Advancing the Art and Science of Psoriasis and Psoriatic Arthritis Management

Program Description:

Effective management of psoriasis and psoriatic arthritis must take individual patient characteristics, comorbid diseases, access to treatment, and disease severity—as well as patient preferences—into consideration. This Biologic Bulletin reviews safety issues and efficacy data for traditional systemic therapies and biologic agents based on guidelines from the American Academy of Dermatology.

UPDATE: Since publication and release of this activity, all promotion, manufacturing, distribution, and sales of alefacept have been discontinued in the United States.

INTENDED AUDIENCE:

This educational activity has been designed to meet the current educational needs of dermatologists, dermatology nurses, nurse practitioners, physician assistants, and other health care professionals involved in the care of patients with moderate to severe psoriasis or psoriatic arthritis.

MEDIA:

The Internet and a print publication were selected as the instructional formats to accommodate the learning preferences of a significant portion of the target audience.

Activity Objectives:

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

• Outline appropriate, individualized treatment strategies in accordance with evidence-based recommendations


• Integrate into practice strategies for managing safety-related issues in patients receiving long-term therapy with traditional and biologic systemic agents


• Evaluate evidence-based data for new therapies used to treat psoriasis and psoriatic arthritis


• Distinguish comorbid conditions that can affect the treatment of patients with moderate to severe psoriasis or with psoriatic arthritis


• Implement strategies for managing a diverse set of patients with psoriasis that include consideration of comorbid disease and concomitant conditions

Credits	Type	Accreditation Statement	Designation Statement
1.00	AMA PRA Category 1 Credit(s)TM	The University of Chicago Pritzker School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.	The University of Chicago Pritzker School of Medicine designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. The American Academy of Physician Assistants and the American Academy of Nurse Practitioners accept certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by the ACCME.
1.00	CE for Nurses	The Dermatology Nurses’ Association (DNA) is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s (ANCC) Commission on Accreditation.	Provider approved by the California Board of Registered Nursing (CBRN), Provider Number CEP5708. Accreditation refers to educational content only and does not imply ANCC, CBRN, or DNA endorsement of any product or service.

Faculty:

Steering Committee
Alan Menter, MD—Program Chair
Jerry Bagel, MD
Kenneth B. Gordon, MD
Kristine Kucera, DHS, MPAS, PA-C
Melodie Young, MSN, RN, A/GNP-C

Editors
Jerry Bagel, MD
Director, Psoriasis Treatment Center of Central New Jersey
Clinical Associate Professor of Dermatology
College of Physicians & Surgeons of Columbia University
New York, New York

Kristine Kucera, DHS, MPAS, PA-C
Adjunct Clinical Professor
University of Texas Southwestern Medical Center
Physician Assistant
Dermatology Center of Frisco
Dallas, Texas

Author
Curatio CME Institute

Disclosures:

In accordance with the ACCME Standards for Commercial Support, all CME providers are required to disclose to the activity audience the relevant financial relationships of everyone in a position to control content of an educational activity. A relevant financial relationship is a relationship in any amount occurring in the last 12 months with a commercial interest whose products or services are discussed in the CME activity content over which the individual has control. Relationship information appears below:

Jerry Bagel, MD, has disclosed the following relevant financial relationships:
Speaker, Clinical Trial: Abbott, Amgen, Janssen, LEO Pharma
Dr. Bagel discusses the unlabeled or investigational use of a commercial product.

Kenneth B. Gordon, MD, has disclosed the following relevant financial relationships:
Consultant/Investigator: Abbott, Amgen, Centocor Ortho Biotech
Consultant: Lilly, Merck, Novartis, Pfizer

Kristine Kucera, DHS, MPAS, PA-C, has disclosed the following relevant financial relationships:
Speaker: Abbott, Amgen, Centocor Ortho Biotech, Warner Chilcott
Editorial Board and Author: Educational Awareness Solutions
Ms. Kucera discusses the unlabeled or investigational use of a commercial product.

Alan Menter, MD, has disclosed the following relevant financial relationships:
Advisory Board/Speaker: Abbott, Amgen, Astellas, Centocor Ortho Biotech, Galderma, Genentech, Warner Chilcott, Wyeth
Consultant: Abbott, Amgen, Astellas, Centocor Ortho Biotech, Eli Lilly, Galderma, Genentech, Stiefel, Warner Chilcott, Wyeth
Investigator: Abbott, Allergan, Amgen, Astellas, Asubio, Celgene, Centocor Ortho Biotech, DUSA, Eli Lilly, Genentech, Novartis, Novo Nordisk, Pfizer, Promius, Stiefel, Syntrix Biosystems, Warner Chilcott, Wyeth

Melodie Young, MSN, RN, A/GNP-C, has disclosed the following relevant financial relationships:
Consultant: Janssen, Ortho
Speaker: Abbott, Centocor Ortho Biotech
Subinvestigator: Celgene

Curatio CME Institute
The employees of Curatio CME Institute have disclosed no relevant financial relationships.

University of Chicago Center for Continuing Medical Education
The employees of the Center for Continuing Medical Education have disclosed no relevant financial relationships.

