Free CME

Activity Description / Statement of Need:
In this online, self-learning activity:

Age-related macular degeneration (AMD) is the most common cause of blindness in individuals over the age of 50 years. In the early stages of disease, vision may be gray, hazy, or distorted. As the disease progresses, retinal deterioration can lead to irreversible, bilateral loss of central vision. In the US alone, an estimated 18.3 million people are living with early-stage ARMD, and 1.5 million people are living with late-stage AMD, representing 11.6% and 0.9% of all adults older than 40 years, respectively. In addition to the burden of disability caused by blindness, AMD is also associated with substantial societal and economic costs. In the US, vision loss and blindness incur an economic burden of $134 billion annually, of which $36 billion is attributable to indirect costs such as loss of productivity, injury, and unemployment.

Target Audience:
The following HCPs: comprehensive ophthalmologists and retinal specialists; physician assistants, and nurse practitioners who practice in ophthalmology; and any other HCPs with an interest in or who clinically encounter patients with AMD.

Activity Description / Statement of Need:

In this online, self-learning activity:

Glaucoma, a heterogeneous disease leading to progressive damage to the optic nerve, causes irreversible vision loss and affects approximately 64 million people worldwide.The prevalence of glaucoma is increasing, and more than 100 million people will have glaucoma by 2040. Approximately half of all individuals with glaucoma are unaware of their condition due to the asymptomatic nature of the disease. Although the incidence of glaucoma-related blindness has decreased over the last 20 years, thanks to effective management strategies, 13% to 40% of people with glaucoma still develop unilateral or bilateral blindness, typically at a rate of 1.1% per year.

Target Audience:

The following healthcare professionals: ophthalmologists; physician assistants, nurse practitioners,  and any other healthcare professionals with an interest in or who clinically encounter patients with glaucoma.

Activity Description / Statement of Need:
In this online, self-learning activity:

Transthyretin-mediated amyloidosis (ATTR) is a progressive, multisystem, life-threatening disorder characterized by the extracellular deposition of misfolded, insoluble amyloid fibrils. The role of the TTR protein is to transport thyroxine and retinol-binding proteins, and it is vital for cognition, nerve regeneration, and axonal growth. TTR itself is innately amyloidogenic even without the presence of genetic mutations, which may account for wild-type ATTR (wtATTR), while a hereditary form of ATTR (hATTR) may be passed to offspring through autosomal dominant inheritance. 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, and pharmacists in the aforementioned areas of specialty; and any other HCPs with an interest in or who may clinically encounter patients with ATTR.

Alzheimer Disease (AD) is a degenerative disease that most commonly affects the elderly, although it is occasionally detected as early as middle age. AD accounts for over half of all diagnosed dementia, the prevalence of which is increasing. Once there is a diagnosis of probable AD, one must determine which pharmacotherapy, if any, is most appropriate for treatment of the patient. The literature suggests that gaps in care on the part of healthcare professionals exist. While some physicians continue to use the antiquated, nonspecific term “senile dementia” as a descriptive diagnosis of AD, perhaps suggesting a lack of understanding of the gravity of the disease state or its associated pathophysiology, other report feeling uncertain at times about now to best diagnosis of the disease, particularly in its very early stages. Moreover, a number of different practice guidelines have been updated recently, and HCPs are often unable to keep up with the publishing of literature and evolution of clinical practice.

Target Audience:

Healthcare professionals specializing in: neurology, gerontology, internal medicine, palliative care, or those who otherwise commonly care for patients with AD or who frequently encounter them or their caregivers in practice.

By the end of the session the participant will be able to:

• Describe what is presently known about the pathophysiology of AD.
• Describe the challenges associated with diagnosis and treatment of ADDiscuss the neuropathophysiology of AD and how it relates to presently available AD treatments mechanisms.
• Identify the present treatment options currently available for management of AD and apply them to patient cases using evidence-based medicine.
• Describe emerging drug therapies in the treatment of AD.
• Evaluate a treatment plan for a specific patient based on degree of AD to optimize safety and efficacy, suggesting modifications for improvement.

