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Incorporating Treatment Guidelines and Patient Preference into Management of Rheumatoid Arthritis

Rheumatology
Curriculum:
A Guideline-Driven Approach to RA: Disease Monitoring, Treatment Selection, and Patient Preference
Credits:
1 AMA PRA Category 1 Credit(s)
Launch Date:
September 05, 2017
Expiration Date:
The accreditation for this activity has expired.

Primary Audience:

Physicians, nurse practitioners, and physician assistants who specialize in rheumatology and internal medicine

Relevant Terms:

Rheumatoid Arthritis, RA

Jeffrey R. Curtis, MD, MS, MPH

Jeffrey R. Curtis, MD, MS, MPH
William J. Koopman Endowed Professor in Rheumatology and Immunology
Director
, UAB Arthritis Clinical Intervention Program
Co-Director, UAB Center for Education and Research on Therapeutics
 (CERTS) of Musculoskeletal Disorders 
Co-Director, UAB PharmacoEpidEmiology and phaRmcoeconomics (PEER) Unit
University of Alabama at Birmingham, Division of Clinical Immunology and Rheumatology
Birmingham, Alabama

Dr Jeffrey Curtis is a Professor of Medicine in the Division of Clinical Immunology and Rheumatology at the University of Alabama at Birmingham (UAB). Dr Curtis received a Medical Degree (MD) and a Master of Public Health (MPH) degree from Oregon Health & Science University in Portland, OR. He subsequently completed a residency in internal medicine at Oregon Health & Science University and a fellowship in rheumatology at UAB. He completed graduate work in informatics at Stanford University and is board certified by the American Board of Preventive Medicine in Clinical Informatics. He received his Master of Science (MS) degree in epidemiology at the Harvard School of Public Health. 

Dr Curtis currently holds the William J. Koopman Endowed Professorship in Rheumatology and Immunology at UAB. He is the Co-Director of the UAB Center for Education and Research on Therapeutics (CERTs) of Musculoskeletal Disorders, which has a major emphasis on evaluating the safety and comparative effectiveness of medications for rheumatic diseases. Additionally, as the Director of the UAB Arthritis Clinical Intervention Program, he leads the clinical trials unit for the rheumatology division at UAB, with a particular focus on rheumatoid arthritis (RA) and psoriatic arthritis (PsA). He is the Co-Director of the UAB Pharmacoepidemiology and Pharmacoeconomics Research (PEER) Unit. PEER uses multiple large data sources to study comparative effectiveness questions across multiple chronic diseases. These data sources include national administrative data from Medicare and commercial health plans, electronic health record data, and large registries. In 2012, he was awarded the Henry Kunkel Young Investigator Award by the American College of Rheumatology (ACR) and was accepted into the American Society for Clinical Investigation (ASCI) in 2016.

The evaluation of the efficacy, comparative effectiveness, and safety of the medications used to treat rheumatoid arthritis and spondyloarthritis are among Dr Curtis's research interests. He served on the Core Expert Panel for the ACR's 2008, 2012, and 2015 Recommendations for the Use of Non-Biologic and Biologic Disease Modifying Antirheumatic Drugs in RA. He was the Deputy Director for a collaborative project between the FDA, the Agency for Healthcare Research and Quality (AHRQ), and a number of academic centers studying the safety of biologic agents using multiple, pooled national data sources. He is the Co-PI of the PCORI-funded Patient Powered Research Network "Arthritis-Power" registry, focused on RA, psoriasis, and psoriatic arthritis. He also leads the multi-center NIH-funded large pragmatic randomized controlled trial "VERVE," studying the safety and effectiveness of the live herpes zoster vaccine in patients receiving biologic agents. He is a member of the Center for Disease Control(CDC) Advisory Committee on Immunization Practices (ACIP) Herpes Zoster workgroup. In 2015, he was appointed as a member to the FDA Arthritis Advisory Committee.

Dr Curtis also studies risk factors for and outcomes of osteoporosis. He was a member of the ACR's task force to update recommendations for the management of glucocorticoid induced osteoporosis (GIOP). He served on the ASBMR Task Force on Atypical Subtrochanteric and Diaphyseal Fractures. 

