Clinical Challenges:
Optimizing Patient Management in Psoriatic Disease

Authors
Kathryn Hobbs, MD, Kristine J Kucera, PA-C, MPAS, DHS, Craig L Leonardi, MD, Melodie Young, RN, MSN, ANP-C, GNP-C

Target Audience
This CME/CE activity has been designed to enhance the patient management skills of rheumatology specialists who treat patients with psoriatic conditions. 

Credits Available: CME/CE
This activity is certified for both physicians and nurses.

Original Release/Expiration Dates
April 30, 2007; Valid for credit through April 30, 2008

More than 4.5 million American men, women, and children - or about 1 in 50 Americans - have psoriasis. Each year 150,000 to 260,000 cases of psoriasis are diagnosed and exceed three billion dollars annually in treatment costs. People who have psoriasis also have a 10 to 30 percent chance of developing psoriatic arthritis. Psoriatic arthritis is a condition that causes inflammation in and around the joints, such as the wrists, knees, ankles, lower back, and neck.
Patients who have psoriatic conditions with arthritis often seek treatment from a rheumatology professional. These patients look to the rheumatologist and rheumatology nurse for healthcare guidance, as well as counseling to help them better understand and manage their disease as it manifests within joints.
With the evolution of new therapies, patients with psoriatic conditions have an opportunity to improve their health to a greater extent. Adherence to new therapeutic regimens, in conjunction with a strong and knowledgeable support system, will allow these patients to realize gains never before expected in this population. It is the rheumatology professional who will play important a pivotal role in the lives of these patients by helping them understand their disease and the importance of therapeutic adherence.

This activity will meet the educational needs of rheumatology specialists regarding the treatment of patients with psoriatic conditions. The activity provides the latest medical information regarding the diagnosis and management of psoriatic conditions, the pharmacological agents available for treating patients with psoriasis and psoriatic arthritis, and the best methods of patient counseling.

Kathryn Hobbs, MD
Associate Clinical Professor of Internal Medicine
University of Colorado Health Sciences Center
Denver, Colorado

Kristine J Kucera, PA-C, MPAS, DHS
Texas Dermatology Associates
Adjunct Clinical Instructor
University of Texas Southwestern Medical Center
Dallas, Texas

Craig L Leonardi, MD
Associate Clinical Professor of Dermatology
Saint Louis University
St Louis, Missouri

Melodie Young, RN, MSN, ANP-C, GNP-C
Adjunct Clinical Instructor
The University of Texas at Arlington
Modern Dermatology
Baylor Health Care System
Dallas, Texas

In direct response to the September 2004 Accreditation Council for Continuing Medical Education (ACCME) Standards for Commercial Support, CME Consultants issued a conflict of interest policy dated January 2, 2005.  The policy states that the disclosure of potential financial conflicts of interest within the last 12 months must be made and resolved prior to date of the CME/CE activity where commercial support grants are to be used to fund the activity.  The following conflicts have been managed and resolved through the Independent Review Committee of CME Consultants.  Our intent is to assist learners in assessing the potential for bias in information that is presented during the CME/CE activity.

The faculty is also aware it is their responsibility to inform the audience if discussion of any non-FDA approved uses of pharmaceutical, medical equipment, prostheses, etc., will be included in their presentation. 

Kathryn Hobbs, MD
Discloses the following:
Advisory Board: Abbott Laboratories, Amgen Inc., Genentech Inc., Wyeth Pharmaceuticals
Speaker: Abbott Laboratories, Amgen Inc., BMS, Centocor Inc., Genentech Inc., Wyeth Pharmaceuticals

Kristine J Kucera, PA-C, MPAS, DHS
Discloses the following:
Advisory Board/Consultant: Abbott Laboratories, Amgen Inc., Genentech Inc.
Speaker's Bureau: Abbott Laboratories, Amgen Inc., Centocor Inc., Genentech Inc.

Craig L Leonardi, MD
Discloses the following:
Advisory Board/Consultant: Abbott Laboratories, Amgen Inc., Centocor Inc., Genentech Inc.,
Honoraria: Abbott Laboratories, Amgen Inc., Centocor Inc., Genentech Inc., Warnr Chilcott
Principal Investigator: 3M Pharmaceuticals, Abbott Laboratories, Allergan, Altana Pharma, Amgen Inc., Astellas Pharma US, Inc., Bristo-Myers Squibb, Centocor Inc., CombinatoRX, Galderma, Genentech Inc., Novartis, RTL, Schering-Plough, Vitae Pharmaceuticals
Spearker's Bureau: Abbott Laboratories, Amgen Inc., Centocor Inc., Genentech Inc., Warner Chilcott

Melodie Young, RN, MSN, ANP-C, GNP-C
Discloses the following:
Advisory Board: Abbott Laboratories, Amgen Inc., Astellas Pharma US, Inc., Genentech Inc.
Honoraria: Abbott Laboratories, Amgen Inc., Centocor Inc., Genentech Inc.
Phototherapy: Clinic Income

This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of CME Consultants and Educational Awareness Solutions, a division of Suasion Group, LLC. CME Consultants is accredited by the ACCME to provide continuing medical education for physicians.

CME Consultants designates this activity for a maximum of 6.0 AMA PRA Category 1 Credit(s)TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

CME Consultants is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.

In order to receive credit for this program, each participant must complete the Evaluation and Certificate Request Forms. Certificates will be mailed to program participants in approximately four to six weeks after receipt of the completed Evaluation and Certificate Request Forms.

The estimated time to complete this activity, including the entire Skills Assessment Booklet, is six hours.

At the conclusion of this activity, the participants should be able to:

• Recognize the signs and symptoms of psoriasis and psoriatic arthritis, and accurately assess the disease severity
• Evaluate the relationship between the pathological basis of psoriatic conditions and the mechanism of action of the anti-TNF agents
• Describe the efficacy and safety profiles of various therapies used to treat psoriatic diseases
• Recognize the psychosocial impact of psoriatic diseases in the lives of patients
• Develop strategies for the effective selection and administration of an anti-TNF agent for appropriate patients with psoriatic conditions
  
  

The contents of some CME/CE activities may contain discussions of nonapproved or off-label uses of some of the agents mentioned.  Please consult the prescribing information for full disclosure of approved uses.

This activity is supported by an educational donation provided by Amgen and Wyeth Pharmaceuticals.