.0 AMA PRA Category 1 Credit
Released: April 18, 2019
Expires: April 17, 2020
1 hour to complete

Accredited By

This continuing medical education activity is provided by

Target Audience

The intended audience for this activity is allergists and other health care professionals involved in the treatment of patients with chronic idiopathic urticaria (CIU).

Learning Objectives

Upon successful completion of this activity, participants should be better able to:

  • Assess the impact of chronic idiopathic urticaria (CIU) on quality of life, including sleep, psychological functioning, work and activity.
  • Compare the strengths and limitations of current guideline approaches to the management of CIU.
  • Select treatment options for patients with CIU who fail to achieve complete symptom control with first- and second-line therapy.

Activity Description

Urticaria, a common skin condition characterized by transient pruritic wheals, occurs in 20% to 25% of individuals within their lifetimes. Urticaria can be classified by both symptom duration and underlying etiology. Patients who experience symptom recurrence for a duration over 6 weeks may be diagnosed as having chronic idiopathic urticaria (CIU). CIU negatively impacts physical functioning, work performance, emotional well-being, and overall quality of life, with an impact similar in magnitude to that experienced by patients with coronary disease awaiting bypass surgery. A US practice guideline issued in 2014 and an updated international guideline issued in 2018 are available to guide diagnosis and treatment of urticaria. Although the recommendations in these guidelines largely overlap, specialists need to be knowledgeable about their strengths and limitations to select optimal treatment strategies for their patients. This CME activity will assess the impact of CIU on quality of life, particularly its impact on sleep, psychological functioning, work, and activity. Current guideline approaches to the management of CIU will be evaluated, as well as treatment options for patients with CIU who fail to achieve complete symptom control with first- and second-line therapy.

Activity Chair

Jonathan A. Bernstein, MD
Professor of Medicine
University of Cincinnati College of Medicine
Department of Internal Medicine
Division of Immunology, Allergy Section
Editor in Chief, Journal of Asthma
Partner, Bernstein Allergy Group
Partner, Bernstein Clinical Research Center
Cincinnati, OH

Disclosures
Royalty: CRC Press, Springer Publishing
Intellectual Property/Patent Details: University of Cincinnati
Consulting Fee: ALK, AstraZeneca, BioCryst, CSL Behring, Genentech, Merck, Novartis, Optinose, Pharming, Regeneron, Sanofi, Shire
Speakers Bureau: ALK, AstraZeneca, CSL Behring, Novartis, Optinose, Pharming, Sanofi, Shire
Contracted Research: AstraZeneca, BioCryst, CSL Behring, Merck, Novartis/Genentech, Optinose, Pharming, Sanofi, Shire


Faculty

David A. Khan, MD
Professor of Medicine and Pediatrics
Allergy and Immunology Program Director
University of Texas Southwestern Medical Center
Dallas, TX

Disclosures
Royalty: Elsevier, UpToDate
Speakers Bureau: Genentech
Data Safety Monitoring Committee: Aimmune


Prof. Dr. med. Dr. hc Torsten Zuberbier
Head of the Allergy Center Charité - Dermatology Clinic
Spokesman for the Comprehensive Allergy Center Charité
Allergy Center Charité
Charité - Universitätsmedizin Berlin
Berlin, Germany

Disclosures
Consulting Fee: AbbVie, ALK, Almirall, Astellas, AstraZeneca, Bayer, Bencard, Berlin-Chemie, FAES, HAL Allergy, Henkel, Kryolan, Leti, L'Oreal, Meda, Menarini, Merck, MSD, Novartis, Pfizer, Sanofi, Stallergenes Greer, Takeda, Teva, UCB
Speakers Bureau: AbbVie, ALK, Almirall, Astellas, AstraZeneca, Bayer, Bencard, Berlin-Chemie, FAES, HAL Allergy, Henkel, Kryolan, Leti, L'Oreal, Meda, Menarini, Merck, MSD, Novartis, Pfizer, Sanofi, Stallergenes Greer, Takeda, Teva, UCB
Committee Member: WHO-Initiative "Allergic Rhinitis and its Impact on Asthma" (ARIA)
Member of the Board: German Society for Allergy and Clinical Immunology (DGAKI)
Head: European Centre for Allergy Research Foundation (ECARF)
Secretary General: Global Allergy and Asthma European Network (GA2LEN)
Member: Committee on Allergy Diagnosis and Molecular Allergology, World Allergy Organisation (WAO)


Reviewer
Ronald A. Codario, MD, EMBA, FACP, FNLA, RPVI, CHCP
No relevant financial relationships to disclose.

Staff
Vindico Medical Education
No relevant financial relationships to disclose.

Conflict of Interest Policy/Disclosure Statement

In accordance with the Accreditation Council for Continuing Medical Education’s Standards for Commercial Support, all CME providers are required to disclose to the activity audience the relevant financial relationships of the planners, faculty, reviewers and staff involved in the development of CME content. An individual has a relevant financial relationship if he or she has a financial relationship in any amount occurring in the past 12 months with a commercial interest whose products or services are discussed in the CME activity content over which the individual has control.

Signed Disclosure(s) are on file at Vindico Medical Education, Office of Medical Affairs and Compliance.

Accreditation Statement

Vindico Medical Education is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Designation of Credit

Vindico Medical Education designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit(s)™.

Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This enduring material is approved for 1 year from the date of original release, April 18, 2019 to April 17, 2020.

Instructions for Receiving Credit

To participate in this CME activity, you must read the objectives, answer the pretest questions, watch the presentations, and complete the posttest and evaluation. Provide only one (1) correct answer for each question. A satisfactory score is defined as answering 3 out of 4 of the posttest questions correctly. Upon receipt of the completed materials, if a satisfactory score on the posttest is achieved, Vindico Medical Education will issue an AMA PRA Category 1 Credit(s)™ Certificate or Participation Certificate.

Statement of Commercial Support

This activity is supported by an educational grant from Genentech, Inc.

Disclaimer Statement/Disclosure of Unlabeled Use

The audience is advised that this continuing medical education activity may contain references to unlabeled uses of FDA-approved products or to products not approved by the FDA for use in the United States. The faculty members have been made aware of their obligation to disclose such usage. All activity participants will be informed if any speakers/authors intend to discuss either non-FDA approved or investigational use of products/devices.

Contact Information for Questions about the Activity

Created and published by Vindico Medical Education, 6900 Grove Road, Building 100, Thorofare, NJ 08086-9447. Telephone: 856-994-9400; Fax: 856-384-6680. Printed in the USA. Copyright © 2019 Vindico Medical Education. All rights reserved. No part of this publication may be reproduced without written permission from the publisher. The material presented at or in any of Vindico Medical Education continuing medical education activities does not necessarily reflect the views and opinions of Vindico Medical Education. Neither Vindico Medical Education nor the faculty endorse or recommend any techniques, commercial products, or manufacturers. The faculty/authors may discuss the use of materials and/or products that have not yet been approved by the US Food and Drug Administration. All readers and continuing education participants should verify all information before treating patients or utilizing any product.

CME Questions?
Contact us at CME@VindicoCME.com

0.75 CME
Postgraduate Institute for Medicine
Clinical Convergence®: Approaching Chronic Urticaria from the Patient Perspective

Clinical Convergence®: Approaching Chronic Urticaria from the Patient Perspective

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Activity Details

Free CME
0.75 AMA PRA Category 1 Credit(s)
Released: March 7, 2019
Expires: March 6, 2020
45 minutes to complete

Jointly Provided By

Postgraduate Institute for Medicine (PIM) in joint providership with RMEI Medical Education, LLC (RMEI).

