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Advances in RA: Top 10 Things Rheumatologists Wish PCPs Treating RA Knew, with a Focus on Disease Chronobiology and Chronotherapy

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Target Audience

  • Primary audience
    • Primary care physicians (PCPs), nurse practitioners, and physician assistants
  • Secondary audience
    • Rheumatologists who wish to learn about issues faced by PCPs who encounter patients with rheumatoid arthritis (RA)

Program Description

Rheumatoid arthritis (RA) is a chronic, inflammatory disease characterized by joint swelling, joint tenderness, and progressive destruction of synovial joints, which can lead to severe disability and premature mortality. Treat-to-target recommendations emphasize the need to commence therapeutic intervention early using disease-modifying antirheumatic drugs (DMARDs) with frequent reassessment and adjustment of treatment to ensure that patients have a chance to achieve the goal of disease remission. However, diagnosis and active therapy for early RA is often delayed, which can have long-term adverse consequences on disease progression.

By providing evidence-based “top 10” pearls to PCPs, rheumatologists can help PCPs to diagnose RA and to be familiar with the available treatment options for RA, as they have to decide whether to initiate treatment or refer the patient to a specialist–but also care for the patient while awaiting a specialist appointment. Chronotherapeutic advances in the treatment of RA can help PCPs to bridge therapy and treat to target. Chronotherapy–which is defined as the judicious timing of conventional or special drug-release therapeutic interventions in order to align drug peak and trough concentrations to specific circadian (~24-hour) rhythm markers of disease activity of medical conditions–is a means to optimize treatment outcomes and potentially minimize or avoid adverse effects (AEs).

Learning Objectives

  • Develop strategies that reflect the importance of early initiation of RA treatment and “treating to target”
  • Describe chronotherapeutic advances in the treatment of RA and how this may help to bridge therapy and treat to target
  • Develop ways in which rheumatic disease specialists can work more closely with PCPs to treat RA by using a “team” approach

Faculty

Michael H. Smolensky, PhD
Cockrell School of Engineering,
Department of Biomedical Engineering,
The University of Texas at Austin,
Austin, Texas
Vice-President,
American Association of Medical Chronobiology & Chronotherapeutics

Raymond M. Pertusi, DO
Clinical Associate Professor of Medicine/Rheumatology,
University of Massachusetts Medical School,
Worcester, Massachusetts

Conflict of Interest

The University of North Texas Health Science Center at Fort Worth Office of Professional & Continuing Education (PACE) requires everyone who is in a position to control the content of an accredited educational activity to disclose all relevant financial relationships with any commercial interest. PACE reviews information provided by presenters and determines if a conflict of interest exists and, if so, what steps should be taken to resolve the conflict. Refusing to disclose relevant financial relationships will preclude presenters, planning committee members and/or others who could potentially influence content from participating in the planning and implementation of this accredited continuing education activity.

  • Michael H. Smolensky, PhD, has no conflicts of interest to disclose. He has disclosed that he has received honorarium from EHC Communications for participation on an advisory committee, honorarium from Science Branding for consulting, and honorarium from Informa Healthcare as co-editor of the academic journal Chronobiology International.
  • Raymond M. Pertusi, DO, has no conflicts of interest to disclose.
  • Planning committee members for this activity:
    • From the UNT Health Science Center
      • Andrew Crim, BS, has no conflicts of interest to disclose.
      • Kelly Zarwell has no conflicts of interest to disclose.
    • From PharmaCom Group, Inc.
      • Angela Casey has no conflicts of interest to disclose.

Off-Label Discussion

This educational activity does not include information about off-label use of a product.

Physician Accreditation Statements

The University of North Texas Health Science Center at Fort Worth Office of Professional and Continuing Education is accredited by the American Osteopathic Association to award continuing medical education to physicians.

This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of The University of North Texas Health Science Center at Fort Worth Office of Professional and Continuing Education and PharmaCom Group, Inc. The University of North Texas Health Science Center at Fort Worth Office of Professional and Continuing Medical Education is accredited by the ACCME to provide continuing medical education for physicians.

Physician Credit Designation

The University of North Texas Health Science Center has requested that the AOA Council on Continuing Medical Education approve this program for 1 hour of AOA Category 1B CME credits. Approval is currently pending.

The University of North Texas Health Science Center at Fort Worth designates this activity for a maximum of 1 AMA PRA Category 1 Credit(s)™.

Physicians should claim only the credit commensurate with the extent of their participation in the activity.

American Nurses Credentialing Center (ANCC) accepts AMA PRA Category 1 Credit™ from organizations accredited by the ACCME.

American Academy of Nurse Practitioners (AANP) accepts AMA PRA Category 1 Credit™ from organizations accredited by the ACCME.

American Academy of Physician Assistants (AAPA) accepts certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by the ACCME. Physician assistants may receive a maximum of 1 hour of Category 1 credit for completing this program.

How to Receive a Certificate of Successful Completion

To receive credit, you must:

  • Study this monograph
  • Complete the online evaluation and post-test (scoring 70% or higher)

Release and Expiration Dates

  • Release date: October 7, 2013
  • Expiration date: October 6, 2014

Fee

This activity is offered at no charge.

Data Collection

Aggregated data collected as part of this CME activity may be analyzed and used for research purposes. Individual data will only be used for CME purposes and not included in the research data set.

Privacy Policy

You may view the privacy policy of the University of North Texas Health Science Center at Fort Worth at www.hsc.unt.edu/policies/privacy.cfm.

Commercial Support

This activity is supported by an educational grant from Horizon Pharma.