Spotlight on Gastroenterology

Credits: 0.50 CME
The Big Picture of IBD: An Interactive Experience Highlighting Clinical Advances
Stephen B. Hanauer, MD
Global Education Group

The Big Picture of IBD: An Interactive Experience Highlighting Clinical Advances

Start

Activity Details

Free CME
0.5 AMA PRA Category 1 Credits
Released: December 21, 2018
Expires: December 21, 2019
30 minutes to complete

Jointly Provided by

Target Audience

The educational design of this activity addresses the needs of Clinical gastroenterologists and specialist NP/PAs involved in the treatment of patients with IBD.

Learning Objectives

  • Explain the current understanding of the immuno-inflammatory pathways in irritable bowel disease (IBD) and the evolving role of JAK/STAT as a therapeutic target
  • Describe the treat-to-target approach of managing IBD
  • Distinguish between clinical profiles of current and emerging targeted synthetic agents for the treatment of IBD

Activity Description

This activity presents a review of immunopathogenesis of IBD, existing management options, and investigational targeted therapies through innovative infographic panels, which allow the learner to move through the activity at his or her own speed by delving into one concept presented in multiple layers of the panel.

Statement of Educational Need

The burden of inflammatory bowel diseases (IBD), of which Crohn’s disease and ulcerative colitis are the primary entities, is significant and wide ranging. IBD that is not well-controlled impairs quality of life, social activities, travel, and ability to work, leading to higher rates of absenteeism and permanent work disability.1,2 The idiopathic intestinal inflammation of IBD requires life-long treatment and accounts for enormous hospitalization costs. According to data from the U.S. National Inpatient Sample from 2004-2013, IBD was responsible for 97,865 hospitalizations in 2013 alone, with an annual hospitalization cost of $3.8 trillion.3 The 2015 National Health Interview Survey estimates that IBD affects 3.1 million Americans.4

Over the past two decades, the introduction of biologic therapies that target underlying disease processes has dramatically changed the treatment of IBD. Current biologic therapy with tumor necrosis factor-α (TNF) inhibitors (i.e., infliximab, adalimumab, golimumab, and certolizumab pegol) and anti-integrins (i.e., natalizumab and vedolizumab) has improved the treatment of IBD flares and maintenance of clinical remission. These agents are, however, limited by lack of response and loss of response in a substantial proportion of patients, relapse after cessation of therapy, and effects such as risk for malignancy and infection.5 As the pathogenesis and treatment of IBD are complex and variable, there is a need to better understand the underlying pathogenic mechanisms and develop drug therapies to target these mechanisms.5

Orally administered, conventional drugs may improve adherence compared with parenteral administration. New drugs may prove to have better efficacy, tolerability, cost-effectiveness, without a risk of immunogenicity. The oral JAK inhibitor tofacitinib was approved for use in ulcerative colitis in May 2018. Gastroenterologists can benefit from education that provides an update on the immunopathogenesis of IBD, a treat-to-target strategy of treatment, and data related to newer targeted synthetic agents.

1. Gunnarsson C, Chen J, Rizzo JA, Ladapo JA, Naim A, Lofland JH. The employee absenteeism costs of inflammatory bowel disease: evidence from US National Survey Data. J Occup Environ Med. 2013;55(4):393-401.
2. Moradkhani A, Beckman LJ, Tabibian JH. Health-related quality of life in inflammatory bowel disease: psychosocial, clinical, socioeconomic, and demographic predictors. J Crohns Colitis. 2013;7(6):467-473.
3. Lichtenstein G. Cost of Inpatient Care for IBD in the United States [abstract]. Am J Gastroenterol. 2016;11 (suppl 1):S310.
4. Dahlhamer JM, Zammitti EP, Ward BW, Wheaton AG, Croft JB. Prevalence of Inflammatory Bowel Disease Among Adults Aged >/=18 Years - United States, 2015. MMWR Morb Mortal Wkly Rep. 2016;65(42):1166-1169.
5. Coskun M, Vermeire S, Nielsen OH. Novel Targeted Therapies for Inflammatory Bowel Disease. Trends Pharmacol Sci. 2017;38(2):127-142.

Agenda

  • IBD: 2 distinct idiopathic diseases
  • Immunopathogenesis
  • The central role of the mucosal immune system
    • Focus on JAK/STAT pathway
  • Disease severity indices
  • Selecting therapeutic targets in IBD
  • Available advanced therapies for moderate and severe IBD
  • Targeted mechanism-based therapies for IBD
    • Investigational agents
    • Focus on JAK/STAT inhibitors
  • Conclusions

Faculty

Stephen B. Hanauer, MD
Clifford Joseph Barborka Professor of Medicine
Northwestern Feinberg School of Medicine
Medical Director, Digestive Health Center
Chicago, Illinois


Millie D. Long, MD, MPH
Associate Professor of Medicine
Director, Gastroenterology and Hepatology Fellowship Program
University of North Carolina at Chapel Hill
Division of Gastroenterology and Hepatology
Chapel Hill, North Carolina

Disclosure of Conflicts of Interest

Global Education Group (Global) requires instructors, planners, managers and other individuals and their spouse/life partner 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 spouse/life partner have with commercial interests related to the content of this CME activity:

Stephen B. Hanauer, MD

  • Consulting Fees: AbbVie, Actavis, Allergan, Amgen, Arena, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Celltrion, Ferring, Genentech, Gilead Sciences, Inc., GlaxoSmithKline, Hospira, Janssen Therapeutics, Eli Lilly and Company, Merck, Nestle, Novartis, Pfizer, Prometheus, Receptos, Salix Pharmaceuticals, Samsung Biocpis, Sanofi-Avantis, Seres Health, Shire, Takeda, Therakos, Tigenex, UCB Pharma, VHsquared
  • Contracted Research: AbbVie, Allergan, Amgen, Celgene, Genentech, GlaxoSmithKline, Janssen Therapeutics, Eli Lilly and Company, Novartis, Pfizer, Prometheus, Receptos, Sanofi-Aventis, Takeda, UCB Pharma
  • Data and Safety Monitoring Board: Bristol-Myers Squibb
  • Speaker: AbbVie, Janssen Therapeutics, Takeda

Millie D. Long, MD, MPH

  • Consultant/Independent Contractor: Pfizer, AbbVie, Takeda, UCB, Janssen, Target PharmaSolutions
  • Grant/Research Support:Pfizer, Takeda
  • Honoraria: AbbVie, UCB

The planners and managers reported the following 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:

Lindsay Borvansky
Nothing to disclose

Andrea Funk
Nothing to disclose

Liddy Knight
Nothing to disclose

Kayla Messer
Nothing to disclose

Jim Kappler, PhD
Nothing to disclose

Julia Muino
Nothing to disclose

Designation of Credit

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 Webcast for a maximum of 0.5 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 for Receiving Credit

In order to claim credit, participants must complete the following:

  • Read the educational objectives, accreditation information, and faculty disclosures at the beginning of this activity.
  • Complete the Pre-Activity Questions.
  • Read or review the activity content.
  • Complete the Post-Activity Test Questions and Evaluation.
  • Physicians, NPs and PAs who achieves a grade of 66% or better on the Post-Activity Test and who completes the Evaluation will receive a CME/CE Certificate.
  • All other participant who achieves a grade of 66% or better on the Post-Activity Test Questions and who completes the Evaluation will receive a Certificate of Participation.

