Free CME

Activity Description / Statement of Need:

In this online, self-learning activity:

Cardiovascular (CV) disease (CVD) is the leading cause of mortality and morbidity in adults worldwide, accounting for around one-third of mortality in the United States. High blood pressure, diabetes, and obesity are health conditions that can increase the risk of heart disease, and over half of American adults have at least one major risk factor for adverse cardiovascular events. In particular, T2DM is a risk factor, with CV events implicated in the mortality of two-thirds of patients with T2DM. About one and a half million new cases of diabetes mellitus are diagnosed in in the United States each year, and the incidence of T2DM is increasing owing in part to Western-style diets, sedentary lifestyle, and changing demographics, and the disease is the largest contributor to a number of vascular outcomes, including end-stage chronic kidney disease (CKD) and blindness in individuals under age 75. CKD is itself a major CVD risk factor and affects millions, yet the literature shows that patients with CKD are underserved with respect to CV risk reduction efforts.

This activity has been proposed to enhance the knowledge, competence, and performance of several members of HCPs in mitigating heart and kidney disease risk in patients with T2DM while addressing barriers to optimal care.

Target Audience:

The following HCPs: Endocrinologists, nephrologists, cardiologists, and primary care physicians; certified diabetes educators, physician assistants, nurse practitioners, nurses, and pharmacists who practice in diabetes and endocrinology; and any other HCPs with an interest in or who clinically encounter patients with diabetes.

Activity Description / Statement of Need:

In this online, self-learning activity:

Transthyretin amyloidosis (ATTR) is a progressive, multisystem, life-threatening disorder characterized by the extracellular deposition of misfolded, insoluble amyloid fibrils. As TTR is a protein present in human serum, and its role is to transport thyroxine and retinol-binding proteins, it is vital for behavior, cognition, nerve regeneration, and axonal growth. TTR itself is innately amyloidogenic even without the presence of genetic mutations. The familial variant of the disease (hATTR) is ATTR that is passed to offspring through autosomal dominant inheritance, whereas the wild type variant (wtATTR) refers to ATTR that occurs independently of genetic mutations. hATTR may present as late as mid-adulthood, but its symptoms usually start between the ages of 2 and 10 years. Left untreated, the average life expectancy of ATTR is 3 to 15 years from symptom onset.

Target Audience:

The following HCPs: neurologists, cardiologists, and hematologists; physician assistants, nurse practitioners, nurses, and pharmacists in the aforementioned areas of specialty; and any other HCPs with an interest in or who may clinically encounter patients with ATTR.

Activity Description / Statement of Need:

In this online, self-learning activity:

Pompe disease (PD) is a progressive, often fatal, autosomal recessive, neuromuscular disorder caused by mutations of the α-glucosidase gene on chromosome 17. PD is characterized by glycogen accumulation in skeletal, cardiac and smooth muscles due to a deficiency in α-glucosidase (GAA), an important lysosomal enzyme responsible for glycogen catabolism. PD is categorized into three groups based on symptoms and age of onset. The classic infantile form presents in the first year of life, usually in the first two months, with hypertrophic cardiomyopathy. The non-classic infantile form presents later in the first year of life, without or with less severe cardiomyopathy. The late onset form of PD presents any time after one year of life, usually without cardiac complications.

PD is rare, with one study estimating the incidence in the U.S. to be 1 in 22,000 births. The biggest risk factor for the disease is genetics; at conception, each sibling of an affected individual has a 25% chance of being affected, a 50% chance of being an asymptomatic carrier, and a 25% chance of being not a carrier. Nonspecific diagnostic findings for PD may include abnormal EMG, elevated serum creatine kinase, elevated transaminases and elevated lactate dehydrogenase. A definitive diagnosis for PD involves a dried blood spot test to determine GAA enzyme activity level; reduced GAA activity (less than 40% of normal) is indicative of a positive diagnosis. A gene mutation analysis, or another GAA enzyme test using a different area of tissue, is recommended to confirm the diagnosis. The disease is not uncommonly undiagnosed or is misdiagnosed, representing one practice gap that continued HCP education may address, particularly given that earlier treatment may minimize rapid and irreversible disease progression.

