Release date: August 2010

Expiration date: August 2011

Estimated time to complete activity: 15 minutes

Target Audience

This activity has been designed to meet the educational needs of physicians involved in the diagnosis and management of rheumatoid disease.

Program Overview

Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used for the management of pain and inflammation associated with osteoarthritis, rheumatoid arthritis and other musculoskeletal disorders but they carry a risk for gastrointestinal (GI) toxicity. Although a number of observational studies provide data on risk factors for the development of upper gastrointestinal (GI) complications in NSAID users, there are scant data identifying independent risk factors for the development of ulcers at endoscopy among NSAID users. Prior upper GI clinical events (i.e., symptomatic ulcer, perforation, bleeding) and erosions at baseline endoscopy have been reported to be significant independent predictors of developing an ulcer with NSAID use. Ibuprofen is the most commonly used NSAID for treatrment of arthritis symptoms. Potential risk factors and the incidence of upper GI ulcers were prospectively assessed in two large, parallel, 24-week randomized, double-blind trials (Registration Endoscopic Study to Determine Ulcer Formation of HZT-501 Compared to Ibuprofen: Efficacy and Safety Study [REDUCE]-1 and REDUCE-2), which compared ibuprofen (IBU, 800 mg) vs. a single fixed-dose tablet combination of ibuprofen (800 mg) and famotidine (26.6 mg). This activity discusses gastrointestinal risk factors facing arthritis patients on chronic NSAID therapy and presents the combined results from the above clinical research trials.

Educational Objectives

After completing this activity, the participant should be better able to:

• Recognize suboptimal or refractory responses to pharmacologic interventions and modify treatment plans accordingly
• Coordinate a comprehensive care plan to monitor disease progression, safety, risk surveillance, preventive immunizations, and co-morbid health conditions, including collaboration with other health care specialists as appropriate

Faculty

Michael Schiff, MD
Clinical Professor of Medicine
University of Colorado
Health Services Center
Denver, CO

Accreditation Statement/Joint Sponsorship Statement

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 Omnia Education and Better CME. Omnia Education is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation

Omnia Education designates this educational activity for a maximum of .25 AMA PRA Category 1 Credit