Target Audience

US-based allergy/immunology and dermatology clinicians

Learning Objectives

After engaging in this educational activity, participants will be able to:

  1. Recognize physical exam findings and symptomatology suggestive of chronic urticaria (CU) and appropriately apply evidence-based practices regarding diagnostic testing and laboratory workup
  2. Utilize a guideline-driven approach to treatment intensification for safe and effective management of CU patients in need of second- and third-line treatment options, while taking into account quality of life issues

Activity Description

This activity is designed to engage your critical thinking and challenge suboptimal approaches to patient care. It features videos of 2 patients with CU and challenging interactive questions related to their histories and treatments. You will have an opportunity to hear the patients’ perspectives of CU and learn from our expert faculty.

Statement of Educational Need

Urticaria is an inflammatory skin condition characterized by intensely pruritic, erythematous wheals, commonly referred to as “hives,” ranging from several millimeters to several centimeters in diameter.1 Individual wheals characteristically resolve within 24 hours of development without leaving residual skin markings. However, resolving lesions are often concomitantly replaced by new wheals.

Acute urticaria tends to be self-limiting, often resolving within hours to days.2 By contrast, a diagnosis of chronic urticaria (CU), also referred to as chronic idiopathic urticaria (CIU) or chronic spontaneous urticaria (CSU), is made when symptoms last >6 weeks.3 In some cases of CU, symptoms persist continually, while others are episodic with symptoms occurring at varying intervals (hours to weeks).4 Approximately 40% of patients with CU also develop angioedema,5 characterized by rapid swelling of the lower layers of the dermis and the subcutaneous or submucosal tissue of the skin and mucous membranes, most commonly affecting the lips and eyelids, or more rarely, the respiratory or gastrointestinal tracts.6 The point prevalence of CU is estimated at 0.5% to 1%.4

References:

  1. World Allergy Organization. Urticaria and angioedema: synopsis. 2004. www.worldallergy.org/professional/allergic_diseases_center/urticaria/urticariasynopsis.php. Accessed January 18, 2019.
  2. Axelrod S, Davis-Lorton M. Urticaria and angioedema. Mt Sinai J Med. 2011;78(5):784-802.
  3. Greaves M. Chronic urticaria. J Allergy Clin Immunol. 2000;105(4):664-672.
  4. Powell RJ, Du Toit GL, Siddique N, et al. BSACI guidelines for the management of chronic urticaria and angio-oedema. Clin Exp Allergy. 2007;37(5):631-650.
  5. Amar SM, Dreskin SC. Urticaria. Prim Care. 2008;35(1):141-157.
  6. Maurer M, Weller K, Bindsley-Jensen C, et al. Unmet clinical needs in chronic spontaneous urticaria. A GA²LEN task force report. Allergy. 2011;66(3):317-330.

Faculty

Michael E. Manning, MD, FAAAAI, FACAAI
President/Medical Director
Medical Research of Arizona
Allergy, Asthma and Immunology Associates, Ltd
Scottsdale, AZ

Michael E. Manning, MD, FAAAAI, FACAAI, is president of Allergy, Asthma and Immunology Associates, Ltd., and medical director of the clinical research division, Medical Research of Arizona. Dr Manning received his medical degree from the University of Texas Medical School at Houston. He completed an internship and subsequently residency in internal medicine at St. Joseph’s Hospital and Medical Center in Phoenix, AZ, and an allergy and immunology fellowship at Scripps Clinic and Research Foundation in La Jolla, CA.

Dr Manning has served as president of the Greater Phoenix Allergy Society, the Arizona State Allergy and Asthma Society, and the Western Society of Allergy, Asthma and Immunology. He is a fellow of the American College of Allergy, Asthma and Immunology and American Academy of Allergy, Asthma and Immunology. Dr Manning is currently on the Board of Regents of the American College of Allergy, Asthma and Immunology.

Michael E. Manning, MD, FAAAAI, FACAAI, has affiliations with CSL Behring, DBV Technologies, Pharming, Shire (Consulting Fees); AstraZeneca, CSL Behring, Genentech, Pharming, Shire (Speakers Bureaus); Aimmune, BioCryst, CSL Behring, Genentech/Novartis, GSK, Hoffmann-La Roach, Merck, Sanofi, Shire/Dyax (Contracted Research).


Anne Marie Ditto, MD
Associate Professor of Medicine
Division of Allergy-Immunology  
Northwestern University  
Feinberg School of Medicine  
Chicago, IL 

Anne Marie Ditto, MD, is an associate professor of medicine in the division of Allergy-Immunology at Northwestern University Feinberg School of Medicine in Chicago, IL. She earned her medical degree at the University of Illinois at Chicago. Her internship, residency, and fellowship were all completed at Northwestern University. Dr Ditto is board certified in allergy-immunology.

Dr Ditto is a practicing allergist with a special interest in urticaria, eosinophilic esophagitis, asthma, and idiopathic anaphylaxis. She volunteers monthly at the Community Health Clinic where she founded an asthma/allergy clinic. She is also actively involved in the allergy-immunology training program at Northwestern, where she has trained over 75 allergists and teaches students and residents in outpatient clinics.

Dr Ditto was invited to fellowship in the American College of Physicians (ACP) and Royal Society of Medicine (RSM) and her distinguished teaching and volunteer work has been recognized through numerous awards, including the Northwestern Medical Faculty Foundation “Center of Excellence Award” for Community Service and Community Health’s “Volunteer Specialist of the Year”.

Dr Ditto is a former president of the Illinois Society of Allergy, Asthma and Immunology and currently serves as Governor of the Midwest Region of the American Academy of Allergy, Asthma and Immunology’s Federation of Regional State and Local Allergy, Asthma and Immunology Societies (RSLAAIS) and also serves as vice-chair of the AAAAI anaphylaxis committee. She has published numerous articles and book chapters in the field of allergy-immunology and recently edited the “Anaphylaxis” issue of Immunology and Allergy Clinics of North America.

Anne M. Ditto, MD, has no affiliations with commercial interests to disclose.


Conflict of Interest Policy/Disclosure Statement

The Postgraduate Institute for Medicine (PIM) requires instructors, planners, managers, and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest (COI) they may have as related to the content of this activity. All identified COI are thoroughly vetted and resolved according to PIM policy. PIM is committed to providing its learners with high quality CME activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest.

The PIM planners and managers have nothing to disclose. The RMEI Medical Education, LLC planners and managers have nothing to disclose.

The patients have nothing to disclose.

Joint Accreditation Statement

In support of improving patient care, this activity has been planned and implemented by the Postgraduate Institute for Medicine and RMEI Medical Education, LLC. The Postgraduate Institute for Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Physician Continuing Medical Education

The Postgraduate Institute for Medicine designates this enduring material for a maximum of 0.75 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Media

Internet

Instructions for Receiving Credit

By reviewing the course content and successfully completing the post-test and evaluation, physicians, nurse practitioners, and PAs are entitled to receive up to 0.75 AMA PRA Category 1 Credit(s)™. A statement of credit will be available to print from your user history page. Users must:

  • Read the learning objectives and faculty disclosures.
  • Participate in the activity.
  • Complete the activity evaluation.

Physicians, nurse practitioners, and PAs who successfully complete the post-test and evaluation will receive CME credit. You must score 75% or higher on the post-test to receive credit for this activity. All other participants who successfully complete the post-test and evaluation will receive a certificate of participation. If you would like to contact Postgraduate Institute for Medicine, please e-mail information@pimed.com.

