INTRODUCTION
This free CME activity is based on a dinner meeting titled "Optimizing Remission in Rheumatoid Arthritis: A Disease Management Case-based Approach" taped in Chicago, Illinois, on September 26, 2006. Persons in attendance at the dinner meeting are NOT eligible for AMA PRA Category 1 Credit™ for completing this enduring material. The Discovery Institute of Medical Education (DIME) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. DIME designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit™.

Please note that the course is accredited only for physicians (MD, DO, or equivalent). All other participants receive a certificate of completion.

In accordance with the ACCME Essential Areas and Policies regarding commercial support, participants are advised that 1 or more presentations in this continuing medical education activity may contain references to off-label or unapproved uses of drugs or devices. Participants should note that the use of these agents outside current approved labeling is considered experimental and are advised to consult prescribing information for these products. This CME activity was planned and produced in accordance with the ACCME Essential Areas and Policies.

Intended Audience This CME activity is designed for rheumatologists. Release Date December 6, 2006 Expiration Date December 6, 2007 Term of Offering This CME activity has a release date of December 6, 2006, and is valid for 1 year. Requests for credit must be received no later than December 6, 2007. After reviewing the presentation and completing the test and course evaluation, participants will receive further instruction regarding instantaneous online receipt of credit. A minimum score of 70% is required on the test for credit to be awarded. For inquiries regarding technical issues or registration, please email CME/CE Support. Please direct CME content–related questions to DIME at 212-448-5608 or dimeinfo@dimeded.org.

Presenter Joel M. Kremer, MD Pfaff Family Professor and Chair in Medicine Albany Medical College Albany, New York Estimated Completion Time 1 hour

Learning Objectives

Upon completion of this course, participants should be able to

• enumerate and elaborate the evolutionary steps of biologic disease-modifying antirheumatic drugs (DMARDs) and their use alone and in combination in aggressively treating rheumatoid arthritis (RA) patients;
  
  
• identify newer biologic DMARD therapeutic targets that may prove useful in the event of suboptimal clinical response to interleukins and TNF therapies;
  
  
• discuss the new B- and T-cell immune modulators' effects in RA, including mechanism of action (MOA) and clinical benefits, and the optimal integration of these new immune system modulators into RA patient management;
  
  
• identify early in treatment the patient with poor prognosis/poor response to therapy risk factors;
  
  
• identify the therapeutic position(s) of costimulatory modulators in RA therapy;
  
  
• distinguish between MOAs, therapeutic effects, and adverse effects of methotrexate, TNF inhibitors, and costimulatory modulators; and
  
  
• apply case-based learning principles to real-life practice scenarios.

DIME is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

DIME designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Disclosure Policy

DIME requires that those involved with content development and/or presentation disclose to participants any significant financial interest or other relationship with (1) the manufacturers of any commercial product(s) and/or provider(s) of commercial services discussed in an educational presentation and (2) any commercial supporters of the activity.

Off-label Discussion

This CME activity may include discussions regarding the use of medications that may be outside the approved labeling for these products. Physicians should consult the current prescribing information for these products. DIME requires the speaker to disclose that the product is not labeled for the use under discussion. Compliance is documentation that demonstrates the provider has a practice in place to make this requirement known to the faculty.

Faculty Disclosure

Joel M. Kremer, MD

Sources of Funding for Research: Abbott Laboratories; Amgen Inc.; Bristol-Myers Squibb Company; Centocor, Inc.; Genentech, Inc.
Consulting Agreements: Abbott Laboratories; Amgen Inc.; Bristol-Myers Squibb Company; Centocor, Inc.; Genentech, Inc.
Speakers Bureau/Honorarium Agreements: None.
Financial Interests/Stock Ownership: None.
Discussion of Off-label, Investigational, or Experimental Drug Use: MRA (anti–IL-6).

Instructions to Participants

Course participants must view the entire presentation, take the course test, and complete the course evaluation to receive continuing medical education credit. A minimum score of 70% is required on the test for credit to be awarded. No fees are charged to participate in the activity or to receive the certificate. Full instructions are available on the user instructions page.

Disclaimer

The opinions expressed herein are those of the faculty and do not necessarily represent the views of the grantor, accrediting body, or publisher. Please review complete prescribing information of specific drugs or combinations of drugs, including indications, contraindications, warnings, and adverse effects, before administering pharmacologic therapy to patients.

Medicine is a constantly changing science, and clearly established therapies are not always available for every condition. New research findings necessitate continual changes in drug and treatment therapies. Reasonable efforts have been made to provide up-to-date, accurate information that is within generally accepted medical standards at the time of publication. However, as medical science is ever evolving, and human error is always possible, the educational supporter, provider, and publisher (or any other involved party) do not guarantee total accuracy or comprehensiveness of the information in this article, and they are not responsible for omissions or errors, or the results of using information provided in this course. Participants should confirm the accuracy of the information in this activity from other sources. In particular, all drug doses, indications, and contraindications should be confirmed in package inserts.

Click here to view minimum system requirements.