Seminar in advanced rheumatology: selected proceedings of a live symposium held March, 2008 bulletin of the NYU hospital for joint diseases

Bulletin of the NYU Hospital for Joint Diseases, Sept, 2008

Supported by educational grants from: Amgen & Wyeth Pharmaceuticals; Bristol-Myers Squibb; Centocor, Inc.; Genentech/Biogen IDEC; Roche Laboratories

Target Audience

This program is intended for physicians and allied healthcare professionals in the fields of rheumatology, orthopedics and internal medicine.

Statement of Need

New therapies are available for rheumatoid arthritis (e.g., TNF blockers. Additional therapeutic strategies (e.g., new approaches to TNF blockade, IL-6-targeted therapy) appear poised to be introduced in the foreseeable future. There is a need for physicians to understand the proper use of the newer treatments, particularly when used in combination with existing disease modifying treatments. Fibromyalgia is a common and frequently debilitating disease. To date, therapy for fibromyalgia has been off-label and largely empirically-based. Recently the FDA approved the first drug for fibromyalgia. There is a need for physicians to understand the pathophysiology of fibromyalgia as well as the best practices for treating the condition, including the use of pregabalin vs older, off-label therapies. Osteoarthritis afflicts approximately 40 million Americans, but currently available therapies are analgesic and/or palliative. New insights into the pathophysiology of osteoarthritis raise the possibility of developing disease-modifying agents. Physicians treating OA patients need to know the best current practices for OA therapy, and recognize the implications of current research on future therapies. The pathophysiology and recommended treatments for childhood arthritides differ from those for adult patients, and new treatments for pediatric arthritides are available whose use may differ from their use in adult populations. Rheumatologists treating children with arthritis need to be knowledgeable about both well-established and newly-available therapies. Skin involvement in lupus presents with a wide range of potential findings, but since rheumatologists are not formally trained in dermatology, they may not always recognize the rashes of lupus or know the best treatments for these conditions. Giant cell arteritis is a form of vasculitis that carries a risk of disastrous outcomes including blindness. While steroids are effective in many patients, some patients respond poorly or fail to tolerate the treatment. For these patients, there is a strong need for better insights into, and approaches for, vasculitis management.

Educational Objectives

* recognize the new therapies available for the treatment of rheumatoid arthritis and develop individualized treatment plans to ameliorate symptoms, improve joint function and slow disease progression;

* distinguish between the currently available therapies for fibromyalgia, and based on best-practice data, develop decision making protocols for optimizing therapy for individual patients;

* apply knowledge of osteoarthritis pathophysiology and therapeutic best-practices to develop treatment plans that provide optimum benefit with minimal risk to specific patients;

* recognize the indications and contraindications for both established and newer therapies available for the treatment of pediatric arthritis, and develop a treatment plan for the safe, appropriate and effective treatment of pediatric arthritis patients;

* identify specific rash types on lupus patients, and treat and monitor appropriately with the most effective medications;

* identify patients who are failing or are likely to fail conventional therapy for giant cell arteritis, and institute appropriate alternative treatments.

Accreditation Statement

The NYU Post-Graduate Medical School is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Credit Designation Statement

The NYU Post-Graduate Medical School designates this educational activity for a maximum of 7 AMA PRA Category 1 CreditsTM. Physicians should only claim credits commensurate with the extent of their participation in the activity.

Method of Participation

To receive up to 7 CME credits, read this supplement, which should take 7 hours of your time, complete the post-test with a minimum passing grade of 70%, complete the evaluation, and submit to the NYU Post-Graduate Medical School (instructions enclosed).

This activity is valid for credit from October 15, 2008 through October 14, 2009.

Faculty Credentials

Steven B. Abramson, MD

Professor of Medicine and Pathology

NYU School of Medicine

New York, NY

Clifton Bingham, MD

Professor of Medicine

Johns Hopkins University School of Medicine

Baltimore, MD

Lindsey Criswell, MD

Professor of Medicine

University of California San Francisco

San Francisco, CA

Gary Hoffman, MD

Professor of Medicine

Cleveland Clinic Foundation

Cleveland, OH

Stephen Honig, MD

Clinical Associate Professor of Medicine

NYU School of Medicine

New York, NY

David Hunter, MD

Professor of Medicine

Boston University School of Medicine

Boston, MA

Michael Lockshin, MD

Professor of Medicine

Weill Medical College of Cornell University