Statement of Commercial Support

This activity is supported by an independent educational grant from Gilead Sciences, Inc.

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. 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.

Contact Information for Questions About the Activity

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

Activity Details

Free CME
0.5 AMA PRA Category 1 Credits
Released: December 21, 2018
Expires: December 21, 2019
30 minutes to complete

Jointly Provided by

Target Audience

The educational design of this activity addresses the needs of Clinical gastroenterologists and specialist NP/PAs involved in the treatment of patients with IBD.

Learning Objectives

  • Explain the current understanding of the immuno-inflammatory pathways in irritable bowel disease (IBD) and the evolving role of JAK/STAT as a therapeutic target
  • Describe the treat-to-target approach of managing IBD
  • Distinguish between clinical profiles of current and emerging targeted synthetic agents for the treatment of IBD

Activity Description

This activity presents a review of immunopathogenesis of IBD, existing management options, and investigational targeted therapies through innovative infographic panels, which allow the learner to move through the activity at his or her own speed by delving into one concept presented in multiple layers of the panel.

Statement of Educational Need

The burden of inflammatory bowel diseases (IBD), of which Crohn’s disease and ulcerative colitis are the primary entities, is significant and wide ranging. IBD that is not well-controlled impairs quality of life, social activities, travel, and ability to work, leading to higher rates of absenteeism and permanent work disability.1,2 The idiopathic intestinal inflammation of IBD requires life-long treatment and accounts for enormous hospitalization costs. According to data from the U.S. National Inpatient Sample from 2004-2013, IBD was responsible for 97,865 hospitalizations in 2013 alone, with an annual hospitalization cost of $3.8 trillion.3 The 2015 National Health Interview Survey estimates that IBD affects 3.1 million Americans.4

Over the past two decades, the introduction of biologic therapies that target underlying disease processes has dramatically changed the treatment of IBD. Current biologic therapy with tumor necrosis factor-α (TNF) inhibitors (i.e., infliximab, adalimumab, golimumab, and certolizumab pegol) and anti-integrins (i.e., natalizumab and vedolizumab) has improved the treatment of IBD flares and maintenance of clinical remission. These agents are, however, limited by lack of response and loss of response in a substantial proportion of patients, relapse after cessation of therapy, and effects such as risk for malignancy and infection.5 As the pathogenesis and treatment of IBD are complex and variable, there is a need to better understand the underlying pathogenic mechanisms and develop drug therapies to target these mechanisms.5

Orally administered, conventional drugs may improve adherence compared with parenteral administration. New drugs may prove to have better efficacy, tolerability, cost-effectiveness, without a risk of immunogenicity. The oral JAK inhibitor tofacitinib was approved for use in ulcerative colitis in May 2018. Gastroenterologists can benefit from education that provides an update on the immunopathogenesis of IBD, a treat-to-target strategy of treatment, and data related to newer targeted synthetic agents.

1. Gunnarsson C, Chen J, Rizzo JA, Ladapo JA, Naim A, Lofland JH. The employee absenteeism costs of inflammatory bowel disease: evidence from US National Survey Data. J Occup Environ Med. 2013;55(4):393-401.
2. Moradkhani A, Beckman LJ, Tabibian JH. Health-related quality of life in inflammatory bowel disease: psychosocial, clinical, socioeconomic, and demographic predictors. J Crohns Colitis. 2013;7(6):467-473.
3. Lichtenstein G. Cost of Inpatient Care for IBD in the United States [abstract]. Am J Gastroenterol. 2016;11 (suppl 1):S310.
4. Dahlhamer JM, Zammitti EP, Ward BW, Wheaton AG, Croft JB. Prevalence of Inflammatory Bowel Disease Among Adults Aged >/=18 Years - United States, 2015. MMWR Morb Mortal Wkly Rep. 2016;65(42):1166-1169.
5. Coskun M, Vermeire S, Nielsen OH. Novel Targeted Therapies for Inflammatory Bowel Disease. Trends Pharmacol Sci. 2017;38(2):127-142.

Agenda

  • IBD: 2 distinct idiopathic diseases
  • Immunopathogenesis
  • The central role of the mucosal immune system
    • Focus on JAK/STAT pathway
  • Disease severity indices
  • Selecting therapeutic targets in IBD
  • Available advanced therapies for moderate and severe IBD
  • Targeted mechanism-based therapies for IBD
    • Investigational agents
    • Focus on JAK/STAT inhibitors
  • Conclusions

Faculty

Stephen B. Hanauer, MD
Clifford Joseph Barborka Professor of Medicine
Northwestern Feinberg School of Medicine
Medical Director, Digestive Health Center
Chicago, Illinois


Millie D. Long, MD, MPH
Associate Professor of Medicine
Director, Gastroenterology and Hepatology Fellowship Program
University of North Carolina at Chapel Hill
Division of Gastroenterology and Hepatology
Chapel Hill, North Carolina

Disclosure of Conflicts of Interest

Global Education Group (Global) requires instructors, planners, managers and other individuals and their spouse/life partner 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 spouse/life partner have with commercial interests related to the content of this CME activity:

Stephen B. Hanauer, MD

  • Consulting Fees: AbbVie, Actavis, Allergan, Amgen, Arena, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Celltrion, Ferring, Genentech, Gilead Sciences, Inc., GlaxoSmithKline, Hospira, Janssen Therapeutics, Eli Lilly and Company, Merck, Nestle, Novartis, Pfizer, Prometheus, Receptos, Salix Pharmaceuticals, Samsung Biocpis, Sanofi-Avantis, Seres Health, Shire, Takeda, Therakos, Tigenex, UCB Pharma, VHsquared
  • Contracted Research: AbbVie, Allergan, Amgen, Celgene, Genentech, GlaxoSmithKline, Janssen Therapeutics, Eli Lilly and Company, Novartis, Pfizer, Prometheus, Receptos, Sanofi-Aventis, Takeda, UCB Pharma
  • Data and Safety Monitoring Board: Bristol-Myers Squibb
  • Speaker: AbbVie, Janssen Therapeutics, Takeda

Millie D. Long, MD, MPH

  • Consultant/Independent Contractor: Pfizer, AbbVie, Takeda, UCB, Janssen, Target PharmaSolutions
  • Grant/Research Support:Pfizer, Takeda
  • Honoraria: AbbVie, UCB

The planners and managers reported the following 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:

Lindsay Borvansky
Nothing to disclose

Andrea Funk
Nothing to disclose

Liddy Knight
Nothing to disclose

Kayla Messer
Nothing to disclose

Jim Kappler, PhD
Nothing to disclose

Julia Muino
Nothing to disclose

Designation of Credit

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 Webcast for a maximum of 0.5 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 for Receiving Credit

In order to claim credit, participants must complete the following:

  • Read the educational objectives, accreditation information, and faculty disclosures at the beginning of this activity.
  • Complete the Pre-Activity Questions.
  • Read or review the activity content.
  • Complete the Post-Activity Test Questions and Evaluation.
  • Physicians, NPs and PAs who achieves a grade of 66% or better on the Post-Activity Test and who completes the Evaluation will receive a CME/CE Certificate.
  • All other participant who achieves a grade of 66% or better on the Post-Activity Test Questions and who completes the Evaluation will receive a Certificate of Participation.

