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Targeting the IL-12/23 Pathway in IBD: Update on Current and Emerging Strategies for Perianal Fistulas in Crohn's Disease

OVERVIEW

Inflammatory bowel disease (IBD), which comprises Crohn’s disease (CD) and ulcerative colitis (UC), is a chronic and progressive illness that produces not only painful symptoms but also structural damage to the gastrointestinal (GI) tract. In years past, clinicians were able to treat only the inflammation and symptomatic manifestations of IBD and did not have the tools with which to alter the natural history of the disease. The advent of monoclonal antibodies targeting tumor necrosis factor alpha (TNFα) and the proliferation of newer targeted therapies for the treatment of IBD, however, have resulted in a paradigm shift away from the traditional step-care approach to therapy focused primarily on symptom alleviation in favor of a top-down approach more likely to induce and maintain remission and mucosal healing (MH). Earlier, more aggressive treatment has been shown to improve outcomes, significantly delaying disease progression, GI complications, and the need for surgery.

While TNFα inhibitors remain an important option for many patients with moderate to severe IBD, the rapidly expanding IBD treatment armamentarium offers vastly improved opportunities to achieve treatment goals—but it also complicates treatment decisions. Between- and within-class distinctions of newer and emerging targeted therapies create a knowledge gap that clinicians must overcome to be prepared to provide the most efficient, up-to-date, and personalized care to each patient. Leukocyte trafficking agents have shown promise in the regulation of leukocyte adhesion infiltration, leading to an inhibition of IBD pathogenesis. These newer and emerging agents consist of several biologics and small molecule drugs including anti-α4 integrins and associated receptors, intercellular adhesion molecule 1 (ICAM-1) and mucosal vascular addressin cell adhesion molecule 1 (MAdCAM-1) inhibitors, and sphingosine 1-phosphate (S1P) receptor agonists. Emerging S1P agents, in particular, may be an optimal choice for first- or second-line therapy due to their innovative mechanism of action, favorable efficacy and safety profile, and oral route of administration.

 

FACULTY

Bruce E. Sands, MD, MS, FACG
Chief, Division of Gastroenterology
Icahn School of Medicine at Mount Sinai
New York, New York

PROVIDER STATEMENT

Provided by HMP Education, an HMP Global company.

For questions regarding this educational activity, please call 609-371-1137 or email info@naccme.com.

INTENDED LEARNERS

Designed and certified for the entire IBD healthcare team and includes education for gastroenterologists, pediatric gastroenterologists, surgeons, physicians, PhDs, researchers, pharmacists, nurse practitioners, physician assistants, gastroenterology nurses, and residents/fellows/students.

LEARNING OBJECTIVES

After participating in this activity, learners should be able to:

  • Evaluate the most recent efficacy and safety data associated with IL-12/23 and IL-23 inhibitors for the management of UC and CD
  • Describe considerations for optimal positioning of IL-12/23 and IL-23 inhibitors in personalized therapeutic strategies for IBD

CLAIMING CREDIT

To be eligible for credit, participants must complete the online activity and the evaluation. Upon completing the activity, there will be instructions on how to complete the evaluation and print a certificate or other documentation of credit.

Release Date: January 11, 2022
Expiration Date: January 11, 2023
Estimated Time to Complete: 30 minutes

There is no fee associated with this activity.

EDUCATION GRANT SUPPORT

HMP Education would like to thank the following company who has supported this program through an educational grant: Janssen Scientific Affairs, LLC

CONTINUING EDUCATION


In support of improving patient care, HMP Education is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

PHYSICIANS

HMP Education designates this internet enduring activity for a maximum of 0.50 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

NURSES

This continuing nursing education internet enduring activity awards 0.50 contact hours.

PHARMACISTS

This internet enduring, knowledge-based activity (Universal Activity Number: JA0006201-0000-22-011-H01-P) has been approved for a maximum of 0.50 contact hours (.05 CEUs).

The certificate is not the official record of your participation in the activity. The official record of credit will be the information in CPE Monitor system. The deadline to claim credit is 60 days after activity. Following ACPE Policy, HMP Education will not be able to report your claimed credit to CPE Monitor after this 60-day period. Eligibility for pharmacy credit is contingent upon the successful completion of a post-test and/or evaluation for each activity or session attended. 

PHYSICIAN ASSISTANTS

HMP Education has been authorized by the American Academy of PAs (AAPA) to award AAPA Category 0.50 CME credit for activities planned in accordance with the AAPA CME Criteria. This activity is designated for 0.50 AAPA Category 1 credit(s). PAs should only claim credit commensurate with the extent of their participation.

USE OF PROPRIETARY NAMES

This continuing medical education activity may include device or medicine brand names for participant clarity purposes only, due to the presence of different branded versions of the same product. No product promotion or recommendation should be inferred.

UNAPPROVED AND/OR INVESTIGATIONAL USES OF DRUGS AND DEVICES

This activity may contain information about experimental and other uses of drugs or devices that are not currently approved by the European Medicines Agency (EMA) of the European Union or the Food and Drug Administration (FDA) of the United States. Participants are strongly encouraged to consult approved product labeling for any drug or device mentioned in this activity before use. The opinions expressed during this activity are the opinions of the respective authors, presenters or moderators and do not necessarily reflect the opinions of HMP Education.