Target Audience:

The following HCPs: Neurologists, pediatricians, and primary care physicians; physician assistants and nurse practitioners in those areas of specialty; pharmacists who practice in specialty pharmacies that treat patients with rare diseases; and any other HCPs with an interest in or who may clinically encounter patients with PD.

Activity Description / Statement of Need:

In this online, self-learning activity:

Thalassemias are a group of recessively inherited blood disorders characterized by little or no hemoglobin production and chronic anemia of varying severity. Beta-thalassemia (BT) is most commonly found in people of Mediterranean, Middle Eastern, Asian, and North African descent. Worldwide, 1.5% of people are BT carriers, with about 40,000 infants born with BT annually. About half of patients with BT are transfusion-dependent, which may significantly impact patient quality of life. BT is caused by a point mutation in the gene encoding hemoglobin subunit beta (HBB), resulting in either lower beta-globin production (termed beta-plus [B⁺]) or the prevention of all beta-globin production (termed beta-zero [B⁰]). Disease severity depends on the extent of hemoglobin β and γ chain imbalance.

Target Audience:

The following HCPs: hematologists; physician assistants, nurse practitioners, and pharmacists who practice in hematology; and any other healthcare professionals with an interest in or who may clinically encounter patients with beta-thalassemia.

Activity Description / Statement of Need:

In this online, self-learning activity:

Neonatal respiratory distress syndrome (RDS) occurs in an estimated five to seven percent of term births and up to 90% of preterm births. The risk for neonatal RDS decreases with increasing gestational age,  such that at a gestational age of 37 weeks, the risk has fallen to just three times that of a full-term infant. In addition to premature birth, risk factors for neonatal RDS include maternal gestational diabetes, male sex, multiparity, abnormal fetoplacental circulation, fetal distress, Cesarean delivery, and low birth weight. The ability for the clinician to recognize neonatal RDS is a documented practice gap, and failure to do so is associated with mortality and complications that may include respiratory failure in the short-term and chronic lung disease in the long-term.

Target Audience:

The following healthcare professionals: neonatologists; physician assistants, nurse practitioners, nurses, and pharmacists who practice in neonatology; and any other healthcare professionals with an interest in or who clinically encounter patients with neonatal RDS.  

Activity Description / Statement of Need:

In this online, self-learning activity:

 Chronic kidney disease (CKD) affects about 15% of the general population in the United States and is the tenth-leading cause of death, accounting for 52,260 deaths in 2020. Along with the risk for end-stage kidney disease (ESKD) and cardiovascular disease (CVD), CKD has also been associated with a number of complications, including anemia and hyperphosphatemia. Anemia occurs in about 15% of patients with CKD and arises from decreased erythropoiesis and abnormal iron metabolism. Hyperphosphatemia occurs in the later stages of CKD because the kidney is the primary method by which the body maintains phosphate. This retention of phosphate leads to the development of CKD-mineral bone disorder (CKD-MBD), with the literature suggesting that hyperphosphatemia occurs in a large portion of patients on dialysis based on phosphate binder (PB) usage.

This learning activity has been designed to bring HCPs’ knowledge of the treatment and screening of anemia and hyperphosphatemia in patients with CKD up to date and to improve their competence and performance in treating it. It will walk participants through treatment pathways and review of the evidence behind therapies to treat CKD’s complications.

Target Audience:

The following HCPs: nephrologists and primary care physicians; physician assistants, nurse practitioners, and pharmacists who practice in nephrology; and any other HCPs with an interest in or who clinically encounter patients with CKD.

Activity Description / Statement of Need:

In this online, self-learning activity:

Irritable bowel syndrome (IBS) is among the most common disorders seen by primary care as well as gastroenterology specialty clinics. Patients with IBS usually present with chronic abdominal pain and altered bowel habit, in the absence of any other disease to cause these sorts of symptoms. The disorder is associated with annual healthcare expenditures of $20 billion and significant costs in lost work productivity and health-related quality-of-life.

Although not uncommon, there is still much that is unknown about IBS-C, and its diagnosis has largely remained dependent on symptom-based criteria with their share of limitations.

This activity has been designed to update HCPs’ knowledge of IBS-C and to improve their competence and performance in treating it.