Complete the evaluation form and participants will be entered into a drawing to win a $100 Amazon Gift Card!

*The expense for this gift card is solely funded by RMEI Medical Education. No supporter funding was used for the expense of this gift card.

Rules and Regulations
This sweepstakes is managed by RMEI Medical Education, LLC (RMEI), a full-service medical education company. The winner will be selected via automated random drawing on a monthly basis from among all eligible entries and notified through the contact information provided. In accordance with our privacy policy, we do not share your information with any third parties. By entering the sweepstakes, you grant RMEI permission to use your e-mail address to reach you for notification and prize fulfillment. Only individuals who complete the evaluation forms and provide contact information will be eligible to win. Open to those who have a US postal address and who are 18 years or older. Only one prize per person and per household will be awarded. The prize will be a $100 Amazon gift card.

Statement of Commercial Support

This activity is supported by an educational grant from Novartis Pharmaceuticals Corporation.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications. The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Hardware/Software Requirements

Pro-CME recommends using the latest versions of these supported browsers: Google Chrome, Microsoft Internet Explorer, Mozilla Firefox, Safari. Depending on your browser of choice, additional software, such as Adobe Reader® and Adobe® Flash® Player may be required.

0.75 CME
Postgraduate Institute for Medicine
Clinical Reflections®: Reflecting on Errors and Missed Opportunities in Chronic Urticaria

Clinical Reflections®: Reflecting on Errors and Missed Opportunities in Chronic Urticaria

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Activity Details

Free CME
0.75 AMA PRA Category 1 Credits
Released: February 1, 2019
Expires: January 31, 2020
45 minutes to complete

Jointly Provided By

Postgraduate Institute for Medicine (PIM) in joint providership with RMEI Medical Education (RMEI).

Target Audience

US-based allergy/immunology and dermatology clinicians

Learning Objectives

After engaging in this educational activity, participants will be able to:

  1. Recognize physical exam findings and symptomatology suggestive of chronic urticaria (CU) and appropriately apply evidence-based practices regarding diagnostic testing and laboratory workup
  2. Utilize a guideline-driven approach to treatment intensification for safe and effective management of CU patients in need of second- and third-line treatment options, while taking into account quality of life issues

Activity Description

This unique educational initiative harnesses the power of reflection and recognition of suboptimal approaches to patient care to allow you to rethink clinical decisions based on the scenarios presented, and to modify treatment plans accordingly. You can compare your responses to interactive questions with those of your peers and learn from our expert faculty.

Statement of Educational Need

Urticaria is an inflammatory skin condition characterized by intensely pruritic, erythematous wheals, commonly referred to as “hives,” ranging from several millimeters to several centimeters in diameter.1 Individual wheals characteristically resolve within 24 hours of development without leaving residual skin markings. However, resolving lesions are often concomitantly replaced by new wheals.

Acute urticaria tends to be self-limiting, often resolving within hours to days.2 By contrast, a diagnosis of chronic urticaria (CU), also referred to as chronic idiopathic urticaria (CIU) or chronic spontaneous urticaria (CSU), is made when symptoms last >6 weeks.3 In some cases of CU, symptoms persist continually, while others are episodic with symptoms occurring at varying intervals (hours to weeks).4 Approximately 40% of patients with CU also develop angioedema,5 characterized by rapid swelling of the lower layers of the dermis and the subcutaneous or submucosal tissue of the skin and mucous membranes, most commonly affecting the lips and eyelids, or more rarely, the respiratory or gastrointestinal tracts.6 The point prevalence of CU is estimated at 0.5% to 1%.4

References:
  1. World Allergy Organization. Urticaria and angioedema: synopsis. 2004. www.worldallergy.org/professional/allergic_diseases_center/urticaria/urticariasynopsis.php. Accessed December 21, 2018.
  2. Axelrod S, Davis-Lorton M. Urticaria and angioedema. Mt Sinai J Med. 2011;78(5):784-802.
  3. Greaves M. Chronic urticaria. J Allergy Clin Immunol. 2000;105(4):664-672.
  4. Powell RJ, Du Toit GL, Siddique N, et al. BSACI guidelines for the management of chronic urticaria and angio-oedema. Clin Exp Allergy. 2007;37(5):631-650.
  5. Amar SM, Dreskin SC. Urticaria. Prim Care. 2008;35(1):141-157.
  6. Maurer M, Weller K, Bindsley-Jensen C, et al. Unmet clinical needs in chronic spontaneous urticaria. A GA²LEN task force report. Allergy. 2011;66(3):317-330.

Faculty

Michael E. Manning, MD, FAAAAI, FACAAI
Michael E. Manning, MD, FAAAAI, FACAAI
President/Medical Director
Medical Research of Arizona
Allergy, Asthma and Immunology Associates, Ltd.
Scottsdale, AZ

Michael E. Manning, MD, FAAAAI, FACAAI, is president of Allergy, Asthma and Immunology Associates, Ltd., and medical director of the clinical research division, Medical Research of Arizona.

Dr Manning is a graduate of Baylor University in Waco, TX and he received his medical degree from the University of Texas Medical School at Houston. He completed an internship and subsequently residency in internal medicine at St. Joseph’s Hospital and Medical Center in Phoenix, AZ, and an allergy and immunology fellowship at Scripps Clinic and Research Foundation in La Jolla, CA.

Dr Manning has served as president of the Greater Phoenix Allergy Society, the Arizona State Allergy and Asthma Society, and the Western Society of Allergy, Asthma and Immunology. He is a fellow of the American College of Allergy, Asthma and Immunology and American Academy of Allergy, Asthma and Immunology. Dr Manning is currently on the Board of Regents of the American College of Allergy, Asthma and Immunology.

Michael E. Manning, MD, FAAAAI, FACAAI, has affiliations with CSL Behring, DBV Technologies, Pharming, Shire (Consulting Fees); AstraZeneca, CSL Behring, Genentech, Pharming, Shire (Speakers Bureaus); Aimmune, BioCryst, CSL Behring, Genentech/Novartis, GSK, Hoffmann-La Roach, Merck, Sanofi, Shire/Dyax (Contracted Research).



Anne Marie Ditto, MD 
Associate Professor of Medicine
Division of Allergy-Immunology 
Northwestern University
Feinberg School of Medicine 
Chicago, IL 

Anne Marie Ditto, MD, is an associate professor of medicine in the division of Allergy-Immunology at Northwestern University Feinberg School of Medicine in Chicago, IL. She earned her medical degree at the University of Illinois at Chicago. Her internship, residency, and fellowship were all completed at Northwestern University. Dr Ditto is board certified in allergy-immunology.

Dr Ditto is a practicing allergist with a special interest in urticaria, eosinophilic esophagitis, asthma, and idiopathic anaphylaxis. She volunteers monthly at the Community Health Clinic where she founded an asthma/allergy clinic. She is also actively involved in the allergy-immunology training program at Northwestern, where she has trained over 75 allergists and teaches students and residents in outpatient clinics.

Dr Ditto was invited to fellowship in the American College of Physicians (ACP) and Royal Society of Medicine (RSM) and her distinguished teaching and volunteer work has been recognized through numerous awards, including the Northwestern Medical Faculty Foundation “Center of Excellence Award” for Community Service and Community Health’s “Volunteer Specialist of the Year.