Biosimilar drugs are products meant to be similar in quality, safety, and efficacy to an already licensed reference biotherapeutic product. Whereas generics are virtually identical replicas of conventional medications, biosimilars are not the same as the original product – a practically unavoidable outcome because of the considerably large molecular structure that biologics mimic. The literature suggests that learning activities focused on the evolving landscape of biosimilars, which are germane to the therapeutic area because of their potential role in cost containment. Both the FDA and medical literature independently affirm the need for clinician education on biosimilars, including:  comparative efficacy; adverse event rates and management (potential concerns have included immunogenicity); regulatory guidance on interchangeability and substitution – including prescribers retaining some degree of ability to intervene in a product’s substitution at the dispensing stage; and cost considerations.

Target Audience:

The following healthcare professionals: Rheumatologists, gastroenterologists, and primary care physicians; physician assistants, nurse practitioners, and pharmacists who practice in the aforementioned areas of specialty; and any other healthcare professionals with an interest in or who clinically encounter patients with the inflammatory disease states covered by this activity.

By the end of the session the participant will be able to:

• Describe biosimilar drugs, how they differ from generic drugs, the FDA process for their approval.
• Describe practical considerations the clinician needs when determining whether to consider when deciding whether substituting or allowing the substitution of a biosimilar medication for its reference medication, and apply them to patient case(s).
• Describe how biosimilars for inflammatory health conditions are impacting the treatment landscape with respect to number of treatment options, affordability, and safety considerations.
• Identify the currently available and emerging pharmacotherapeutic treatments for management of inflammatory health conditions and apply them to patient cases using evidence-based medicine.
• Describe strategies for helping patients understand the implications of using biosimilars.

Activity Description / Statement of Need:

In this online, self-learning activity:

Immune thrombocytopenia (ITP) is a phenomenon characterized by a peripheral platelet count of less than 100 x 109/L in the absence of any discernable cause, with an increased risk of bleeding. Also known as thrombocytopenic purpura, it occurs in around two to four cases per 100,000 adults, with incidence peaking bimodally: Once between 20-30 years with female predominance and also at 60 years with even distribution between the sexes.

The diagnosis of ITP is one of exclusion and includes platelet autoantibody testing. However, it is complicated and associated with documented gaps in care, with preventable delays in diagnosis and misdiagnosis not uncommon. One study found that one in seven patients diagnosed with ITP were misdiagnosed and reclassified as they received additional clinical evaluation. Another study found that over 22% of patients with ITP did not receive guideline-recommended peripheral blood film examination. These diagnostic challenges have real-world consequences on patient lives, creating anxiety in 73% of patients who experience a delayed diagnosis.

Treatment goals include prevention of severe bleeding episodes, maintaining platelet counts for symptomatic patients, minimizing treatment toxicity, and maximizing health-related quality of life. Conventional therapy includes corticosteroids, intravenous immunoglobulin (IVIg), and anti-D IVIg. However, treatment challenges remain, including variability in practice between providers and high rates of relapse between following standard first-line therapies together with considerable patient frustration. Moreover, some patient subpopulations are more challenging to treat and are less likely to achieve therapeutic success.

Target Audience:

HCPs specializing in: hematology; physician assistants, nurse practitioners, nurses, pharmacists; and any other healthcare professionals with an interest in or who clinically encounter patients with ITP.

Activity Description / Statement of Need:
In this online, self-learning activity:

Helicobacter pylori (H. pylori) infection is one of the most common infections in the world, affecting approximately 50% of the world’s population and 36% of the U.S. population, with a higher prevalence in Blacks, Hispanics, and those of lower socioeconomic status. Most patients are asymptomatic, but H. pylori is the major cause of gastritis and peptic ulcer disease, and it is a risk factor for duodenal ulcers and gastric cancer. H. pylori may be diagnosed by endoscopy or noninvasive testing, including urea breath testing, stool antigen assay, or H. pylori serology.

