Release Date: December 19, 2022
Expiration Date: December 19, 2023
Time to Complete Activity: 1 hour
*This activity expired for credit on December 19, 2023 and is no longer available for credit

Faculty
Mohamad Bittar, MD
Assistant Professor
College of Medicine
Department of Medicine
Division of Medicine—Rheumatology
The University of Tennessee Health Science Center
Memphis, TN

Alexis Ogdie, MD, MSCE
Associate Professor of Medicine and Epidemiology
Director, Penn Center for Clinical Epidemiology and Biostatistics
Director, Penn Psoriatic Arthritis and Spondyloarthritis Program
Perelman School of Medicine at the University of Pennsylvania
Hospital of the University of Pennsylvania
Philadelphia, PA

Cheryl Rosen, MD, FRCPC
Professor, Department of Medicine
University of Toronto
Head, Division of Dermatology
Toronto Western Hospital and University Health Network Hospitals
Toronto, Ontario, Canada 

Target Audience 
This activity has been designed to address the educational needs of rheumatology and dermatology clinicians. It may also be of benefit to other clinicians interested in the care of patients who have psoriatic disease.
This activity is provided by Paradigm Medical Communications, LLC.   
In collaboration with Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA). 

Supporter Acknowledgment 
This activity is supported by an educational grant from Janssen Biotech, Inc, administered by Janssen Scientific Affairs, LLC, and Novartis.

Program Overview 
Psoriatic disease is a complex disease in which musculoskeletal and cutaneous inflammation occurs alongside hyperproliferation of both bone and skin. Patients have heterogeneous presentations of disease activity across 6 domains: Psoriasis, peripheral arthritis, enthesitis, dactylitis, spondylitis, and nail disease. Associated inflammatory processes give rise to additional conditions such as uveitis and inflammatory bowel disease, and comorbid metabolic diseases can further complicate disease management. Psoriatic arthritis (PsA) is frequently accompanied by fatigue, pain, and disability that negatively impact quality of life for patients and further challenge effective management. Aggressive targeted treatment started early in the disease process has demonstrated the best patient outcomes. New guidelines are available that provide treatment recommendations but are not concrete algorithms, so clinicians are left to make treatment decisions based on their understanding of agents’ mechanisms of action and personal experience without sufficient data because head-to-head data to inform decisions are lacking. In this roundtable discussion, rheumatologist and dermatologist faculty discuss the pathologic pathways targeted by biologic therapy, and screening to identify PsA in patients with psoriasis early. Cases are used to illustrate the complexities of psoriatic disease management, and as a springboard to show clinical application of recent guideline recommendations for treatment.
 
Learning Objectives
Upon completion of this activity, participants should be able to:

• Describe the mechanisms of action for targeted agents to treat psoriasis/PsA
• Develop treatment plans for patients with psoriasis/PsA based on clinical evidence, guideline recommendations, and individual disease manifestations and disease activity
• Make appropriate individualized treatment decisions based on assessment of patient phenotypes, disease activity, comorbidities, treatment experience, and preferences

Table of Contents

• Introduction to psoriatic disease domains
• Case 1: Axial PsA
• Case 2: Longstanding PsA and metabolic disease
• Discussion of treatment recommendations 

Physician Accreditation Statement
Paradigm Medical Communications, LLC is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.


Physician Credit Designation Statement
Paradigm Medical Communications, LLC designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

PA Continuing Education 
PAs may claim a maximum of 1.0 Category 1 credit for completing this activity. NCCPA accepts AMA PRA Category 1 Credit™ from organizations accredited by ACCME or a recognized state medical society.

Nurse Practitioner Continuing Education 
The American Academy of Nurse Practitioners Certification Program (AANPCP) accepts certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by the ACCME. Individuals are responsible for checking with the AANPCP for further guidelines.

Hardware/Software Requirements
This accredited CME activity is designed using HTML5 web components. As you navigate the video using the supplied controls, the slides will sync to the speaker.
Supported Browsers (Desktop/Mobile)
Chrome 45+, Firefox 40+, Edge, Edge Chromium, Safari 8+, Opera 31+
PDF documents
This activity may contain PDF documents. Most current browsers support viewing of PDFs natively, but you may also download a free version of Adobe Acrobat Reader here: http://get.adobe.com/reader

Technical Support: If you have any technical problems or playback issues, email us at contactus@paradigmmc.com.