Dr Ditto is a former president of the Illinois Society of Allergy, Asthma and Immunology and currently serves as Governor of the Midwest Region of the American Academy of Allergy, Asthma and Immunology’s Federation of Regional State and Local Allergy, Asthma and Immunology Societies (RSLAAIS) and also serves as vice-chair of the AAAAI anaphylaxis committee. She has published numerous articles and book chapters in the field of allergy- immunology and recently edited the “Anaphylaxis” issue of Immunology and Allergy Clinics of North America.

Anne Marie Ditto, MD, has no affiliations with commercial interests to disclose.



Luz Fonacier, MD, FAAAAI, FACAAI
Professor of Medicine
State University of New York at Stony Brook
Stony Brook, NY
Head of Allergy
Program Director, Allergy and Immunology
Fellowship Program
NYU Winthrop Hospital
Mineola, NY 

Luz Fonacier, MD, FAAAAI, FACAAI, is the head of allergy in NYU Winthrop Hospital, a clinical campus of Stony Brook University School of Medicine and serves as the program director for the Allergy and Immunology Fellowship Program. Dr Fonacier is also a professor of medicine in USNY at Stony Brook. She completed residencies in dermatology and internal medicine, a fellowship in allergy and immunology in New York Hospital-Cornell Medical Center, and a fellowship in dermal immunology at New York University Medical Center.

Dr Fonacier serves as the Treasurer of the American College of Allergy, Asthma and Immunology (ACAAI). She chaired the Committee on Dermatologic Allery of the ACAAI and the Food Allergy, Dermatologic, Drug and Anaphylaxis Interest Section of the American Academy of Allergy, Asthma and Immunology (AAAAI). She is the recipient of the ARTrust™  and Anjuli Seth Nayak AAAAI Lectureship, the ACAAI John P. McGovern Lectureship, the ACAAI Jean A. Chapman Memorial Lectureship, the ACAAI “Women in Allergy Award”, and the Presidential Award of Asian Pacific Association of Allergy and Clinical Immunology. Dr Fonacier also served as president of the Long Island Allergy Society.

Dr Fonacier has numerous publications in textbooks and journals and continues to be a speaker and faculty in the annual national conventions of ACAAI, AAAAI, and other national and international societies. Because of her training in dermatology, allergy, and immunology, Dr Fonacier’s special interest is the dermatologic manifestations of allergic diseases.

Luz Fonacier, MD, FAAAAI, FACAAI, has affiliations with Regeneron (Consulting Fees); Regeneron (Speakers Bureaus); Pfizer, Regeneron, Shire (Contracted Research).



Conflict of Interest Policy/Disclosure Statement

The Postgraduate Institute for Medicine (PIM) requires instructors, planners, managers, and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest (COI) they may have as related to the content of this activity. All identified COI are thoroughly vetted and resolved according to PIM policy. PIM is committed to providing its learners with high quality CME activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest.

Joint Accreditation Statement

In support of improving patient care, this activity has been planned and implemented by the Postgraduate Institute for Medicine and RMEI Medical Education, LLC. The Postgraduate Institute for Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Physician Continuing Medical Education

The Postgraduate Institute for Medicine designates this enduring material for a maximum of 0.75 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Instructions for Receiving Credit

By reviewing the course content and successfully completing the post-test and evaluation, physicians, nurse practitioners, and PAs are entitled to receive up to 0.75 AMA PRA Category 1 Credit(s)™. A statement of credit will be available to print from your user history page. Users must:

  • Read the learning objectives and faculty disclosures.
  • Participate in the activity.
  • Complete the activity evaluation.

Physicians, nurse practitioners, and PAs who successfully complete the post-test and evaluation will receive CME credit. You must score 75% or higher on the post-test to receive credit for this activity. All other participants who successfully complete the post-test and evaluation will receive a certificate of participation. If you would like to contact Postgraduate Institute for Medicine, please email information@pimed.com.

Complete the evaluation form and participants will be entered into a drawing to win a $100 Amazon Gift Card!

*The expense for this gift card is solely funded by RMEI Medical Education. No supporter funding was used for the expense of this gift card.

Rules and Regulations
This sweepstakes is managed by RMEI Medical Education, LLC (RMEI), a full-service medical education company. The winner will be selected via automated random drawing on a monthly basis from among all eligible entries and notified through the contact information provided. In accordance with our privacy policy, we do not share your information with any third parties. By entering the sweepstakes, you grant RMEI permission to use your email address to reach you for notification and prize fulfillment. Only individuals who complete the evaluation forms and provide contact information will be eligible to win. Open to those who have a US postal address and who are 18 years or older. Only one prize per person and per household will be awarded. The prize will be a $100 Amazon gift card.

Statement of Commercial Support

This activity is supported by an educational grant from Novartis Pharmaceuticals Corporation.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications. The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Hardware/Software Requirements

Pro-CME recommends using the latest versions of these supported browsers: Google Chrome, Microsoft Internet Explorer, Mozilla Firefox, Safari. Depending on your browser of choice, additional software, such as Adobe Reader® and Adobe® Flash® Player may be required.

1.00 CME
Global Education Group
Evolving Management Strategies for Moderate-to-Severe Atopic Dermatitis: Looking Beyond Barriers to Optimize Therapy

Evolving Management Strategies for Moderate-to-Severe Atopic Dermatitis: Looking Beyond Barriers to Optimize Therapy

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Free CME
1.0 AMA PRA Category 1 Credit
Released: December 14, 2018
Expires: December 13, 2019
60 minutes to complete

This activity is supported by an educational grant from Sanofi Genzyme and Regeneron Pharmaceuticals.
This activity is jointly provided by Global Education Group and Integritas Communications.

Target Audience

The educational design of this activity addresses the needs of dermatologists, allergists, and other clinicians who treat patients with atopic dermatitis.

Statement of Need

Atopic dermatitis is a common, chronic inflammatory disease that manifests primarily in the skin, although research has uncovered potentially deleterious effects in other organ systems throughout the body.1,2 The disease-related physical and biopsychosocial burdens of atopic dermatitis can have a substantial effect on patients’ quality of life, particularly in those with moderate-to-severe disease.3,4 A better understanding of atopic dermatitis etiology has supported the development of new approaches to disease characterization and targeted therapies.5,6 As a result, the first biologic therapy is now available to treat patients with moderate-to-severe disease, and several other therapies are in late-stage clinical development.7-10 With novel therapies emerging for patients with difficult-to-treat atopic dermatitis, dermatologists will benefit from updates on the latest clinical trial data and practical recommendations on how to translate those results into daily clinical decision-making. In this Evidence-Based Best Practices™ program, internationally recognized experts will review the latest published evidence with a goal of providing recommendations to enhance overall patient outcomes. The expert faculty panel will discuss the pathophysiologic underpinnings of atopic dermatitis, share best practices related to comprehensive patient evaluations, and relay their own clinical experience in managing patients with moderate-to-severe disease.