Dr Curtis is a member of the American College of Rheumatology, the International Society for Pharmacoepidemiology, the American Medical Informatics Association, and the American Society of Bone and Mineral Research. He has been on the editorial board for Arthritis & Rheumatism, Pharmacoepidemiology and Drug Safety, and Arthritis Care & Research. He has authored more than 300 peer-reviewed manuscripts, review articles, and book chapters.

Martin Jan Bergman, MD, FACR, FACP, FCPP

Martin Jan Bergman, MD, FACR, FACP, FCPP
Clinical Associate Professor of Medicine
Drexel University School of Medicine
Philadelphia, Pennsylvania

Martin Jan Bergman, MD, FACR, FACP, FCPP, is Clinical Associate Professor of Medicine at the Drexel University School of Medicine in Philadelphia, and Chief of the Division of Rheumatology at Taylor Hospital in Ridley Park, Pennsylvania. He is also a full-time clinical rheumatologist in a private practice setting, with over 25 years of clinical experience.

In addition to issues affecting the running of a successful clinical practice, Dr Bergman is interested in issues facing practicing rheumatologists on a daily basis. With collaborators, Dr Bergman has played a pivotal role in the development of patient management tools, particularly the RAPID 3. This disease measurement tool is now an outcomes measure accepted by the American College of Rheumatology and used worldwide.

Dr Bergman is a recognized leader in the field of clinical and patient reported outcomes, and has spoken both nationally and internationally on this and other topics. For his work, he has received the Joseph L Hollander Award for Excellence and Achievement in Rheumatology by the SE PA Arthritis Foundation and has been elected as a Fellow of the College of Physicians of Philadelphia.

Iris Navarro-Millán MD, MSPH

Iris Navarro-Millán MD, MSPH
Assistant Professor 
Division of General Internal Medicine
Hospital for Special Surgery
Division of Rheumatology
Weill Cornell Medicine
New York, New York

Dr Iris Navarro-Millán is an assistant professor of medicine in the Division of General Internal Medicine at the Division of General Internal Medicine at Weill Cormell Medicine and the Division of Rheumatology at the Hospital for Special Surgery. Dr Navarro-Millán received a Medical Degree (MD) from Universidad Autónoma de Guadalajara, Jalisco, México, and a Master in Science of Public Health (MSPH) degree from the University of Alabama at Birmingham (UAB) in Birmingham, Alabama. She subsequently completed a residency in internal medicine at Physicians Carraway Medical Center and Baptist Health System in Birmingham and a fellowship in rheumatology at UAB. She is board certified in both rheumatology and internal medicine. 

Dr Navarro-Millán research focuses on factors that influence outcomes, particularly cardiovascular (CV) disease among patients with rheumatoid arthritis (RA). She is developing, testing, and implementing behavioral patient-centered interventions to reduce pain and cardiovascular risk in RA patients. This includes the use of peer-coaches and community-based participatory research as a way of dissemination and implementing newly developed interventions. These interventions that aim to address and improve modifiable CV risk factors among patients with RA are applicable to other forms of inflammatory arthritis with high CV burden such as psoriatic arthritis and ankylosing spondylitis.  

Dr Navarro-Millán serves in the American College of Rheumatology Early Career Investigators Subcommittee. This committee aims to disseminate research in the rheumatology field among trainees in rheumatology. She was chosen in 2016 to the American College of Rheumatology European League Against Rheumatology (ACR/EULAR) Exchange Program (one of 10 junior faculty chosen nationally). Her work includes the development of a platform for electronic collection of patient-reported outcomes in patients with RA (https://arthritispower.org). This was the result of her work through a Rheumatology Research Foundation (RRF) Innovative Research Award that she received in 2014. 