Statement of Commercial Support

This activity is supported by an independent educational grant from Gilead Sciences, Inc.

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. 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.

Contact Information for Questions About the Activity

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

Gastroenterology Presentations

1.00 CME
Academy for Continued Healthcare Learning
JAK-STAT-GO: Personalized, Targeted Therapy Options for Your IBD Patients

JAK-STAT-GO: Personalized, Targeted Therapy Options for Your IBD Patients

Start

Activity Details

Free CME
1.0 AMA PRA Category 1 Credit(s)
Released: June 27, 2019
Expires: June 27, 2020
60 minutes to complete

Accredited By

Target Audience

This activity is intended for gastroenterologists, and other allied health care professionals interested in the JAK/STAT signaling pathway and applications to treatment of IBD.

Learning Objectives

Upon completion of this activity, participants will be able to:

  • Discuss the role of the JAK/STAT signaling pathway in the pathogenesis of IBD and the rationale for inhibition
  • Compare and contrast the cytokine pathways targeted by available and emerging JAK inhibitors in IBD
  • Interpret the clinical trial efficacy and safety data of JAK inhibitors investigated for Crohn’s disease and ulcerative colitis
  • Identify IBD patients who require a change in therapy

Activity Description

How can clinicians know they have current information for improving patients’ IBD outcomes? Expert faculty from the Icahn School of Medicine at Mount Sinai, University of Chicago Medicine and Biological Sciences, and Montefiore Medical Center/Albert Einstein College of Medicine recently led a symposium at Digestive Disease Week® (DDW) 2019 exploring the latest in treat-to-target paradigms, the role of the JAK-STAT pathway, and related research on investigational JAK inhibitors in IBD treatment. Video excerpts from the symposium are available as modules making it easier for the learner to move easily from one excerpt to another. This activity qualifies for QPP Improvement Activity points.

Statement of Educational Need

Clinicians who treat patients with inflammatory disease such as IBD need to be updated on new and emerging therapies that will lead to individualized treatment and improved outcomes. Specifically, clinicians require education surrounding the role of the JAK/STAT signaling pathway in immune mediated diseases, up-to-date knowledge of the efficacy and safety of investigational JAK inhibitors, and the role of new and emerging JAK inhibitors in the treatment paradigm in IBD.

Agenda

Video module highlights includes:

  • What’s New in IBD Care? Choosing Targets and Selecting Therapy
  • The JAK/STAT Signaling Pathway as a Target/Panel Discussion
  • Available Data on the Safety of JAK Inhibition: Rheumatology Experience/Panel Discussion
  • Available and Emerging JAK Inhibitors in IBD: Clinical Trials, Populations, and Safety/Panel Discussion

Faculty

Bruce Sands, MD, MS
Bruce Sands, MD, MS
Chief of the Dr. Henry D. Janowitz Division of Gastroenterology
Dr. Burrill B. Crohn Professor of Medicine
Icahn School of Medicine at Mount Sinai
Mount Sinai Health System
New York, NY


Joel Pekow, MD
Joel Pekow, MD
Assistant Professor of Medicine, Section of Gastroenterology, Hepatology, and Nutrition
University of Chicago Medicine and Biological Sciences
Chicago, IL


Thomas Ullman, MD
Thomas Ullman, MD
Chief, Division of Gastroenterology
Montefiore Medical Center/Albert Einstein College of Medicine
Bronx, NY


Conflict of Interest Policy/Disclosure Statement

The Academy for Continued Healthcare Learning (ACHL) requires that the faculty participating in a CME activity disclose all affiliations or other financial relationships (1) with the manufacturers of any commercial product(s) and/or provider(s) of commercial services discussed in an educational presentation and (2) with any commercial supporters of the activity. All conflicts of interest have been resolved prior to this CME activity.

The following financial relationships have been provided:

Bruce Sands, MD, MS, (Chair)
Consulting Agreements: AbbVie, Allergan, Amgen, Inc., Arena Pharmaceuticals, AstraZeneca, Boehringer Ingelheim, Celgene, Celltrion Healthcare, F. Hoffmann-La Roche Ltd., Ferring Pharmaceuticals, Gilead Sciences, Inc., Ironwood Pharmaceuticals, Inc., Janssen Pharmaceuticals, Inc., Lilly, Otsuka, Pfizer, Inc., Prometheus Laboratories Inc., Salix Pharmaceuticals, Shire, Takeda, Theravance Biopharma R&D, Inc.
Grant/Research Support: Celgene
Honoraria Recipient: Takeda

Joel Pekow, MD, (Faculty)
Advisory Board: Janssen Pharmaceuticals, Inc. and Pfizer, Inc.
Consulting Agreement: Verastem
Grant Support: Takeda and AbbVie

Thomas Ullman, MD, (Faculty)
Advisory Board: Pfizer, Inc.
Honoraria Recipient: Janssen Pharmaceuticals, Inc.

Discussion of Off-Label, Investigational, or Experimental Drug/Device Use: Tofacitinib, peficitinib, filgotinib, upadacitinib, and other JAK inhibitors under investigation for IBD

Accreditation Statement

The Academy for Continued Healthcare Learning is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Designation of Credit

The Academy for Continued Healthcare Learning 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.

MIPS Improvement Activity

Completion of this activity including the pre/posttest and follow-up assignments qualifies as a medium weight MIPS improvement activity under MACRA, and can be claimed as completion of IA_PSPA 28 of an Accredited Safety or Quality Improvement Program in the Quality Payment Program. Clinicians should submit their improvement activities by attestation via the CMS Quality Payment Program website. You will receive a certificate of completion after completing the follow-up survey.

Instructions for Receiving Credit

This activity will take approximately 60 minutes to complete. To receive credit, participants are required to complete the pretest, view the online activity and complete the posttest and evaluation. To receive credit, 65% must be achieved on the posttest. A certificate will be immediately available. There is no fee to participate in the activity or for the generation of the certificate.

Statement of Commercial Support

Supported by an educational grant from Gilead Sciences, Inc.