References

  • Nutten S. Atopic dermatitis: global epidemiology and risk factors. Ann Nutr Metab. 2015;66(suppl 1):8-16.
  • Brunner PM, et al. Increasing comorbidities suggest that atopic dermatitis is a systemic disorder. J Invest Dermatol. 2017;137(1):18-25.
  • Whiteley J, et al. The burden of atopic dermatitis in US adults: results from the 2013 National Health and Wellness Survey. Curr Med Res Opin. 2016;32(10):1-7. [Epub ahead of print].
  • Drucker AM, et al. The burden of atopic dermatitis: summary of a report for the National Eczema Association. J Invest Dermatol. 2017;137(1):26-30.
  • Mansouri Y, Guttman-Yassky E. Immune pathways in atopic dermatitis, and definition of biomarkers through broad and targeted therapeutics. J Clin Med. 2015;4(5):858-873.
  • Gandhi NA, et al. Targeting key proximal drivers of type 2 inflammation in disease. Nat Rev Drug Discov. 2016;15(1):35-50.
  • Simpson EL, et al. Two phase 3 trials of dupilumab versus placebo in atopic dermatitis. N Engl J Med. 2016;375(24):2335-2348.
  • de Bruin-Weller M, et al. Dupilumab with concomitant topical corticosteroid treatment in adults with atopic dermatitis with an inadequate response or intolerance to ciclosporin A or when this treatment is medically inadvisable: a placebo-controlled, randomized phase III clinical trial (LIBERTY AD CAFÉ). Br J Dermatol. 2018;178(5):1083-1101.
  • Boguniewicz M. Biologic therapy for atopic dermatitis: moving beyond the practice parameter and guidelines. J Allergy Clin Immunol Pract. 2017;5(6):1477-1487.
  • Cotter DG, et al. Emerging therapies for atopic dermatitis: JAK inhibitors. J Am Acad Dermatol. 2018;78(3S1):S53-S62.

Educational Objectives

After completing this activity, the participant should be better able to:

  • Discuss atopic dermatitis pathophysiology, including clinically relevant molecular and cellular targets
  • Assess patients with atopic dermatitis longitudinally for uncontrolled symptoms, disease flares, comorbidities, and clinical responses to their current treatment regimens
  • Describe the clinical profiles of targeted biologic therapies for the treatment of moderate-to-severe atopic dermatitis
  • Optimize treatment regimens for patients with moderate-to-severe atopic dermatitis to reduce symptomatology, address comorbidities, maximize health-related quality of life, and minimize treatment-related side effects
  • Educate patients and caregivers to improve their understanding of atopic dermatitis to promote shared decision-making and treatment adherence

Faculty

Marjolein de Bruin-Weller, MD, PhD
Head, National Expertise Center for Atopic Dermatitis
Department of Dermatology/Allergology
University Medical Center Utrecht
Utrecht, The Netherlands



Eric L. Simpson, MD, MCR
Professor of Dermatology
Director, Clinical Research
Department of Dermatology
Oregon Health & Science University
Portland, Oregon, USA



Andreas Wollenberg, MD, PhD
Professor
Department of Dermatology and Allergy
Ludwig-Maximilian University of Munich
Munich, Germany


Physician Accreditation Statement

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Global Education Group (Global) and Integritas Communications. Global is accredited by the ACCME to provide continuing medical education for physicians.

This CME/CE activity complies with all requirements of the federal Physician Payment Sunshine Act. If a reportable event is associated with this activity, the accredited provider managing the program will provide the appropriate physician data to the Open Payments database.

Physician Credit Designation

Global Education Group designates this enduring activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Global Contact Information

For information about the accreditation of this program, please contact Global at 303-395-1782 or cme@globaleducationgroup.com.

Instructions to Receive Credit

In order to receive credit for this activity, the participant must score 70% on the posttest and complete the program evaluation.

Fee Information & Refund/Cancellation Policy

There is no fee for this educational activity.

Disclosure of Conflicts of Interest

Global Education Group (Global) requires instructors, planners, managers, and other individuals and their spouses/life partners who are in a position to control the content of this activity to disclose any real or apparent conflict of interest they may have as related to the content of this activity. All identified conflicts of interest are thoroughly vetted by Global for fair balance, scientific objectivity of studies mentioned in the materials or used as the basis for content, and appropriateness of patient care recommendations.

The faculty reported the following financial relationships or relationships to products or devices they or their spouses/life partners have with commercial interests related to the content of this CME activity:

Marjolein de Bruin-Weller, MD, PhD

  • Consultant/Advisor: AbbVie Inc., Regeneron Pharmaceuticals, Inc., Sanofi Genzyme
  • Grant/Research Support: Regeneron Pharmaceuticals, Inc., Sanofi Genzyme.

Eric L. Simpson, MD, MCR

  • Consultant/Advisor: AbbVie Inc., Eli Lilly and Company, Galderma Laboratories, L.P., LEO Pharma Inc., Menlo Therapeutics Inc., Pfizer Inc., Regeneron Pharmaceuticals, Inc., Sanofi Genzyme.
  • Grant/Research Support: Eli Lilly and Company, GlaxoSmithKline, Novartis Pharmaceuticals Corporation, Regeneron Pharmaceuticals, Inc., Vanda Pharmaceuticals Inc.

Andreas Wollenberg, MD, PhD

  • Consultant/Advisor: Almirall Limited, Beiersdorf AG, Galderma S.A., LEO Pharma Inc., L’Oréal S.A., MedImmune, LLC, Pierre Fabre Laboratories, Pfizer Inc., Regeneron Pharmaceuticals, Inc., Sanofi-Aventis Europe S.A.S.
  • Grant/Research Support: Beiersdorf AG, LEO Pharma Inc.
  • Speakers Bureau: Almirall Limited, Anacor Pharmaceuticals, Inc., Astellas Pharma Europe Ltd, Beierdsorf AG, Bioderma Laboratoire Dermatologique, Celgene Corporation, Chugai Pharmaceutical Co., Ltd., Galderma S.A., Hans Karrer GMBH, LEO Pharma Inc., L’Oréal S.A., Meda AB, MedImmune, LLC, Merck Sharp & Dohme Corp., Novartis Pharma AG, Pierre Fabre Laboratories, Pfizer Inc., Regeneron Pharmaceuticals, Inc., Sanofi-Aventis Europe S.A.S.

The planners and managers reported the following financial relationships or relationships to products or devices they or their spouses/life partners have with commercial interests related to the content of this CME activity:

Stacey Ullman, MHS
Nothing to disclose

Ashley Marostica, RN, MSN
Nothing to disclose

Lindsay Borvansky
Nothing to disclose

Andrea Funk
Nothing to disclose

Liddy Knight
Nothing to disclose

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the US Food and Drug Administration. Global Education Group (Global) and Integritas Communications do not recommend the use of any agent outside of the labeled indications. 

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of any organization associated with this activity. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed in this activity should not be used by clinicians without evaluation of patient conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Hardware/Software Requirements

Pro-CME recommends using the latest versions of these supported browsers: Google Chrome, Microsoft Internet Explorer, Mozilla Firefox, Safari. Depending on your browser of choice, additional software, such as Adobe Reader® and Adobe® Flash® Player may be required.

0.75 CME
Vindico
Advances in the Treatment of Peanut Allergy: Rapid Response from Seattle

Advances in the Treatment of Peanut Allergy: Rapid Response from Seattle

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Activity Details

Free CME
0.75 AMA PRA Category 1 Credits
Released: November 30, 2018
Expires: November 30, 2019
0.75 hours to complete

Accredited By

This continuing medical education activity is provided by Vindico Medical Education.

