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Systemic Inflammation in Rheumatoid Arthritis: Understanding the Effects of RA Outside the Joints



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Systemic Inflammation in Rheumatoid Arthritis: Understanding the Effects of RA Outside the Joints

Release Date:

October 12, 2012

Expiration Date:

April 12, 2013

Topics:

Arthritis / Rheumatoid / Osteo
Autoimmune Diseases
Cardiovascular Diseases
Geriatrics
Men's Health
Musculoskeletal and Connective Tissue Disorders
Pain Management
Pediatrics
Women's Health

Specialty:

Adolescent Medicine
Allergy / Immunology
Family Medicine / General Practice
Internal Medicine
Men's Health
Pain Medicine
Pediatrics
Rheumatology
Women's Health

Profession:

General Practitioner
Nurse
Nurse Practitioner
Physician
Physician Assistant
Resident

Format:

Monograph

Credits:

1.00 / AMA PRA Category 1 Credit(s)TM


Estimated Time to Complete:

1 hour

Program Description:

Rheumatoid arthritis (RA) is well known for its debilitating effects on the joints. However, individuals with RA can also develop extra-articular manifestations of RA (ExRA) that can affect multiple other organ systems, including the lungs, gastrointestinal tract, liver, heart, cardiovascular system, eyes, and salivary glands. These systemic manifestations are associated with more active disease, but also confer an increased risk of morbidity and mortality over and above that seen even after adjusting for disease activity. Steps to minimize cardiovascular risk are particularly important, given the elevated risk of cardiovascular disease in individuals with RA. A greater understanding of the molecular events leading to RA may help reduce the adverse effects of RA both in the joints and beyond. Mounting evidence suggests that RA is associated with systemic inflammation that may develop before the joint is even targeted. A variety of mediators and factors are being explored that may contribute to the development of clinical RA in predisposed individuals.

INTENDED AUDIENCE:

This activity has been designed for rheumatologists and internists who provide care and support to patients with rheumatoid arthritis. Clinical nurse specialists, nurse practitioners, physician assistants and other healthcare professionals may also participate.

Activity Objectives:

As a result of participating in this educational activity, learners will be better able to:

  • Describe the potential mechanisms in the evolution of rheumatoid arthritis development

  • Evaluate the inter-relationship of risk factors and the pathogenesis of extra-articular manifestations of rheumatoid arthritis

  • Identify the ways in which extra-articular manifestations have an impact on morbidity, mortality and quality of life

  • Assess targeted treatment options for patients with extra-articular manifestations of RA and other systemic inflammatory conditions


Credits Type Accreditation Statement Designation Statement
1.00 AMA PRA Category 1 Credit(s)TM This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of CME and Alliance Medical Communications. The American Academy of CME is accredited by the ACCME to provide continuing medical education for physicians. The American Academy of CME designates this enduring material for a maximum of 1.0 AMA PRA Category 1 CreditTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Faculty:

William F.C. Rigby, MD (Activity Director)
Professor of Medicine, Microbiology and Immunology
Division of Rheumatology
Department of Medicine
Dartmouth-Hitchcock Medical Center
Lebanon, New Hampshire

Click to Expand/Collapse Disclosures:

According to the disclosure policy of the Academy, all faculty, planning committee members, editors, managers and other individuals who are in a position to control content are required to disclose any relevant relationships with any commercial interests related to this activity. The existence of these interests or relationships is not viewed as implying bias or decreasing the value of the presentation. All educational materials are reviewed for fair balance, scientific objectivity and levels of evidence. Disclosures are as follows:

William F.C. Rigby, MD (Activity Director)
Advisory Board – for scientific information: Bristol-Myers Squibb, UCB Pharma
Consultant – for marketing purposes: Hoffman-La Roche
Consultant – for clinical trial design: Crescendo Bioscience, Hoffman-La Roche
Promotional Speakers’ Bureau: Hoffman-La Roche

Independent Clinical Peer Reviewer
Rodolfo V. Curiel, MD
, Assistant Professor of Medicine, Rheumatology Fellowship, Program Director, The George Washington University, Washington, DC: No relevant financial relationships with any commercial interests.

Planning Committee
John JD Juchniewicz, MCIS, CCMEP
, American Academy of CME and Deborah Dean, Michelle Yechout, and Melinda Tanzola, PhD (editorial assistance provided), Alliance Medical Communications: No relevant financial relationships with any commercial interests.

Unapproved Product Use
This activity will not review off-label or investigational information.

This activity is designed for use by health care professionals for educational purposes only. The opinions expressed in this educational activity are those of the faculty, and do not represent those of the Academy or Alliance Medical Communications. This activity is intended as a supplement to existing knowledge, published information, and practice guidelines. Learners should appraise the information presented critically, and draw conclusions only after careful consideration of all available scientific information.

In addition, the American Academy of CME requires all faculty/authors to note the level of evidence for any patient care recommendation made during their presentations. For this activity, the Academy used the Category of Evidence and the Strength of Recommendation classification schemes from the 1999 British Medical Journal Clinical Guidelines (Shekelle PG, et al. Clinical Guidelines: Developing Guidelines. BMJ. 1999;318(7183):593-596.) for levels of evidence.

Category of Evidence:
 Ia Evidence for metaanalysis of randomized controlled trials
 Ib  Evidence from at least one randomized controlled trial
 IIa Evidence from at least one controlled study without randomization
 IIb Evidence from at least one other type of quasiexperimental study
 III Evidence from nonexperimental descriptive studies, such as comparative studies, correlation studies, and casecontrol studies
 IV Evidence from expert committee reports or opinions or clinical experience of respected authorities, or both


Strength of Recommendation:
 A  Directly based on category I evidence
 B   Directly based on category II evidence or extrapolated recommendation from category I evidence
 C  Directly based on category III evidence or extrapolated recommendation from category I or II evidence
 D  Directly based on category IV evidence or extrapolated recommendation from category I, II or III evidence


Disclaimer
The information presented at 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:

Jointly sponsored by:
          

If you have any questions relating to the accreditation for this activity, please contact:
John JD Juchniewicz, MCIS, CCMEP
American Academy of CME, Inc.
2275 West County Line Road
Suite 6-329
Jackson, NJ 08527
E-mail: jjuchniewicz@academycme.org
www.academycme.org

Commercial Supporter:

Support for this activity has been made possible through an independent educational grant from



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Instructions:

There are no fees to participate in the activity. Participants must review the CME information including the learning objectives and disclosure statements, as well as the content of the activity. To receive CME credit for your participation, please complete the post-test (achieving a passing grade of 70% or greater), and program evaluation.

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

Copyright
© 2012. This CME-certified activity is held as copyrighted © by the American Academy of CME and Alliance Medical Communications. Through this notice, the Academy and Alliance Medical Communications grant permission of its use for educational purposes only. These materials may not be used, in whole or in part, for any commercial purposes without prior permission in writing from the copyright owner(s).

Click to Expand/Collapse 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.



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