Disclaimer Statement/Disclosure of Unlabeled Use

The content for this activity was developed independently of the commercial supporter. All materials are included with permission. The opinions expressed are those of the faculty and are not to be construed as those of the publisher or grantor.

This educational activity was planned and produced in accordance with the ACCME Accreditation Criteria, Policies, and Standards for Commercial Support. Recommendations involving clinical medicine in a continuing medical education (CME/CE) activity must be based on evidence that is accepted within the profession of medicine as adequate justification for their indications and contraindications in the care of patients. All scientific research referred to, reported, or used in CME/CE in support or justification of a patient care recommendation must conform to the generally accepted standards of experimental design, data collection, and analysis.

This CME/CE activity might describe the off-label, investigational, or experimental use of medications and/or devices that may exceed their FDA-approved labeling. Physicians should consult the current manufacturers’ prescribing information for these products. ACHL requires the speaker to disclose that a product is not labeled for the use under discussion.

Contact Information for Questions about the Activity

For questions, contact Michelle Forcier at mforcier@achlcme.org

Activity Details

Free CME
1.0 AMA PRA Category 1 Credit(s)
Released: June 27, 2019
Expires: June 27, 2020
60 minutes to complete

Accredited By

Target Audience

This activity is intended for gastroenterologists, and other allied health care professionals interested in the JAK/STAT signaling pathway and applications to treatment of IBD.

Learning Objectives

Upon completion of this activity, participants will be able to:

  • Discuss the role of the JAK/STAT signaling pathway in the pathogenesis of IBD and the rationale for inhibition
  • Compare and contrast the cytokine pathways targeted by available and emerging JAK inhibitors in IBD
  • Interpret the clinical trial efficacy and safety data of JAK inhibitors investigated for Crohn’s disease and ulcerative colitis
  • Identify IBD patients who require a change in therapy

Activity Description

How can clinicians know they have current information for improving patients’ IBD outcomes? Expert faculty from the Icahn School of Medicine at Mount Sinai, University of Chicago Medicine and Biological Sciences, and Montefiore Medical Center/Albert Einstein College of Medicine recently led a symposium at Digestive Disease Week® (DDW) 2019 exploring the latest in treat-to-target paradigms, the role of the JAK-STAT pathway, and related research on investigational JAK inhibitors in IBD treatment. Video excerpts from the symposium are available as modules making it easier for the learner to move easily from one excerpt to another. This activity qualifies for QPP Improvement Activity points.

Statement of Educational Need

Clinicians who treat patients with inflammatory disease such as IBD need to be updated on new and emerging therapies that will lead to individualized treatment and improved outcomes. Specifically, clinicians require education surrounding the role of the JAK/STAT signaling pathway in immune mediated diseases, up-to-date knowledge of the efficacy and safety of investigational JAK inhibitors, and the role of new and emerging JAK inhibitors in the treatment paradigm in IBD.

Agenda

Video module highlights includes:

  • What’s New in IBD Care? Choosing Targets and Selecting Therapy
  • The JAK/STAT Signaling Pathway as a Target/Panel Discussion
  • Available Data on the Safety of JAK Inhibition: Rheumatology Experience/Panel Discussion
  • Available and Emerging JAK Inhibitors in IBD: Clinical Trials, Populations, and Safety/Panel Discussion

Faculty

Bruce Sands, MD, MS
Bruce Sands, MD, MS
Chief of the Dr. Henry D. Janowitz Division of Gastroenterology
Dr. Burrill B. Crohn Professor of Medicine
Icahn School of Medicine at Mount Sinai
Mount Sinai Health System
New York, NY


Joel Pekow, MD
Joel Pekow, MD
Assistant Professor of Medicine, Section of Gastroenterology, Hepatology, and Nutrition
University of Chicago Medicine and Biological Sciences
Chicago, IL


Thomas Ullman, MD
Thomas Ullman, MD
Chief, Division of Gastroenterology
Montefiore Medical Center/Albert Einstein College of Medicine
Bronx, NY


Conflict of Interest Policy/Disclosure Statement

The Academy for Continued Healthcare Learning (ACHL) requires that the faculty participating in a CME activity disclose all affiliations or other financial relationships (1) with the manufacturers of any commercial product(s) and/or provider(s) of commercial services discussed in an educational presentation and (2) with any commercial supporters of the activity. All conflicts of interest have been resolved prior to this CME activity.

The following financial relationships have been provided:

Bruce Sands, MD, MS, (Chair)
Consulting Agreements: AbbVie, Allergan, Amgen, Inc., Arena Pharmaceuticals, AstraZeneca, Boehringer Ingelheim, Celgene, Celltrion Healthcare, F. Hoffmann-La Roche Ltd., Ferring Pharmaceuticals, Gilead Sciences, Inc., Ironwood Pharmaceuticals, Inc., Janssen Pharmaceuticals, Inc., Lilly, Otsuka, Pfizer, Inc., Prometheus Laboratories Inc., Salix Pharmaceuticals, Shire, Takeda, Theravance Biopharma R&D, Inc.
Grant/Research Support: Celgene
Honoraria Recipient: Takeda

Joel Pekow, MD, (Faculty)
Advisory Board: Janssen Pharmaceuticals, Inc. and Pfizer, Inc.
Consulting Agreement: Verastem
Grant Support: Takeda and AbbVie

Thomas Ullman, MD, (Faculty)
Advisory Board: Pfizer, Inc.
Honoraria Recipient: Janssen Pharmaceuticals, Inc.

Discussion of Off-Label, Investigational, or Experimental Drug/Device Use: Tofacitinib, peficitinib, filgotinib, upadacitinib, and other JAK inhibitors under investigation for IBD

Accreditation Statement

The Academy for Continued Healthcare Learning is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Designation of Credit

The Academy for Continued Healthcare Learning 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.

MIPS Improvement Activity

Completion of this activity including the pre/posttest and follow-up assignments qualifies as a medium weight MIPS improvement activity under MACRA, and can be claimed as completion of IA_PSPA 28 of an Accredited Safety or Quality Improvement Program in the Quality Payment Program. Clinicians should submit their improvement activities by attestation via the CMS Quality Payment Program website. You will receive a certificate of completion after completing the follow-up survey.

Instructions for Receiving Credit

This activity will take approximately 60 minutes to complete. To receive credit, participants are required to complete the pretest, view the online activity and complete the posttest and evaluation. To receive credit, 65% must be achieved on the posttest. A certificate will be immediately available. There is no fee to participate in the activity or for the generation of the certificate.

Statement of Commercial Support

Supported by an educational grant from Gilead Sciences, Inc.

Disclaimer Statement/Disclosure of Unlabeled Use

The content for this activity was developed independently of the commercial supporter. All materials are included with permission. The opinions expressed are those of the faculty and are not to be construed as those of the publisher or grantor.