Faculty

Activity Chair:
J. Andrew Bird, MD
J. Andrew Bird, MD
Associate Professor of Pediatrics
Division of Allergy and Immunology
University of Texas Southwestern Medical Center
Director, Food Allergy Center
Children’s Medical Center of Dallas
Dallas, TX

Disclosure: Consulting Fee: Aimmune, DBV Technologies, Pharm-Olam
Non-CME Services Fees: Aimmune, DBV Technologies
Contracted Research: Aimmune, DBV Technologies


Faculty:
Ruchi S. Gupta, MD, MPH
Ruchi S. Gupta, MD, MPH
Professor of Pediatrics and Medicine
Northwestern Feinberg School of Medicine
Director
Science and Outcomes of Allergy and Asthma Research Team
Clinical Attending
Ann and Robert H. Lurie Children's Hospital Chicago
Chicago, IL

Disclosure: Consulting Fee: Aimmune, BEFORE Brands, DBV Technologies, Kaleo Pharma
Contracted Research: Thermo Fisher Scientific, United Health Group


Edwin H. Kim, MD, MS
Edwin H. Kim, MD, MS
Director, UNC Food Allergy Initiative
University of North Carolina at Chapel Hill
Chapel Hill, NC

Disclosure: Consulting Fee: Aimmune, DBV Technologies
Contracted Research: Aimmune, Astellas, DBV Technologies, FARE, HAL Allergy
Research Support: Wallace Foundation


Reviewer:
Ronald A. Codario, MD, EMBA, FACP, FNLA, RPVI, CHCP
Disclosure: No relevant financial relationships to disclose.


Vindico Medical Education Staff:
Disclosure: No relevant financial relationships to disclose.


Signed Disclosures are on file at Vindico Medical Education, Office of Medical Affairs and Compliance.

Activity Description

The prevalence of peanut allergy in adults and children continues to increase, significantly disrupting the lives of the millions of affected individuals as well as their families. Although no therapies have been approved for the treatment of peanut allergies, several are currently being evaluated in clinical studies, providing the potential for safe and effective therapeutic options. Within this Rapid Response from Seattle, experts in the field examine the prevalence and burden of IgE-mediated food allergy with a focus on peanut allergy, assess the latest clinical data regarding the use of oral immunotherapy for the treatment of patients with peanut allergy, and evaluate the challenges associated with heterogeneity in terminology used in immunotherapy clinical trials for the management of patients with peanut allergy.

Learning Objectives

Upon successful completion of the activity, participants should be better able to:

  • Examine the prevalence and burden of IgE-mediated food allergy, with a focus on peanut allergy.
  • Assess the latest clinical data regarding the use of oral immunotherapy for the treatment of patients with peanut allergy.
  • Examine the challenges associated with heterogeneity in terminology used in immunotherapy clinical trials for the management of patients with peanut allergy.

Target Audience

The intended audience for the activity is allergists, immunologists and other health care professionals involved in the treatment of patients with food allergies, particularly peanut allergy.

Conflict of Interest Policy/Disclosure Statement

In accordance with the Accreditation Council for Continuing Medical Education’s Standards for Commercial Support, all CME providers are required to disclose to the activity audience the relevant financial relationships of the planners, teachers, and authors involved in the development of CME content. An individual has a relevant financial relationship if he or she has a financial relationship in any amount occurring in the past 12 months with a commercial interest whose products or services are discussed in the CME activity content over which the individual has control. Relationship information appears above.

Accreditation Statement

Vindico Medical Education is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Designation of Credit

Vindico Medical Education designates this enduring material for a maximum of 0.75 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Instructions for Receiving Credit

To participate in this CME activity, you must read the objectives, answer the pretest questions, view the CME content, and complete the posttest and evaluation. Provide only one (1) correct answer for each question. A satisfactory score is defined as answering 66% of the posttest questions correctly. Upon receipt of the completed materials, if a satisfactory score on the posttest is achieved, Vindico Medical Education will issue an AMA PRA Category 1 Credit(s) Certificate.

Statement of Commercial Support

This activity is supported by an educational grant from Aimmune Therapeutics.

Disclaimer Statement/Disclosure of Unlabeled Use

The material presented at or in any Vindico Medical Education continuing education activity does not necessarily reflect the views and opinions of Vindico Medical Education. Neither Vindico Medical Education, nor the faculty endorse or recommend any techniques, commercial products, or manufacturers. The faculty/authors may discuss the use of materials and/or products that have not yet been approved by the US Food and Drug Administration. All readers and continuing education participants should verify all information before treating patients or utilizing any product.

Contact Information for Questions About the Activity

Contact us at CME@VindicoCME.com

Hardware/Software Requirements

Pro-CME recommends using the latest versions of these supported browsers: Google Chrome, Microsoft Internet Explorer, Mozilla Firefox, Safari. Depending on your browser of choice, additional software, such as Adobe Reader® and Adobe® Flash® Player may be required.

Copyright Statement

Created and published by Vindico Medical Education, 6900 Grove Road, Building 100, Thorofare, NJ 08086-9447. Telephone: 856-994-9400; Fax: 856-384-6680. Printed in the USA. Copyright © 2018 Vindico Medical Education. All rights reserved. No part of this publication may be reproduced without written permission from the publisher. The material presented at or in any of Vindico Medical Education continuing medical education activities does not necessarily reflect the views and opinions of Vindico Medical Education. Neither Vindico Medical Education nor the faculty endorse or recommend any techniques, commercial products, or manufacturers. The faculty/authors may discuss the use of materials and/or products that have not yet been approved by the US Food and Drug Administration. All readers and continuing education participants should verify all information before treating patients or utilizing any product.

0.75 CME
Integrity Continuing Education, Inc.
Improving Severe Asthma Control through Comprehensive Patient Assessment and Tailored Treatment Selection

Improving Severe Asthma Control through Comprehensive Patient Assessment and Tailored Treatment Selection

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Activity Details

Free CME
1.0 AMA PRA Category 1 Credit
Released: November 20, 2018
Expires: November 20, 2019
1 hour to complete

Provided by


Integrity Continuing Education, Inc.

Target Audience

This educational initiative has been designed for allergists, pulmonologists, and otolaryngic allergists involved in the management of patients with severe asthma.

Learning Objectives

Upon completion of this educational activity, participants should be able to:

  • Describe clinical criteria for severe asthma and outline an approach to assessing symptom control and disease burden
  • Identify known phenotypes of severe asthma
  • Develop an approach to the treatment of severe asthma that is personalized to the individual patient and describe the most recent clinical data on new and emerging therapies for severe asthma
  • Identify strategies for improving communication to promote collaborative decision-making and the ability to self-manage among patients with severe asthma

Activity Description

Despite recent advances in our understanding of the pathophysiology of asthma and a corresponding expansion of targeted treatment modalities, severe asthma care continues to be a challenge in clinical practice. This program is designed to address this issue by imparting clinical knowledge and competence to clinicians that will promote comprehensive assessment and highly personalized treatment of patients whose symptoms meet the criteria for severe asthma. In addition, this initiative is also targeted at providing clinicians with guidance on strategies for improving disease awareness, increasing collaborative decision-making, and promoting self-management among patients with severe asthma.

Faculty

William W. Busse, MD
Professor of Medicine
Division of Allergy, Pulmonary, and Critical Care Medicine
School of Medicine and Public Health
University of Wisconsin
Madison, Wisconsin


Conflict of Interest Policy/Disclosure Statement

Integrity Continuing Education requires instructors, planners, managers, and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest they may have as related to the content of this activity. All identified conflicts of interest are thoroughly vetted by Integrity Continuing Education for fair balance, scientific objectivity of studies mentioned in the materials or used as the basis for content, and appropriateness of patient care recommendations.

The following faculty/planners reported the financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:

William W. Busse, MD
Royalty: Elsevier
Consulting Fees: AstraZeneca Pharmaceuticals LP, Genentech, GlaxoSmithKline, Novartis Pharmaceuticals Corporation, Sanofi Genzyme and Regeneron Pharmaceuticals, Teva Pharmaceuticals
Data Monitoring Boards/Study Oversight Committees: Boston Scientific, Genentech, ICON Clinical Research Ltd.

The Integrity CE planners and managers have nothing to disclose.