Dermatology Nurses’ Association
The management and contractors of the Dermatology Nurses’ Association have disclosed no relevant financial relationships.

Society of Dermatology Physician Assistants
The employees of the Society of Dermatology Physician Assistants have disclosed no relevant financial relationships.

National Psoriasis Foundation
The employees of the National Psoriasis Foundation have disclosed no relevant financial relationships.

International Psoriasis Council
Paul Tebbey, PhD, has disclosed the following relevant financial relationships:
Consultant: Incyte Pharmaceuticals
Employee: Baxter Healthcare

Unapproved Product Use
This educational activity contains discussion of published and/or investigational uses of agents that are not indicated by the US Food and Drug Administration. Curatio CME Institute, the University of Chicago, the Dermatology Nurses’ Association, the Society of Dermatology Physician Assistants, the National Psoriasis Foundation, the International Psoriasis Council, Abbott, and Janssen do not recommend the use of any agent outside the labeled indications.

The opinions expressed in this educational activity are those of the faculty and do not represent the views of Curatio CME Institute, the University of Chicago, the Dermatology Nurses’ Association, the Society of Dermatology Physician Assistants, the National Psoriasis Foundation, the International Psoriasis Council, Abbott, or Janssen. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Generic Name	Trade Name	Approved Use (if any)	Unapproved Use
Acitretin	Soriatane	Treatment of adult patients with severe psoriasis	Use in combination with narrowband UVB phototherapy
Adalimumab	Humira	Treatment of adults with moderate to severe chronic plaque psoriasis who are candidates for systemic therapy or phototherapy, and when other systemic therapies are medically less appropriate	Investigational use as treatment for children and adolescents with psoriasis
Alefacept	Amevive	Treatment of adult patients with moderate to severe chronic plaque psoriasis who are candidates for systemic therapy or phototherapy	Investigational use as treatment for children and adolescents with psoriasis
Etanercept	Enbrel	Treatment of adult patients (18 years or older) with moderate to severe plaque psoriasis who are candidates for phototherapy or systemic therapy	Investigational use as treatment for children and adolescents with psoriasis
Methotrexate	Rheumatrex	Symptomatic control of severe, recalcitrant, disabling psoriasis that is not adequately responsive to other forms of therapy	Investigational use as treatment for children and adolescents with psoriasis
Pimecrolimus	Elidel	Second-line therapy for the short-term and noncontinuous chronic treatment of mild to moderate atopic dermatitis in nonimmunocompromised adults and children 2 years of age and older who have not responded adequately to other topical prescription treatments or in whom those treatments are not advisable	Treatment of psoriasis
Tacrolimus ointment	Protopic	Second-line therapy for the short-term and noncontinuous chronic treatment of moderate to severe atopic dermatitis in nonimmunocompromised adults and children who have not responded adequately to other topical prescription treatments for atopic dermatitis or in whom those treatments are not advisable	Treatment of psoriasis
Ustekinumab	Stelara	Treatment of adult patients (18 years or older) with moderate to severe plaque psoriasis who are candidates for phototherapy or systemic therapy	Treatment of psoriatic arthritis; use in combination with methotrexate for the treatment of psoriatic arthritis Investigational use as treatment for children and adolescents with psoriasis

Disclaimer
The information presented in this activity is for continuing medical education purposes only and is not meant to substitute for the independent medical judgment of a physician regarding diagnosis and treatment of a specific patient’s medical condition.

Accredited Provider:

This educational initiative is provided by Curatio CME Institute, the University of Chicago, the Dermatology Nurses’ Association, and the Society of Dermatology Physician Assistants. This activity has been created in collaboration with the National Psoriasis Foundation and the International Psoriasis Council.

                    

Commercial Supporter:

Support for this activity has been provided through educational grants from Abbott and Janssen.

Instructions:

Method of Participation
To obtain credit, a score of 70% or better is required. This CME is offered at no cost to participants. Please proceed with the activity until you have successfully completed this program, answered all pre-survey questions, post-test questions, completed the evaluation survey, and have received your digital copy of your credit certificate. Your online certificate will be saved on myCME.com within your Profile/Exam History, which you can then access at any time.

If you have any questions relating to the accreditation for this activity, please contact The University of Chicago Center for Continuing Medical Education by email at cme@bsd.uchicago.edu or by phone at 773-702-1056.

If you have any questions relating to your certificate or other issues with this activity, please contact myCME.Support@haymarketmedical.com.

Privacy Policy:
To view the myCME privacy policy, please click here.

To view the University of Chicago Center for Continuing Medical Education privacy policy, please click here.

SYSTEM REQUIREMENTS:

WINDOWS PC SYSTEM REQUIREMENTS:
266-MHz Pentium II; Windows 98 or higher; 64 MB RAM; 800 x 600 screen resolution set for “High Color (16-Bit)”; Macromedia Flash Player 6 or higher.

MACINTOSH^® SYSTEM REQUIREMENTS:
Power Mac g3 at 300 MHz; System 8.5 or higher (excluding Mac OSX); 96 MB RAM; 20 MB minimum hard disk space available; 800 x 600 screen resolution set to “Thousands of Colors”; Macromedia Flash Player 6 or higher.