This educational activity was planned and produced in accordance with the ACCME Accreditation Criteria, Policies, and Standards for Commercial Support. Recommendations involving clinical medicine in a continuing medical education (CME/CE) activity must be based on evidence that is accepted within the profession of medicine as adequate justification for their indications and contraindications in the care of patients. All scientific research referred to, reported, or used in CME/CE in support or justification of a patient care recommendation must conform to the generally accepted standards of experimental design, data collection, and analysis.

This CME/CE activity might describe the off-label, investigational, or experimental use of medications and/or devices that may exceed their FDA-approved labeling. Physicians should consult the current manufacturers’ prescribing information for these products. ACHL requires the speaker to disclose that a product is not labeled for the use under discussion.

Contact Information for Questions about the Activity

For questions, contact Michelle Forcier at mforcier@achlcme.org

1.50 CME
Global Education Group
The Changing Landscape of IBD: Emerging Concepts in Patient Management

The Changing Landscape of IBD: Emerging Concepts in Patient Management

Start

A Multimedia Educational eHealth Source™

Activity Details

Free CME
1.5 AMA PRA Category 1 Credits
Released: January 17, 2019
Expires: January 17, 2020
1 hour, 30 mins to complete

Jointly Provided by

Target Audience

This activity is intended for clinical gastroenterologists and specialist NP/PAs involved in the treatment of patients with inflammatory bowel disease (IBD).

Learning Objectives

  • Evaluate disease risk and identify individuals who are likely to benefit from biologic or targeted synthetic therapy
  • Tailor management regimens for patients with inflammatory bowel disease (IBD) using a treat-to-target approach that reflects disease severity, treatment goals, therapeutic responses, and patient preferences
  • Partner with patients to provide IBD disease state education, promote shared clinical decision-making, encourage self-management efforts, and personalize long-term care
  • Discuss the cytokine networks underlying IBD pathophysiology, with a focus on newer mechanisms of action
  • Review mechanisms of current and novel non–tumor necrosis factor biologic and targeted synthetic therapies for the treatment of IBD

Activity Description

This activity presents an in-depth review of IBD patient care in moderate to severe disease, including immunopathogenesis of IBD, existing management options, shared decision-making, and investigational targeted therapies, via text and concise video commentaries provided by noted IBD experts

Statement of Educational Need

In the past 2 decades, the introduction of biologic therapies that target underlying disease processes has dramatically changed the treatment of the inflammatory bowel diseases (IBDs)—ulcerative colitis and Crohn’s disease. Current biologic therapy with tumor necrosis factor inhibitors and anti-integrins has improved the treatment of IBD flares and maintenance of clinical remission. These agents are, however, limited by primary nonresponse and loss of response in a substantial proportion of patients, disease relapse after cessation of therapy, immunogenicity, and adverse effects such as risk for infection and malignancy.1 As the pathogenesis and treatment of IBD are complex and variable, there is a need to better understand the underlying pathogenic mechanisms and develop drug therapies to target these mechanisms.1

Geared to the needs of gastroenterologists, this IBD eHealth program includes an update on patient assessment and treat-to-target goals, as well as a review of best practices in shared decision-making in treatment decisions for induction and maintenance of remission. In addition, the immunopathogenesis of IBD is discussed in the context of current and emerging targeted therapies for moderate to severe disease.

Reference

1. Coskun M, Vermeire S, Nielsen OH. Novel targeted therapies for inflammatory bowel disease. Trends Pharmacol Sci. 2017;38(2):127-142.

Agenda

  • Chapter 1: Assessment Strategies and Treatment Goals in IBD
  • Chapter 2: Best Practices in Tailoring Treatment of Moderate and Severe IBD
  • Chapter 3: Evolving Concepts in IBD Pathophysiology
  • Chapter 4: Targeted Mechanism-Based Therapies for IBD on the Horizon

Faculty

Raymond K. Cross, MD, MS
Professor of Medicine
Director, Inflammatory Bowel Disease Program
University of Maryland School of Medicine
Co-Director, Digestive Health Center
University of Maryland Medical Center
Baltimore, MD


Gary R. Lichtenstein, MD
Professor of Medicine
Director, Center for Inflammatory Bowel Diseases
The Raymond and Ruth Perelman School of Medicine of the University of Pennsylvania
Hospital of the University of Pennsylvania
Gastroenterology Division, Department of Internal Medicine
Perelman Center for Advanced Medicine
Philadelphia, PA


Disclosure of Conflicts of Interest

Global Education Group (Global) requires instructors, planners, managers and other individuals and their spouse/life partner 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 spouse/life partner have with commercial interests related to the content of this CME activity:


Raymond K. Cross, MD, MS
  • Consultant/Independent Contractor: AbbVie Inc, Janssen, LabCorp, Pfizer, UCB
  • Grant/Research Support: AbbVie Inc

Gary R. Lichtenstein, MD
  • Consultant: AbbVie Inc., Celgene Corporation, Eli Lilly and Company, Ferring Pharmaceuticals Inc., Gilead Sciences, Inc., Janssen Pharmaceuticals, Inc., Luitpold Pharmaceuticals, Inc., Merck & Co., Pfizer Inc., Prometheus Laboratories Inc., Romark, L.C., Salix Pharmaceuticals, Inc., Shire Plc, Takeda Pharmaceuticals North America, Inc., UCB, Inc., Valeant Pharmaceuticals International, Inc.
  • Grant/Research Support: Celgene Corporation, Janssen Pharmaceuticals, Inc., Salix Pharmaceuticals, Inc., Shire Plc, UCB, Inc., Valeant Pharmaceuticals International, Inc.
  • Honoraria: American College of Gastroenterology, Clinical Advances in Gastroenterology, Gastroenterology and Hepatology (Gastro-Hep Communications, Inc.), Luitpold Pharmaceuticals, Inc., McMahon Publishing, Merck & Co., Romark, L.C., Springer Science+Business Media, UpToDate®
  • Other/Royalty: Eli Lilly and Company (Data and Safety Monitoring Board), Janssen Pharmaceuticals, Inc. (Funding for IBD Fellow Education to the University of Pennsylvania), Pfizer Inc. (Funding for IBD Fellow Education to the University of Pennsylvania), SLACK, Incorporated (Book Royalty), Takeda Pharmaceuticals North America, Inc. (Funding for IBD Fellow Education to the University of Pennsylvania)

The planners and managers reported no 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: Lindsay Borvansky, Andrea Funk, Liddy Knight, Kayla Messer, Jim Kappler, PhD, Julia Muino.

Designation of Credit

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.

Physician Credit Designation

Global Education Group designates this enduring activity for a maximum of 1.5 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Instructions to Receive Credit

In order to receive credit for this activity, the participant must complete the post-test and program evaluation. Your post-test will automatically be graded. If you successfully complete the post-test (score of 70% or higher), your statement of participation will be made available immediately.

Statement of Commercial Support

This activity is supported by an independent educational grant from Gilead Sciences, Inc.

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.