Accreditation Statement

Integrity Continuing Education, Inc. is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Designation of Credit

Integrity Continuing Education, Inc. designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Instructions for Receiving Credit

There are no fees for participating and receiving CME credit for this activity. During the period of November 20, 2018 through November 20, 2019 participants must:

  • Read the learning objectives and faculty disclosures
  • Complete the pretest
  • Study the educational activity
  • Complete the posttest and the evaluation form

A statement of credit will be issued only upon receipt of a completed activity evaluation form and a completed posttest with a score of 70% or better.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. Integrity Continuing Education, Inc. and Sanofi Genzyme and Regeneron Pharmaceuticals do not recommend the use of any agent outside of the labeled indications. 

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of any organization associated with this activity. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

The information provided at this CME activity is for continuing education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient’s medical condition.

Contact Information for Questions About the Activity

For information about the ACCME accreditation of this activity, please contact Integrity Continuing Education, Inc. at (855) 835-4004 or via email at information@integrityce.com.

Hardware/Software Requirements

Pro-CME recommends using the latest versions of these supported browsers: Google Chrome, Microsoft Internet Explorer, Mozilla Firefox, Safari. Depending on your browser of choice, additional software, such as Adobe Reader® and Adobe® Flash® Player may be required.

Statement of Commercial Support

Supported by an educational grant from Sanofi Genzyme and Regeneron Pharmaceuticals.

0.50 CME
The France Foundation
Spinal Muscular Atrophy Expert Discussion Conference Series — Transformative Treatment for SMA

Spinal Muscular Atrophy Expert Discussion Conference Series — Transformative Treatment for SMA

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Conference Series: Part 2 of 3

Activity Details

Free CME
0.50 AMA PRA Category 1 Credit(s)
Released: August 21, 2018
Expires: August 20, 2019
30 minutes to complete

Accredited By

Target Audience

Neurologists, pediatric neurologists, neuromuscular specialists, pediatricians, genetic counselors, and other clinicians who see patients with spinal muscular atrophy

Learning Objectives

  • Explore the potential implications of gene therapy for SMA
  • Summarize key clinical trial data on available/emerging treatments for SMA

Activity Description

As new therapies emerge for spinal muscular atrophy (SMA) that include gene replacement and gene modifying therapies, clinicians need to consider the expectations for these treatments. Experts, Dr. Eugenio Mercuri, Dr. Richard Finkel, and Dr. Gyula Acsadi, recently discussed these emerging therapies and their implications on the clinical disease state at an international meeting. This activity is a recording of their roundtable discussion with informative slides broken into 3 parts. The first part discusses diagnosis, genetics, and the role of SMN in SMA. Part 2 explains the results of emerging clinical trial data. The final activity is a practical discussion about the implications of these new therapies for this lethal disease. Discussion topics include the durability of new and emerging treatments and changes to the standards of care for patients with SMA. This education is an engaging update on SMA from the leading experts in the field.

Statement of Educational Need

Many clinicians have questions regarding the genetics of spinal muscular atrophy. In addition, carrier screening is not routinely done, despite ACOG recommendations. Routine newborn testing is currently being considered in many states and internationally. Identification of the neuromotor deficits associated with SMA (and other conditions) is often inaccurate or delayed. As new therapies emerge that include gene replacement and gene modifying therapies, clinicians need to consider the expectations of these treatments. Gene replacement therapy is still a mystery to most clinicians. New therapies prompt a reevaluation of current standards of SMA care.

Agenda

  • Gene splicing modifiers
  • Gene replacement therapy MOA
  • Clinical trial results

Faculty

Eugenio Mercuri, MD, PhD (Chair)
Professor of Pediatric Neurology
Catholic University of the Sacred Heart
Rome, Italy

Dr. Eugenio Mercuri is a consultant for AveXis, Biogen, F. Hoffmann-La Roche, and IONIS. He is a principal investigator for Biogen/IONIS and F. Hoffmann-La Roche studies.


Richard S. Finkel, MD
Division Chief of Neurology
Pediatric Neurology
Nemours Children’s Hospital
Orlando, Florida, United States

Dr. Richard Finkel is a consultant for AveXis, Biogen, Catabasis, Ionis, Mitobridge, Novartis, and Roche. He receives clinical trial support from AveXis, Biogen, Catabasis, Cytokinetics, Ionis, Lilly, MDA, NIH, ReveraGen, and Summit. Dr. Finkel owns stock in Roche. His partner holds several patents and receives patent licensing royalties from National Jewish Center and Children’s Hospital of Philadelphia.


Gyula Acsadi, MD, PhD
Division Head of Neurology and Rehabilitation
Professor of Pediatric Neurology
Connecticut Children’s Medical Center
University of Connecticut Medical School
Hartford, Connecticut, United States

Dr. Gyula Acsadi serves as a consultant for AveXis, Biogen, and Serepta. He is on the speakers bureau for Biogen and conducts contract research for Biogen, Italfarmaco, and Serepta.


Disclosure Policy

In accordance with the ACCME Standards for Commercial Support, The France Foundation (TFF) requires that individuals in a position to control the content of an educational activity disclose all relevant financial relationships with any commercial interest. TFF resolves all conflicts of interest to ensure independence, objectivity, balance, and scientific rigor in all its educational programs. Furthermore, TFF seeks to verify that all scientific research referred to, reported, or used in a CME/CE activity conforms to the generally accepted standards of experimental design, data collection, and analysis. TFF is committed to providing learners with high-quality CME/CE activities that promote improvements in health care and not those of a commercial interest

Activity Staff Disclosure

The planners, reviewers, editors, staff, CME committee, or other members at The France Foundation who control content have no relevant financial relationships to disclose.

Accreditation Statement

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

Designation of Credit

The France Foundation designates this enduring activity for a maximum of 0.50 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nurses who are certified by the American Nurses Credentialing Center (ANCC) may utilize activities that are certified by ACCME-accredited providers toward their requirement for certification renewal by the ANCC. A certificate of attendance will be provided by The France Foundation, an ACCME accredited provider.

Instructions for Receiving Credit

  • There are no fees for participating in and receiving credit for this activity.
  • Review the activity objectives and CME information.
  • Complete the CME activity
  • Complete the online posttest. A score of at least 75% is required to successfully complete this activity. The participant may take the test until successfully passed.
  • Complete the CME evaluation/attestation form, which provides each participant with the opportunity to comment on how participating in the activity will affect their professional practice; the quality of the instructional process; the perception of enhanced professional effectiveness; the perception of commercial bias; and his/her views on future educational needs.
  • Credit documentation/reporting:
    • If you are requesting AMA PRA Category 1 Credits™ or a certificate of participation—your CME certificate will be available for download.

Statement of Commercial Support

This activity is supported by an educational grant from AveXis, Inc.

Disclaimer Statement

The France Foundation presents this information for educational purposes only. The content is provided solely by faculty who have been selected because of recognized expertise in their field. Participants have the professional responsibility to ensure that products are prescribed and used appropriately on the basis of their own clinical judgment and accepted standards of care. The France Foundation and the commercial supporter(s) assume no liability for the information herein.

Disclosure of Unlabeled Use

TFF requires CME faculty (speakers) to disclose when products or procedures being discussed are off label, unlabeled, experimental, and/or investigational, and any limitations on the information that is presented, such as data that are preliminary, or that represent ongoing research, interim analyses, and/or unsupported opinion. Faculty in this activity may discuss information about pharmaceutical agents that is outside of US Food and Drug Administration approved labeling. This information is intended solely for continuing medical education and is not intended to promote off-label use of these medications. TFF does not recommend the use of any agent outside of the labeled indications. If you have questions, contact the Medical Affairs Department of the manufacturer for the most recent prescribing information.