Instructions for Participation
To receive a certificate of participation, participants must:

• Follow instructions to register or log in with your professional information and complete the preassessment
• View the online activity in its entirety
• Complete and submit the online postassessment and evaluation. You must answer 70% of the postassessment questions correctly to earn credit. You will have unlimited opportunities to successfully complete the postassessment

A certificate of participation will be available for download/printing immediately following your successful completion of the postassessment and evaluation.

For questions regarding CME credit, contact the Paradigm CME Department at cme@paradigmmc.com.

There are no fees for participating in this activity.

Disclosure of Relevant Financial Relationships
In accordance with the ACCME Standards for Integrity and Independence in Accredited Continuing Education, Paradigm requires that all planners, faculty, and others who are in a position to control the content of this activity disclose all financial relationships with ineligible companies during the past 24 months.

All relevant relationships are identified and mitigated according to Paradigm policy prior to individuals assuming their roles, and are disclosed prior to learners’ engagement in the activity. Paradigm is committed to providing learners with high-quality accredited continuing education that promotes improvements or quality in healthcare and not a specific proprietary business interest of an ineligible company. 

The content of this activity was independently reviewed to ensure that it is fair and balanced, scientifically rigorous, evidence based, and aligned with the public interest. All relevant relationships have been mitigated. 

Mohamad Bittar, MD
Has no relevant financial relationships with ineligible companies to disclose

Alexis Ogdie, MD, MSCE
Consultant: AbbVie Inc.; Amgen Inc; Bristol-Myers Squibb Company; Celgene Corporation; CorEvitas; Eli Lilly and Company; Gilead Sciences, Inc.; Janssen Pharmaceuticals, Inc; Novartis AG; Pfizer Inc; UCB S.A.
Research Funding: AbbVie Inc. (paid to Penn); Amgen Inc (paid to National Databank for Rheumatic Disease and Forward Databank); Novartis AG (paid to Penn); Pfizer Inc (paid to Penn)

Cheryl Rosen, MD, FRCPC
Consultant: AbbVie Inc.; Amgen Inc; Novartis AG; UCB S.A.

Paradigm Medical Communications, LLC staff members have no relevant financial relationships with ineligible companies to disclose.

GRAPPA staff reviewer has no relevant financial relationships with ineligible companies to disclose. 

Independent peer reviewer has no relevant financial relationships with ineligible companies to disclose.

Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not approved by the FDA.

Disclaimer
This CME activity represents the views and opinions of the individual faculty, and does not constitute the opinion or endorsement of, or promotion by, 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.

If included, signed statements of informed consent granting permission for publication have been obtained for all photographs and videos in which an individual can be identified.

As an ACCME-accredited provider, Paradigm Medical Communications, LLC must ensure that its activities include a balanced view of therapeutic options. Use of generic names contributes to this impartiality. The use of trade names should not be viewed as an endorsement of specific products by Paradigm Medical Communications, LLC. 

Terms of Use and Privacy Policy
Disclaimer
The materials provided for this activity are for informational purposes only and should not be used for diagnosis or treatment of a health problem without consulting a licensed medical professional. This CME activity represents the views and opinions of the individual faculty, and does not constitute the opinion or endorsement of, or promotion by, Paradigm Medical Communications, LLC. References to any entity, product, service, or source of information on this website should not be considered an endorsement, either direct or implied, by Paradigm Medical Communications, LLC. Paradigm Medical Communications, LLC accepts no liability for the content referenced in this activity.

Privacy policy
Paradigm Medical Communications, LLC or hosted contracted partner is committed to protecting the privacy of those who participate in the activities located at www.paradigmmc.com (herein referred to as “website”). The information below describes the security of the website for safeguarding personal information and the rationale for collection and use of personal information.

Security/safeguarding personal information
This website has physical and procedural safeguards in place to prevent unauthorized access to personal information used to access this website.

Collection and use of your personal information
The submission of certain personally identifiable information is necessary to award and track the credits participants may earn after completing the program. Required items include first name, last name, degree, and email address. These items are necessary. Participants are also required to complete an evaluation of the CME activity. All evaluative information submitted is collected and retained, and used by Paradigm Medical Communications, LLC to continuously improve the learning experience.

Paradigm Medical Communications, LLC does not transfer, sell, or share personal information with outside parties. Paradigm Medical Communications, LLC will not otherwise disclose personal information unless required to in a legal process. Paradigm Medical Communications, LLC staff members review individual test results to the extent necessary to record and track participants’ credits.

Contact Us
If you have any questions or comments, please email us at contactus@paradigmmc.com. 

© 2022 Paradigm Medical Communications, LLC except where noted. Content may not be reproduced in whole or part without the express written permission of Paradigm Medical Communications, LLC.