Contact Information for Questions About the Activity

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

A Multimedia Educational eHealth Source™

Activity Details

Free CME
1.5 AMA PRA Category 1 Credits
Released: January 17, 2019
Expires: January 17, 2020
1 hour, 30 mins to complete

Jointly Provided by

Target Audience

This activity is intended for clinical gastroenterologists and specialist NP/PAs involved in the treatment of patients with inflammatory bowel disease (IBD).

Learning Objectives

  • Evaluate disease risk and identify individuals who are likely to benefit from biologic or targeted synthetic therapy
  • Tailor management regimens for patients with inflammatory bowel disease (IBD) using a treat-to-target approach that reflects disease severity, treatment goals, therapeutic responses, and patient preferences
  • Partner with patients to provide IBD disease state education, promote shared clinical decision-making, encourage self-management efforts, and personalize long-term care
  • Discuss the cytokine networks underlying IBD pathophysiology, with a focus on newer mechanisms of action
  • Review mechanisms of current and novel non–tumor necrosis factor biologic and targeted synthetic therapies for the treatment of IBD

Activity Description

This activity presents an in-depth review of IBD patient care in moderate to severe disease, including immunopathogenesis of IBD, existing management options, shared decision-making, and investigational targeted therapies, via text and concise video commentaries provided by noted IBD experts

Statement of Educational Need

In the past 2 decades, the introduction of biologic therapies that target underlying disease processes has dramatically changed the treatment of the inflammatory bowel diseases (IBDs)—ulcerative colitis and Crohn’s disease. Current biologic therapy with tumor necrosis factor inhibitors and anti-integrins has improved the treatment of IBD flares and maintenance of clinical remission. These agents are, however, limited by primary nonresponse and loss of response in a substantial proportion of patients, disease relapse after cessation of therapy, immunogenicity, and adverse effects such as risk for infection and malignancy.1 As the pathogenesis and treatment of IBD are complex and variable, there is a need to better understand the underlying pathogenic mechanisms and develop drug therapies to target these mechanisms.1

Geared to the needs of gastroenterologists, this IBD eHealth program includes an update on patient assessment and treat-to-target goals, as well as a review of best practices in shared decision-making in treatment decisions for induction and maintenance of remission. In addition, the immunopathogenesis of IBD is discussed in the context of current and emerging targeted therapies for moderate to severe disease.

Reference

1. Coskun M, Vermeire S, Nielsen OH. Novel targeted therapies for inflammatory bowel disease. Trends Pharmacol Sci. 2017;38(2):127-142.

Agenda

  • Chapter 1: Assessment Strategies and Treatment Goals in IBD
  • Chapter 2: Best Practices in Tailoring Treatment of Moderate and Severe IBD
  • Chapter 3: Evolving Concepts in IBD Pathophysiology
  • Chapter 4: Targeted Mechanism-Based Therapies for IBD on the Horizon

Faculty

Raymond K. Cross, MD, MS
Professor of Medicine
Director, Inflammatory Bowel Disease Program
University of Maryland School of Medicine
Co-Director, Digestive Health Center
University of Maryland Medical Center
Baltimore, MD


Gary R. Lichtenstein, MD
Professor of Medicine
Director, Center for Inflammatory Bowel Diseases
The Raymond and Ruth Perelman School of Medicine of the University of Pennsylvania
Hospital of the University of Pennsylvania
Gastroenterology Division, Department of Internal Medicine
Perelman Center for Advanced Medicine
Philadelphia, PA


Disclosure of Conflicts of Interest

Global Education Group (Global) requires instructors, planners, managers and other individuals and their spouse/life partner 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 spouse/life partner have with commercial interests related to the content of this CME activity:


Raymond K. Cross, MD, MS
  • Consultant/Independent Contractor: AbbVie Inc, Janssen, LabCorp, Pfizer, UCB
  • Grant/Research Support: AbbVie Inc

Gary R. Lichtenstein, MD
  • Consultant: AbbVie Inc., Celgene Corporation, Eli Lilly and Company, Ferring Pharmaceuticals Inc., Gilead Sciences, Inc., Janssen Pharmaceuticals, Inc., Luitpold Pharmaceuticals, Inc., Merck & Co., Pfizer Inc., Prometheus Laboratories Inc., Romark, L.C., Salix Pharmaceuticals, Inc., Shire Plc, Takeda Pharmaceuticals North America, Inc., UCB, Inc., Valeant Pharmaceuticals International, Inc.
  • Grant/Research Support: Celgene Corporation, Janssen Pharmaceuticals, Inc., Salix Pharmaceuticals, Inc., Shire Plc, UCB, Inc., Valeant Pharmaceuticals International, Inc.
  • Honoraria: American College of Gastroenterology, Clinical Advances in Gastroenterology, Gastroenterology and Hepatology (Gastro-Hep Communications, Inc.), Luitpold Pharmaceuticals, Inc., McMahon Publishing, Merck & Co., Romark, L.C., Springer Science+Business Media, UpToDate®
  • Other/Royalty: Eli Lilly and Company (Data and Safety Monitoring Board), Janssen Pharmaceuticals, Inc. (Funding for IBD Fellow Education to the University of Pennsylvania), Pfizer Inc. (Funding for IBD Fellow Education to the University of Pennsylvania), SLACK, Incorporated (Book Royalty), Takeda Pharmaceuticals North America, Inc. (Funding for IBD Fellow Education to the University of Pennsylvania)

The planners and managers reported no 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: Lindsay Borvansky, Andrea Funk, Liddy Knight, Kayla Messer, Jim Kappler, PhD, Julia Muino.

Designation of Credit

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.

Physician Credit Designation

Global Education Group designates this enduring activity for a maximum of 1.5 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Instructions to Receive Credit

In order to receive credit for this activity, the participant must complete the post-test and program evaluation. Your post-test will automatically be graded. If you successfully complete the post-test (score of 70% or higher), your statement of participation will be made available immediately.

Statement of Commercial Support

This activity is supported by an independent educational grant from Gilead Sciences, Inc.

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.

Contact Information for Questions About the Activity

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

0.50 CME
Global Education Group
The Big Picture of IBD: An Interactive Experience Highlighting Clinical Advances

The Big Picture of IBD: An Interactive Experience Highlighting Clinical Advances

Start

Activity Details

Free CME
0.5 AMA PRA Category 1 Credits
Released: December 21, 2018
Expires: December 21, 2019
30 minutes to complete

Jointly Provided by

Target Audience

The educational design of this activity addresses the needs of Clinical gastroenterologists and specialist NP/PAs involved in the treatment of patients with IBD.

Learning Objectives

  • Explain the current understanding of the immuno-inflammatory pathways in irritable bowel disease (IBD) and the evolving role of JAK/STAT as a therapeutic target
  • Describe the treat-to-target approach of managing IBD
  • Distinguish between clinical profiles of current and emerging targeted synthetic agents for the treatment of IBD

Activity Description

This activity presents a review of immunopathogenesis of IBD, existing management options, and investigational targeted therapies through innovative infographic panels, which allow the learner to move through the activity at his or her own speed by delving into one concept presented in multiple layers of the panel.