Contact Information for Questions About the Activity

If you have questions about this CME activity, please contact The France Foundation at 860-434-1650 or info@francefoundation.com.

Hardware/Software Requirements

Pro-CME recommends using the latest versions of these supported browsers: Google Chrome, Microsoft Internet Explorer, Mozilla Firefox, Safari. Depending on your browser of choice, additional software, such as Adobe Reader® and Adobe® Flash® Player may be required.

0.25 CME
The France Foundation
Spinal Muscular Atrophy Expert Discussion Conference Series — What Causes SMA? Genetics, Diagnosis, and the Role of SMN

Spinal Muscular Atrophy Expert Discussion Conference Series — What Causes SMA? Genetics, Diagnosis, and the Role of SMN

Start

Conference Series: Part 1 of 3

Activity Details

Free CME
0.25 AMA PRA Category 1 Credit(s)
Released: August 21, 2018
Expires: August 20, 2019
15 minutes to complete

Accredited By

Target Audience

Neurologists, pediatric neurologists, neuromuscular specialists, pediatricians, genetic counselors, and other clinicians who see patients with spinal muscular atrophy

Learning Objectives

  • Explain the genetic aspects of SMA, including its recessive nature, carriers, and recommendations for genetic screening
  • Describe criteria for SMA diagnosis

Activity Description

As new therapies emerge for spinal muscular atrophy (SMA) that include gene replacement and gene modifying therapies, clinicians need to consider the expectations for these treatments. Experts, Dr. Eugenio Mercuri, Dr. Richard Finkel, and Dr. Gyula Acsadi, recently discussed these emerging therapies and their implications on the clinical disease state at an international meeting. This activity is a recording of their roundtable discussion with informative slides broken into 3 parts. The first part discusses diagnosis, genetics, and the role of SMN in SMA. Part 2 explains the results of emerging clinical trial data. The final activity is a practical discussion about the implications of these new therapies for this lethal disease. Discussion topics include the durability of new and emerging treatments and changes to the standards of care for patients with SMA. This education is an engaging update on SMA from the leading experts in the field.

Statement of Educational Need

Many clinicians have questions regarding the genetics of spinal muscular atrophy. In addition, carrier screening is not routinely done, despite ACOG recommendations. Routine newborn testing is currently being considered in many states and internationally. Identification of the neuromotor deficits associated with SMA (and other conditions) is often inaccurate or delayed. As new therapies emerge that include gene replacement and gene modifying therapies, clinicians need to consider the expectations of these treatments. Gene replacement therapy is still a mystery to most clinicians. New therapies prompt a reevaluation of current standards of SMA care.

Agenda

  • Introduction to SMA
  • Role of SMN1 and SMN2 genes in SMA
  • Role of SMN protein in development

Faculty

Eugenio Mercuri, MD, PhD (Chair)
Professor of Pediatric Neurology
Catholic University of the Sacred Heart
Rome, Italy

Dr. Eugenio Mercuri is a consultant for AveXis, Biogen, F. Hoffmann-La Roche, and IONIS. He is a principal investigator for Biogen/IONIS and F. Hoffmann-La Roche studies.


Richard S. Finkel, MD
Division Chief of Neurology
Pediatric Neurology
Nemours Children’s Hospital
Orlando, Florida, United States

Dr. Richard Finkel is a consultant for AveXis, Biogen, Catabasis, Ionis, Mitobridge, Novartis, and Roche. He receives clinical trial support from AveXis, Biogen, Catabasis, Cytokinetics, Ionis, Lilly, MDA, NIH, ReveraGen, and Summit. Dr. Finkel owns stock in Roche. His partner holds several patents and receives patent licensing royalties from National Jewish Center and Children’s Hospital of Philadelphia.


Gyula Acsadi, MD, PhD
Division Head of Neurology and Rehabilitation
Professor of Pediatric Neurology
Connecticut Children’s Medical Center
University of Connecticut Medical School
Hartford, Connecticut, United States

Dr. Gyula Acsadi serves as a consultant for AveXis, Biogen, and Serepta. He is on the speakers bureau for Biogen and conducts contract research for Biogen, Italfarmaco, and Serepta.


Disclosure Policy

In accordance with the ACCME Standards for Commercial Support, The France Foundation (TFF) requires that individuals in a position to control the content of an educational activity disclose all relevant financial relationships with any commercial interest. TFF resolves all conflicts of interest to ensure independence, objectivity, balance, and scientific rigor in all its educational programs. Furthermore, TFF seeks to verify that all scientific research referred to, reported, or used in a CME/CE activity conforms to the generally accepted standards of experimental design, data collection, and analysis. TFF is committed to providing learners with high-quality CME/CE activities that promote improvements in health care and not those of a commercial interest

Activity Staff Disclosure

The planners, reviewers, editors, staff, CME committee, or other members at The France Foundation who control content have no relevant financial relationships to disclose.

Accreditation Statement

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

Designation of Credit

The France Foundation designates this enduring activity for a maximum of 0.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nurses who are certified by the American Nurses Credentialing Center (ANCC) may utilize activities that are certified by ACCME-accredited providers toward their requirement for certification renewal by the ANCC. A certificate of attendance will be provided by The France Foundation, an ACCME accredited provider.

Instructions for Receiving Credit

  • There are no fees for participating in and receiving credit for this activity.
  • Review the activity objectives and CME information.
  • Complete the CME activity
  • Complete the online posttest. A score of at least 75% is required to successfully complete this activity. The participant may take the test until successfully passed.
  • Complete the CME evaluation/attestation form, which provides each participant with the opportunity to comment on how participating in the activity will affect their professional practice; the quality of the instructional process; the perception of enhanced professional effectiveness; the perception of commercial bias; and his/her views on future educational needs.
  • Credit documentation/reporting:
    • If you are requesting AMA PRA Category 1 Credits™ or a certificate of participation—your CME certificate will be available for download.

Statement of Commercial Support

This activity is supported by an educational grant from AveXis, Inc.

Disclaimer Statement

The France Foundation presents this information for educational purposes only. The content is provided solely by faculty who have been selected because of recognized expertise in their field. Participants have the professional responsibility to ensure that products are prescribed and used appropriately on the basis of their own clinical judgment and accepted standards of care. The France Foundation and the commercial supporter(s) assume no liability for the information herein.

Disclosure of Unlabeled Use

TFF requires CME faculty (speakers) to disclose when products or procedures being discussed are off label, unlabeled, experimental, and/or investigational, and any limitations on the information that is presented, such as data that are preliminary, or that represent ongoing research, interim analyses, and/or unsupported opinion. Faculty in this activity may discuss information about pharmaceutical agents that is outside of US Food and Drug Administration approved labeling. This information is intended solely for continuing medical education and is not intended to promote off-label use of these medications. TFF does not recommend the use of any agent outside of the labeled indications. If you have questions, contact the Medical Affairs Department of the manufacturer for the most recent prescribing information.

Contact Information for Questions About the Activity

If you have questions about this CME activity, please contact The France Foundation at 860-434-1650 or info@francefoundation.com.

Hardware/Software Requirements

Pro-CME recommends using the latest versions of these supported browsers: Google Chrome, Microsoft Internet Explorer, Mozilla Firefox, Safari. Depending on your browser of choice, additional software, such as Adobe Reader® and Adobe® Flash® Player may be required.