Target Audience:
HCPs including: gastroenterologists and primary care providers; physician assistants, nurse practitioners, and pharmacists specializing in gastroenterology; and any other HCPs involved or interested in the treatment of H. pylori infection.

Activity Description / Statement of Need:
In this online, self-learning activity:

Acute hepatic porphyria (AHP) is an umbrella term for four types of acute porphyria, the most severe of which is acute intermittent porphyria (AIP). An estimated 80% of AHP cases are AIP, which is an inherited autosomal dominant condition that results from mutations of the third enzyme of heme synthesis, porphobilinogen deaminase. In the Western countries, it is estimated that approximately 1 in 2000 individuals are carriers of the relevant mutated genotype, although the majority have latent AIP and are clinically asymptomatic. Acute attacks occur in less than 10% of the at-risk population, reflecting the role of environmental factors, such as alcohol use, infections, and hormonal changes, among others. AHP symptoms are believed to be caused by ALAS1-mediated accumulation of ALA and PBG in the liver and bloodstream, leading to neurotoxicity.

Target Audience:
The following HCPs: hematologists and gastroenterologists; physician assistants, nurse practitioners, and pharmacists who practice in any of the aforementioned areas of specialties; and any other healthcare professionals with an interest in or who clinically encounter patients with AHP.

Antimicrobial resistance (AMR) is a phenomenon fueled by the selection pressure leveled against microorganisms through the use and misuse of antimicrobials in clinical and agricultural settings as well as horizontal gene transfer between pathogens. The WHO predicts that there will be 50 million deaths caused by infectious diseases, and the U.N. General Assembly has designated the emergence of AMR the largest world health problem.

The World Health Assembly has endorsed a Global Action Plan on Antimicrobial Resistance, including one step to address AMR: the sustainable investment in and development of new antimicrobials. Helping the clinician discern the role of these advances merits continuing healthcare professional education, as research suggests that HCPs are oftentimes unable to keep up with the steady publishing of literature and evolution of clinical practice. In so doing, the goal is to educate clinicians about the appropriate role of novel antibiotics so that they may more effectively address the challenge of AMR rather than contributing to it.

Target Audience:

HCPs specializing in: Infectious disease, critical care, and primary care; physician assistants, nurse practitioners, nurses, and pharmacists who practice in the aforementioned areas of specialty; and any other healthcare professionals with an interest in or who treat patients with antimicrobials.

By the end of the session the participant will be able to:

• Identify key findings from the ID Week 2019 conference.
• Apply the changes in CAP guidelines 2019 from 2007.
• Identify novel drugs approved in 2019 and their potential.
• Understand the implications of some current research and paradigm shifts.
• Review HIV progress in the last year.

Activity Description / Statement of Need:

In this online, self-learning activity:

Paroxysmal nocturnal hemoglobinuria (PNH) is an acquired, hematopoietic stem cell disorder characterized by complement-mediated destruction and loss of erythrocytes and the eponymous clinical manifestation of pink-red discoloration of the urine due to presence of hemoglobin. PNH is a rare disorder with a reported incidence of clinically significant disease of between 1 to 2 cases per million. However, it is possible that this range may be underestimated, as a subset of patients remain undiagnosed. PNH occurs worldwide with no known specific ethnic or geographic distribution patterns.

Approximately 40% of patients with PNH saw at least five or more specialists before receiving a diagnosis. PNH diagnosis is complicated by the rarity of the disorder and the nonspecific findings, meriting continuing healthcare educational programming.

Target Audience:

The following healthcare professionals: Hematologists; physician assistants, nurse practitioners, and pharmacists specializing in hematology and transplant medicine; and any other healthcare professionals with an interest in or who may clinically encounter patients with PNH.