DISCLAIMERS

The material presented and related discussions are not intended to be medical advice, and the presentation or discussion of such material is not intended to create and does not establish a physician-patient relationship. Medical advice of any nature should be sought from an individual’s own physician.

Neither HMP Education nor any of its subsidiaries or affiliates is affiliated with, or formally endorsed by a medical society.

The opinions expressed in this educational activity are those of the faculty and are not attributable to HMP Education nor HMP Global. Clinical judgment must guide each professional in weighing the benefits of treatment against the risk of toxicity. Dosages, indications, and methods of use for products referred to in this activity are not necessarily the same as indicated in the package insert for each product, may reflect the clinical experience of the presenters, and may be derived from the professional literature or other clinical sources. Consult complete prescribing information before administering.

DISCLOSURE OF RELEVANT FINANCIAL RELATIONSHIPS

HMP Education is an independent provider of continuing medical education. HMP Education has no proprietary or financial interest in medical or healthcare products over which the FDA (USA) or EMA (EU) has regulatory authority.

In accordance with our disclosure policies, HMP Education is committed to ensuring balance, independence, objectivity, and scientific rigor for all accredited continuing education. These policies include assigning relevance to, and mitigating, all perceived or real conflicts of interest between any individual with control over the content and any ineligible company (commercial interest) as defined by the ACCME.

Any individual with control over accredited content, including planner, faculty, and reviewer, is required to globally disclose:

  1. Individual relationship(s) or lack thereof, and its nature, with any/all ineligible company, and;
  2. any investigational, off-label, or non-FDA approved content or discussion

HMP Education has reviewed these disclosures, assigned relevance based on the relationship and scope of content, and identified those with the potential to compromise the goals and educational integrity of the education. Relevant relationships, or lack thereof, are shared with the learner.

Education has been independently peer-reviewed to validate content, mitigate identified conflicts of interest, and ensure:

  1. All recommendations involving clinical medicine is based on evidence that is accepted within the medical profession as adequate justification for their indications and contraindications in the care of patients.
  2. All scientific research referred to, reported, or used in accredited continuing education in support or justification of a patient care recommendation conforms to the generally accepted standards of experimental design, data collection, and analysis.
  3. Content is appropriate, fair and balanced, unbiased, referenced, and non-promotional.

FACULTY

The faculty has reported the following:

Bruce E. Sands: Consultant - AbbVie, Abivax, Alimentiv, AMGEN, Arena Pharmaceuticals, AstraZenaca, Bacainn Therapeutics, Boehringer Ingelheim, Bristol-Myers Squibb, Calibr, Celgene, Celltrion Healthcare, ClostraBio, Evommune, Galapagos, Glaxo SmithKline, Gossamer Bio, Index Pharmaceuticals, Inotrem, Janssen, Kaleido, Kallyope, Lilly, MiroBio, Morphic Therapeutic, Pfizer, Prometheus Bioscience, Q32 Bio, Takeda, TARGET RWE, Teva Pharmaceuticals, Ventyx Biosciences, Vivante Health; Advisory Board - Prometheus Bioscience; Stockholder - Ventyx Biosciences, Vivante Health

PLANNING COMMITTEE

HMP Education planners and staff include Samantha Conforti, Damon Harper, Kelly Jackson, Mary Johnson, Randy Robbin, and Greaton Sellers.

No HMP Education planner or staff has disclosed a relevant financial relationship with any ineligible company (commercial interest).

ADA STATEMENT

HMP Education complies with the legal requirements of the Americans with Disabilities Act and the rules and regulations thereof. If any participant in this educational activity is in need of accommodations, please call 609-371-1137.

PRIVACY POLICY

HMP Education protects the privacy of personal and other information regarding participants, educational partners, and joint sponsors. HMP Education and our joint sponsors will not release personally identifiable information to a third party without the individual’s consent, except such information as is required for reporting purposes to the appropriate accrediting agency.

HMP Education maintains physical, electronic, and procedural safeguards that comply with federal regulations to guard your nonpublic personal information.

Copyright © 2022 by HMP Education, LLC. All rights reserved. No part of this accredited continuing education activity may be reproduced or transmitted in any form or by any means, electronic or mechanical, without first obtaining permission from HMP Education.

GRIEVANCE POLICY

Any participant wanting to file a grievance with respect to any aspect of a continuing education activity accredited by HMP Education, LLC may contact Samantha Conforti, Manager, Accreditation and Compliance, by phone at 609-371-1137, by email at sconforti@naccme.com or in writing at 104 Windsor Center Drive, East Windsor, NJ 08520. Ms. Conforti will review the grievance and respond within 30 days of receiving the complaint. If the participant is unsatisfied with the response, an appeal to the Associate Director, Greaton Sellers, Accreditation and Compliance, can be requested for a second level of review. Mr. Sellers can be contacted via phone at 609-371-1137, by email at gsellers@naccme.com or in writing at 104 Windsor Center Drive, East Windsor, NJ 08520.