Dr Navarro-Millán is a member of the American College of Rheumatology (ACR). She is an ad hoc reviewer for multiple rheumatology journals, including Arthritis and Rheumatology, Arthritis Care and Research, Arthritis Research and Therapy and Seminar of Arthritis and Rheumatism.
1. Incorporate guideline-recommended disease activity measures into clinical practice 
2. Select individualized treatments for patients with RA that maximize the opportunity to achieve remission and avoid relapse while minimizing toxicity 
3. Employ a strong patient-provider collaborative approach to managing patients with RA that includes patient education, engagement, and shared decision making 

PHYSICIAN CONTINUING MEDICAL EDUCATION
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Postgraduate Institute for Medicine and RMEI Medical Education, LLC. The Postgraduate Institute for Medicine is accredited by the ACCME to provide continuing medical education for physicians.
 
The Postgraduate Institute for Medicine designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
 
DISCLOSURE OF CONFLICTS OF INTEREST
Postgraduate Institute for Medicine (PIM) requires instructors, planners, managers, and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest (COI) they may have as related to the content of this activity. All identified COI are thoroughly vetted and resolved according to PIM policy.  PIM is committed to providing its learners with high quality CME activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest.
 
The faculty reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:
  • Jeffrey R. Curtis, MD, MS, MPH, has affiliations with AbbVie, Amgen, BMS, Corrona, Janssen, Lilly, Myriad, Pfizer, Roche/Genentech, UCB (Consulting); Amgen, Corrona, Crescendo, and Pfizer (Research).
  • Martin Jan Bergman, MD, MD, FACR, FACP, FCPP, has affiliations with AbbVie, Amgen, BMS, Genentech, Janssen, Novartis, Pfizer, and Sanofi (Consulting); Pfizer and Merck (Ownership interest).
  • Iris Navarro-Millán, MD, MSPH, has no affiliations with commercial interests relative to the content to disclose.
RMEI Medical Education, LLC
  • Jacqui Brooks, MBBCh, MRCPsych, has no affiliations with commercial interests relative to the content to disclose.
  • Tania Dickson, PhD, has no affiliations with commercial interests relative to the content to disclose.
  • Chelsey Goins, PhD, has no affiliations with commercial interests relative to the content to disclose. 
Postgraduate Institute for Medicine 
Planners and Managers
The following PIM planners and managers, Trace Hutchison, PharmD, Samantha Mattiucci, PharmD, CHCP, Judi Smelker-Mitchek, MBA, MSN, RN, and Jan Schultz, MSN, RN, CHCP, have nothing to disclose. 
 
DISCLAIMER
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patients’ conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

DISCLOSURE OF UNLABELED USE
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.
 
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners.  Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
 
Estimated time to complete: 1.0 hour
Media: Internet
 
FEE INFORMATION
There is no fee for this educational activity.
 
STATEMENT OF COMMERCIAL SUPPORT
This activity is jointly provided by RMEI Medical Education, LLC and Postgraduate Institute for Medicine. This activity is supported by an independent educational grant from Genentech.  
 
HOW TO RECEIVE CREDIT
By reviewing the course content and successfully completing the post-test and evaluation, physicians, nurse practitioners, and physician assistants are entitled to receive up to 1.0 AMA PRA Category 1 Credit(s)™. A statement of credit will be available to print from your user history page. Users must:
  • Read the learning objectives and faculty disclosures.
  • Participate in the activity.
  • Complete the activity evaluation.
Physicians, nurse practitioners, and physician assistants who successfully complete the post-test and evaluation will receive CME credit. You must score 75% or higher on the post-test to receive credit for this activity. All other participants who successfully complete the post-test and evaluation will receive a certificate of participation.
 
COURSE VIEWING REQUIREMENTS
Supported Browsers:
Internet Explorer 8.0+ for Windows 2003, Vista, XP, Windows 7, Windows 8.1 and above
Google Chrome 28.0+ for Windows, Mac OS, or Linux
Mozilla Firefox 23.0+ for Windows, Mac OS, or Linux
Safari 6.0+ for Mac OSX 10.7 and above
 
Supported Phones & Tablets:
Android 4.0.3 and above
iPhone/iPad with iOS 6.1 or above.