Statement of Educational Need

The burden of inflammatory bowel diseases (IBD), of which Crohn’s disease and ulcerative colitis are the primary entities, is significant and wide ranging. IBD that is not well-controlled impairs quality of life, social activities, travel, and ability to work, leading to higher rates of absenteeism and permanent work disability.1,2 The idiopathic intestinal inflammation of IBD requires life-long treatment and accounts for enormous hospitalization costs. According to data from the U.S. National Inpatient Sample from 2004-2013, IBD was responsible for 97,865 hospitalizations in 2013 alone, with an annual hospitalization cost of $3.8 trillion.3 The 2015 National Health Interview Survey estimates that IBD affects 3.1 million Americans.4

Over the past two decades, the introduction of biologic therapies that target underlying disease processes has dramatically changed the treatment of IBD. Current biologic therapy with tumor necrosis factor-α (TNF) inhibitors (i.e., infliximab, adalimumab, golimumab, and certolizumab pegol) and anti-integrins (i.e., natalizumab and vedolizumab) has improved the treatment of IBD flares and maintenance of clinical remission. These agents are, however, limited by lack of response and loss of response in a substantial proportion of patients, relapse after cessation of therapy, and effects such as risk for malignancy and infection.5 As the pathogenesis and treatment of IBD are complex and variable, there is a need to better understand the underlying pathogenic mechanisms and develop drug therapies to target these mechanisms.5

Orally administered, conventional drugs may improve adherence compared with parenteral administration. New drugs may prove to have better efficacy, tolerability, cost-effectiveness, without a risk of immunogenicity. The oral JAK inhibitor tofacitinib was approved for use in ulcerative colitis in May 2018. Gastroenterologists can benefit from education that provides an update on the immunopathogenesis of IBD, a treat-to-target strategy of treatment, and data related to newer targeted synthetic agents.

1. Gunnarsson C, Chen J, Rizzo JA, Ladapo JA, Naim A, Lofland JH. The employee absenteeism costs of inflammatory bowel disease: evidence from US National Survey Data. J Occup Environ Med. 2013;55(4):393-401.
2. Moradkhani A, Beckman LJ, Tabibian JH. Health-related quality of life in inflammatory bowel disease: psychosocial, clinical, socioeconomic, and demographic predictors. J Crohns Colitis. 2013;7(6):467-473.
3. Lichtenstein G. Cost of Inpatient Care for IBD in the United States [abstract]. Am J Gastroenterol. 2016;11 (suppl 1):S310.
4. Dahlhamer JM, Zammitti EP, Ward BW, Wheaton AG, Croft JB. Prevalence of Inflammatory Bowel Disease Among Adults Aged >/=18 Years - United States, 2015. MMWR Morb Mortal Wkly Rep. 2016;65(42):1166-1169.
5. Coskun M, Vermeire S, Nielsen OH. Novel Targeted Therapies for Inflammatory Bowel Disease. Trends Pharmacol Sci. 2017;38(2):127-142.

Agenda

  • IBD: 2 distinct idiopathic diseases
  • Immunopathogenesis
  • The central role of the mucosal immune system
    • Focus on JAK/STAT pathway
  • Disease severity indices
  • Selecting therapeutic targets in IBD
  • Available advanced therapies for moderate and severe IBD
  • Targeted mechanism-based therapies for IBD
    • Investigational agents
    • Focus on JAK/STAT inhibitors
  • Conclusions

Faculty

Stephen B. Hanauer, MD
Clifford Joseph Barborka Professor of Medicine
Northwestern Feinberg School of Medicine
Medical Director, Digestive Health Center
Chicago, Illinois


Millie D. Long, MD, MPH
Associate Professor of Medicine
Director, Gastroenterology and Hepatology Fellowship Program
University of North Carolina at Chapel Hill
Division of Gastroenterology and Hepatology
Chapel Hill, North Carolina

Disclosure of Conflicts of Interest

Global Education Group (Global) requires instructors, planners, managers and other individuals and their spouse/life partner 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 spouse/life partner have with commercial interests related to the content of this CME activity:

Stephen B. Hanauer, MD

  • Consulting Fees: AbbVie, Actavis, Allergan, Amgen, Arena, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Celltrion, Ferring, Genentech, Gilead Sciences, Inc., GlaxoSmithKline, Hospira, Janssen Therapeutics, Eli Lilly and Company, Merck, Nestle, Novartis, Pfizer, Prometheus, Receptos, Salix Pharmaceuticals, Samsung Biocpis, Sanofi-Avantis, Seres Health, Shire, Takeda, Therakos, Tigenex, UCB Pharma, VHsquared
  • Contracted Research: AbbVie, Allergan, Amgen, Celgene, Genentech, GlaxoSmithKline, Janssen Therapeutics, Eli Lilly and Company, Novartis, Pfizer, Prometheus, Receptos, Sanofi-Aventis, Takeda, UCB Pharma
  • Data and Safety Monitoring Board: Bristol-Myers Squibb
  • Speaker: AbbVie, Janssen Therapeutics, Takeda

Millie D. Long, MD, MPH

  • Consultant/Independent Contractor: Pfizer, AbbVie, Takeda, UCB, Janssen, Target PharmaSolutions
  • Grant/Research Support:Pfizer, Takeda
  • Honoraria: AbbVie, UCB

The planners and managers reported the following 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:

Lindsay Borvansky
Nothing to disclose

Andrea Funk
Nothing to disclose

Liddy Knight
Nothing to disclose

Kayla Messer
Nothing to disclose

Jim Kappler, PhD
Nothing to disclose

Julia Muino
Nothing to disclose

Designation of Credit

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 Webcast for a maximum of 0.5 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 for Receiving Credit

In order to claim credit, participants must complete the following:

  • Read the educational objectives, accreditation information, and faculty disclosures at the beginning of this activity.
  • Complete the Pre-Activity Questions.
  • Read or review the activity content.
  • Complete the Post-Activity Test Questions and Evaluation.
  • Physicians, NPs and PAs who achieves a grade of 66% or better on the Post-Activity Test and who completes the Evaluation will receive a CME/CE Certificate.
  • All other participant who achieves a grade of 66% or better on the Post-Activity Test Questions and who completes the Evaluation will receive a Certificate of Participation.

Statement of Commercial Support

This activity is supported by an independent educational grant from Gilead Sciences, Inc.

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. 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.

Contact Information for Questions About the Activity

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

Activity Details

Free CME
0.5 AMA PRA Category 1 Credits
Released: December 21, 2018
Expires: December 21, 2019
30 minutes to complete

Jointly Provided by

Target Audience

The educational design of this activity addresses the needs of Clinical gastroenterologists and specialist NP/PAs involved in the treatment of patients with IBD.