Target Audience:

The following HCPs: Gastroenterologists and primary care physicians; physician assistants, nurse practitioners, and pharmacists who practice in gastroenterology; and any other HCPs with an interest in or who clinically encounter patients with IBS-C.

The Evolution of Insulin Replacement Therapy consists of 4 presentations with discussion:
• Session 1: Insulin Options for Diabetes: Update on their Evolution
• Session 2: Advancing to Insulin Therapy for Type 2 Diabetes: The Impact of the New Insulin Options
• Session 3: Physiologic Insulin Replacement: Practical Approaches for the Primary Care Provider
• Session 4: The Evolution of Glycemic Monitoring and Insulin Delivery Devices: Why the Primary Care Provider Should Understand the Options

At the conclusion of The Evolution of Insulin Replacement Therapy, you will be able to:
• Identify clinically relevant pharmacokinetic and pharmacodynamic properties of the new insulins and insulin combinations
• Discuss the clinical importance of similarities and differences between a biosimilar insulin and a reference insulin
• Recognize the indications for advancement to insulin replacement therapy for people with T2DM
• Identify clinically relevant pharmacokinetic and pharmacodynamic properties of the new insulins and insulin combinations
• Describe initiation and titration methods for new insulin-based therapies to optimize achievement of glycemic goals while minimizing adverse effects
• Discuss strategies to overcome patient and clinician barriers to the successful initiation and utilization of insulin therapy in the context of the new insulin-based therapies, and monitoring and delivery devices

Target Audience:
This program is intended for US-based primary care providers, clinical endocrinologists/diabetologists, nephrologists, cardiologists, emergency department specialists, pharmacists, and other clinicians caring for patients with type 2 diabetes mellitus (T2DM).

Treatment Updates on Chronic Inflammatory Demyelinating Polyneuropathy emphasizes the use of IVIg in the treatment of Chronic Inflammatory Demyelinating Polyneuropathy.

The presentation consists of a single lecture, Treatment Updates on Chronic Inflammatory Demyelinating Polyneuropathy, with discussion by Roy L. Freeman, MD, Richard J. Barohn, MD and Kenneth C. Gorson, MD.

After viewing Treatment Updates on Chronic Inflammatory Demyelinating Polyneuropathy, you will be better able to :
• Conduct a thorough and timely evaluation and differential diagnosis of patients with chronic inflammatory demyelinating polyneuropathy.
• Devise appropriate treatment regimen for the effective management of chronic inflammatory polyneuropathy based on guidelines and clinical evidence.

Target Audiences:
This program is intended for US-based neurologists, immunologists, physician assistants, nurse practitioners, and nurses who manage, or have an interest in managing patients with immune-mediated neuropathies.

Activity Description / Statement of Need:

In this online, self-learning activity:

Beta-thalassemia (BT) is a progressive, hereditary, microcytic, hypochromic form of anemia characterized by the reduced synthesis of hemoglobin subunit beta and the underproduction of hemoglobin A (HbA). Although there are limited data regarding the incidence of BT, historical estimates of BT have been placed at about 1 in 100,000 individuals. BT is most commonly found in patients with Mediterranean, the Middle Eastern, Central Asian, Indian, East Asian, and the North African heritage. BT is caused by a point mutation in the encoding gene for hemoglobin subunit beta (HBB) on chromosome 11, which either results in lower beta-globin production (termed beta-plus [B⁺] or prevent cells from producing any beta-globin at all (termed beta-zero [B⁰]). The clinical severity the disease depends on the extent of β and γ chain imbalance; more than 350 genetic alterations that can cause BT have been identified.

There is a demonstrated variation in treatment between providers who practice at a beta thalassemia center of excellence (CoE) and those who do not, and those practitioners at CoEs demonstrate greater familiarity with beta thalassemia and its therapies, including butyrates, gene therapy, and luspatercept. Additional areas of educational need include transitioning patients from pediatric care, management of complications, and clinical trial updates.

Target Audience:

The following healthcare professionals: hematologists; physician assistants, nurse practitioners, and pharmacists who practice in hematology; and any other healthcare professionals with an interest in or who may clinically encounter patients with BT.