The Role of the Inflammatory Cascade in the Pathogenesis and Treatment of Psoriatic Arthritis: New and Emerging Therapies
 
Release Date: August 31, 2017
Last Reviewed: August 30, 2017
Expiration Date: August 31, 2018
Time to Complete Activity: 1.5 hours 
 
Faculty
Christopher T. Ritchlin, MD, MPH (Chair)
Professor of Medicine
Chief, Division of Allergy/Immunology & Rheumatology
Director, Clinical Immunology Research Unit
University of Rochester Medical Center
University of Rochester School of Medicine and Dentistry
Rochester, NY
 
M. Elaine Husni, MD, MPH
Assistant Professor
Cleveland Clinic Lerner College of Medicine
Case Western Reserve University
Vice Chair of Rheumatology
Director of the Arthritis & Musculoskeletal Center
Cleveland Clinic
Cleveland, OH
 
Alexis R. Ogdie, MD, MSCE
Assistant Professor of Medicine
Assistant Professor of Epidemiology in Biostatistics and Epidemiology
Perelman School of Medicine at the University of Pennsylvania
Director, Penn Psoriatic Arthritis Clinic
Hospital of the University of Pennsylvania
Philadelphia, PA

This activity is provided by Indiana University School of Medicine.  Paradigm Medical Communications, LLC, is the educational partner. 
                                                                                               
 
Target Audience
This activity has been designed to address the educational needs of rheumatologists. It may also be of benefit to other healthcare professionals (HCPs) interested in optimal management of psoriatic arthritis.
 
Statement of Need
The workings of the inflammatory cascade are not fully defined, but recent findings have demonstrated roles for novel inflammatory mediators, such as interleukin (IL)-17, IL-12/23, and phosphodiesterase 4 (PDE-4) in the pathophysiology of psoriatic arthritis (PsA). Manipulating these elements has led to the development of newly approved therapies for the treatment of PsA, including approvals for 5 of these unique agents in the past 3 years. The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) treatment guidelines were updated in 2015, and trial results continue to emerge. Rheumatologists lack knowledge of these newly reported inflammatory mechanisms and are therefore challenged to know how newly emerged therapies should fit into the PsA armamentarium; so, which agents are best suited to which patients and when. This activity will provide expert-led, case-based discussion of these newer inflammatory pathways, illustrated by an animated mechanism of action (MOA) video, to enable better informed and appropriate treatment plans that improve outcomes for patients with PsA.
 
Learning Objectives
Upon proper completion of this activity, participants should be better able to:
  • Describe the pathophysiology of psoriatic arthritis, including role of inflammation and its relation to long-term outcomes.
  • Identify mechanisms of action in the inflammatory cascade for new and emerging therapies for psoriatic arthritis.
  • Review safety and efficacy data, as well as appropriate patient selection, for treating patients with psoriatic arthritis with new and emerging therapies.
     
Table of Contents
Introduction to Psoriatic Arthritis: Definition, Classification, and Presentation
Pathophysiology of PsA: Inflammatory pathways and intervention points
Targeting Inflammation in PsA: Current Treatment Recommendations
Emerging Therapies: Targeting the Inflammatory Cascade
Clinical Case Perspectives
Clinical Case Perspectives Discussion
Video: The Inflammatory Cascade in the Pathogenesis and Treatment of Psoriatic Arthritis
Resources

Accreditation Statement
Indiana University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
 
Credit Designation Statement
Indiana University School of Medicine designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

For information about the accreditation of this program, please contact Indiana University School of Medicine at (317) 274-0104 or cme@iu.edu.com.
 
Disclosure of Commercial Support
This activity is supported by educational grants from Celgene Corporation and Novartis Pharmaceuticals Corporation.
 
Instructions for Participation
To receive a CME certificate of participation, you should:
  • Follow instructions to register or log in with your professional information and complete the pre-activity assessment
  • View the online activity in its entirety.
  • Complete and submit the online posttest and evaluation. You must answer 70% of the posttest questions correctly to earn credit. You will have unlimited opportunities to successfully complete the posttest.
A certificate of participation will be available for download/printing immediately following your successful completion of the posttest and evaluation.

For questions regarding CME credit, contact the Paradigm CME Department at (845) 398-5949.
 
There is no fee required for participation in this activity.

Hardware/Software Requirements
This certified CME activity is designed using HTML5 video and audio.
 
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For Desktops (Windows/Mac)
Internet Explorer 9 or higher, Firefox 28 or higher, Safari 5.1 or higher, Google Chrome 31 or higher, Opera 21 or higher.
 
For Tablets (iPad/Android/Surface)
iOS Safari 4 or higher, Android 2.3 or higher, IE Mobile 10 or higher
 
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Disclosures
In accordance with Accreditation Council for Continuing Medical Education requirements on disclosure, faculty and contributors are asked to disclose any relationships with commercial interests associated with the area of medicine featured in the activity. These relationships are described below.
 
Christopher T. Ritchlin, MD, MPH (Chair)
Grant/Research Support: AbbVie Inc.; Amgen Inc; UCB, Inc.
Retained Consultant: AbbVie Inc.; Amgen Inc; Boehringer Ingelheim Pharmaceuticals, Inc; Celgene Corporation; Eli Lilly and Company; Novartis Pharmaceuticals Corporation; Pfizer Inc; Sun Pharmaceutical Industries Ltd; UCB, Inc
 
M. Elaine Husni, MD, MPH
Retained Consultant: AbbVie Inc; Amgen Inc; Bristol-Myers Squibb Company; Eli Lilly and Company; Janssen Pharmaceuticals, Inc; Novartis Pharmaceuticals Corporation; Pfizer Inc
 
Alexis R. Ogdie, MD, MSCE
Grant/Research Support: Novartis Pharmaceuticals Corporation; Pfizer Inc
Retained Consultant: Bristol-Myers Squibb Company; Novartis Pharmaceuticals Corporation; Pfizer Inc; Takeda Pharmaceutical Company Ltd
 
Indiana University School of Medicine staff members have no financial relationships to disclose.
 
Paradigm Medical Communications, LLC, staff members have no financial relationships to disclose.

Independent peer reviewer has no financial relationships to disclose.
 
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Indiana University School of Medicine and Paradigm Medical Communications, LLC, has implemented a system to resolve conflicts of interest for each CME activity to help ensure content objectivity, independence, fair balance, and that the content is aligned with the interest of the public. Conflicts, if any, are resolved through one or more processes. All CME content in this activity was independently reviewed to ensure that it is free of commercial bias, scientifically rigorous, aligned with the public interest, and compliant with all regulatory guidance and the ACCME’s Standards for Commercial Support of Continuing Medical Education.
 
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This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA.
 
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This CME activity represents the views and opinions of the individual faculty, and does not constitute the opinion or endorsement of, or promotion by, Indiana University or Paradigm Medical Communications, LLC. Reasonable efforts have been taken to present educational subject matter in a balanced, unbiased fashion, and in compliance with regulatory requirements. However, each activity participant must always use his or her own personal and professional judgment when considering further application of this information, particularly as it may relate to patient diagnostic or treatment decisions including, without limitation, FDA-approved uses and any off-label uses.

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