Learning Objectives

  • Explain the current understanding of the immuno-inflammatory pathways in irritable bowel disease (IBD) and the evolving role of JAK/STAT as a therapeutic target
  • Describe the treat-to-target approach of managing IBD
  • Distinguish between clinical profiles of current and emerging targeted synthetic agents for the treatment of IBD

Activity Description

This activity presents a review of immunopathogenesis of IBD, existing management options, and investigational targeted therapies through innovative infographic panels, which allow the learner to move through the activity at his or her own speed by delving into one concept presented in multiple layers of the panel.

Statement of Educational Need

The burden of inflammatory bowel diseases (IBD), of which Crohn’s disease and ulcerative colitis are the primary entities, is significant and wide ranging. IBD that is not well-controlled impairs quality of life, social activities, travel, and ability to work, leading to higher rates of absenteeism and permanent work disability.1,2 The idiopathic intestinal inflammation of IBD requires life-long treatment and accounts for enormous hospitalization costs. According to data from the U.S. National Inpatient Sample from 2004-2013, IBD was responsible for 97,865 hospitalizations in 2013 alone, with an annual hospitalization cost of $3.8 trillion.3 The 2015 National Health Interview Survey estimates that IBD affects 3.1 million Americans.4

Over the past two decades, the introduction of biologic therapies that target underlying disease processes has dramatically changed the treatment of IBD. Current biologic therapy with tumor necrosis factor-α (TNF) inhibitors (i.e., infliximab, adalimumab, golimumab, and certolizumab pegol) and anti-integrins (i.e., natalizumab and vedolizumab) has improved the treatment of IBD flares and maintenance of clinical remission. These agents are, however, limited by lack of response and loss of response in a substantial proportion of patients, relapse after cessation of therapy, and effects such as risk for malignancy and infection.5 As the pathogenesis and treatment of IBD are complex and variable, there is a need to better understand the underlying pathogenic mechanisms and develop drug therapies to target these mechanisms.5

Orally administered, conventional drugs may improve adherence compared with parenteral administration. New drugs may prove to have better efficacy, tolerability, cost-effectiveness, without a risk of immunogenicity. The oral JAK inhibitor tofacitinib was approved for use in ulcerative colitis in May 2018. Gastroenterologists can benefit from education that provides an update on the immunopathogenesis of IBD, a treat-to-target strategy of treatment, and data related to newer targeted synthetic agents.

1. Gunnarsson C, Chen J, Rizzo JA, Ladapo JA, Naim A, Lofland JH. The employee absenteeism costs of inflammatory bowel disease: evidence from US National Survey Data. J Occup Environ Med. 2013;55(4):393-401.
2. Moradkhani A, Beckman LJ, Tabibian JH. Health-related quality of life in inflammatory bowel disease: psychosocial, clinical, socioeconomic, and demographic predictors. J Crohns Colitis. 2013;7(6):467-473.
3. Lichtenstein G. Cost of Inpatient Care for IBD in the United States [abstract]. Am J Gastroenterol. 2016;11 (suppl 1):S310.
4. Dahlhamer JM, Zammitti EP, Ward BW, Wheaton AG, Croft JB. Prevalence of Inflammatory Bowel Disease Among Adults Aged >/=18 Years - United States, 2015. MMWR Morb Mortal Wkly Rep. 2016;65(42):1166-1169.
5. Coskun M, Vermeire S, Nielsen OH. Novel Targeted Therapies for Inflammatory Bowel Disease. Trends Pharmacol Sci. 2017;38(2):127-142.

Agenda

  • IBD: 2 distinct idiopathic diseases
  • Immunopathogenesis
  • The central role of the mucosal immune system
    • Focus on JAK/STAT pathway
  • Disease severity indices
  • Selecting therapeutic targets in IBD
  • Available advanced therapies for moderate and severe IBD
  • Targeted mechanism-based therapies for IBD
    • Investigational agents
    • Focus on JAK/STAT inhibitors
  • Conclusions

Faculty

Stephen B. Hanauer, MD
Clifford Joseph Barborka Professor of Medicine
Northwestern Feinberg School of Medicine
Medical Director, Digestive Health Center
Chicago, Illinois


Millie D. Long, MD, MPH
Associate Professor of Medicine
Director, Gastroenterology and Hepatology Fellowship Program
University of North Carolina at Chapel Hill
Division of Gastroenterology and Hepatology
Chapel Hill, North Carolina

Disclosure of Conflicts of Interest

Global Education Group (Global) requires instructors, planners, managers and other individuals and their spouse/life partner 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 spouse/life partner have with commercial interests related to the content of this CME activity:

Stephen B. Hanauer, MD

  • Consulting Fees: AbbVie, Actavis, Allergan, Amgen, Arena, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Celltrion, Ferring, Genentech, Gilead Sciences, Inc., GlaxoSmithKline, Hospira, Janssen Therapeutics, Eli Lilly and Company, Merck, Nestle, Novartis, Pfizer, Prometheus, Receptos, Salix Pharmaceuticals, Samsung Biocpis, Sanofi-Avantis, Seres Health, Shire, Takeda, Therakos, Tigenex, UCB Pharma, VHsquared
  • Contracted Research: AbbVie, Allergan, Amgen, Celgene, Genentech, GlaxoSmithKline, Janssen Therapeutics, Eli Lilly and Company, Novartis, Pfizer, Prometheus, Receptos, Sanofi-Aventis, Takeda, UCB Pharma
  • Data and Safety Monitoring Board: Bristol-Myers Squibb
  • Speaker: AbbVie, Janssen Therapeutics, Takeda

Millie D. Long, MD, MPH

  • Consultant/Independent Contractor: Pfizer, AbbVie, Takeda, UCB, Janssen, Target PharmaSolutions
  • Grant/Research Support:Pfizer, Takeda
  • Honoraria: AbbVie, UCB

The planners and managers reported the following 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:

Lindsay Borvansky
Nothing to disclose

Andrea Funk
Nothing to disclose

Liddy Knight
Nothing to disclose

Kayla Messer
Nothing to disclose

Jim Kappler, PhD
Nothing to disclose

Julia Muino
Nothing to disclose

Designation of Credit

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 Webcast for a maximum of 0.5 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 for Receiving Credit

In order to claim credit, participants must complete the following:

  • Read the educational objectives, accreditation information, and faculty disclosures at the beginning of this activity.
  • Complete the Pre-Activity Questions.
  • Read or review the activity content.
  • Complete the Post-Activity Test Questions and Evaluation.
  • Physicians, NPs and PAs who achieves a grade of 66% or better on the Post-Activity Test and who completes the Evaluation will receive a CME/CE Certificate.
  • All other participant who achieves a grade of 66% or better on the Post-Activity Test Questions and who completes the Evaluation will receive a Certificate of Participation.

Statement of Commercial Support

This activity is supported by an independent educational grant from Gilead Sciences, Inc.

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. 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.

Contact Information for Questions About the Activity

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