Clinical Updates In Systemic Lupus Erythematosus

Target Audience

The educational design of this activity addresses the needs of rheumatologists and other healthcare professionals who are critical to diagnosing SLE accurately and optimizing management approaches.

Statement of Need

Systemic lupus erythematosus is a chronic, multisystem autoimmune disorder that affects as many as 1.5 million Americans.^1,2 The disease is pathologically characterized by the generation of autoantibodies and generalized, multisystem inflammation.1 Patients may present with a broad range of clinical symptoms, which usually wax and wane over time and can potentially involve almost all organs and tissues.^3,4 The serious consequences of this disease, including increased mortality risks, elevate the urgency of early diagnosis, ongoing monitoring, and aggressive management.^5,6 Yet nonspecific and varied symptomatology often leads to diagnostic delays, presenting an important opportunity to improve assessment approaches.⁷ Additionally, clinicians must evaluate all treatment options when individualizing management strategies for systemic lupus erythematosus, a concept that will only become more complex and critical as therapies in intermediate or late stages of clinical development become available.^8-11

References

1. Tsokos GC. Systemic lupus erythematosus. N Engl J Med. 2011;365:2110-2121.
2. Ward MM. Prevalence of physician-diagnosed systemic lupus erythematosus in the United States: results from the Third National Health and Nutrition Examination Survey. J Womens Health (Larchmt). 2004;13:713-718.
3. Conti F, Ceccarelli F, Perricone C, et al. Flare, persistently active disease, and serologically active clinically quiescent disease in systemic lupus erythematosus: a 2-year follow-up study. PLoS One. 2012;7:e45934.
4. Steiman AJ, Gladman DD, Ibanez D, Urowitz MB. Outcomes in patients with systemic lupus erythematosus with and without a prolonged serologically active clinically quiescent period. Arthritis Care Res (Hoboken). 2012;64:511-518.
5. Rooney J. Systemic lupus erythematosus: unmasking a great imitator. Nursing. 2005;35:54-60.
6. Lateef A, Petri M. Unmet medical needs in systemic lupus erythematosus. Arthritis Res Ther. 2012;14 (suppl 4):S4.
7. Alarcon GS, McGwin G, Madger L, Petri M. Comparing the ACR and the SLICC Criteria for the classification of SLE patients using data from an existing multi-ethnic cohort. Arthritis Rheum. 2012;64:S262.
8. Tan EM, Cohen AS, Fries JF, et al. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1982;25:1271-1277.
9. Heyland DK, Cook DJ, Schoenfeld PS, Frietag A, Varon J, Wood G. The effect of acidified enteral feeds on gastric colonization in critically ill patients: results of a multicenter randomized trial. Canadian Critical Care Trials Group. Crit Care Med. 1999;27:2399-2406.
10. Bertsias G, Ioannidis JP, Boletis J, et al. EULAR recommendations for the management of systemic lupus erythematosus. Report of a Task Force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics. Ann Rheum Dis. 2008;67:195-205.
11. Jordan N, Lutalo PM, D'Cruz DP. Novel therapeutic agents in clinical development for systemic lupus erythematosus. BMC Med. 2013;11:120.

Educational Objectives

After completing this activity, the participant should be better able to:

• Discuss the pathophysiologic mechanisms of SLE with an emphasis on the roles of various immune cell populations and the heterogeneity of disease manifestations
• Differentially diagnose SLE by integrating patient demographics, clinical presentations, laboratory testing, and the relative specificities and sensitivities of published classification criteria
• Describe the mechanisms of action and clinical profiles of emerging treatment strategies for SLE
• Construct individualized multimodal treatment regimens for patients with SLE to address disease activity levels, complete symptom profiles, and comorbid conditions
• Employ standardized clinical approaches to longitudinally monitor patients with SLE for disease activity, organ system damage, and therapeutic responses

Faculty

Jill P. Buyon, MD
Professor of Medicine
Director, Division of Rheumatology
New York University School of Medicine
Hospital for Joint Diseases
New York, New York

Michelle Petri, MD, MPH
Professor, Department of Medicine
Director, Lupus Center
Johns Hopkins University School of Medicine
Baltimore, Maryland

William Stohl, MD, PhD
Professor of Medicine, Rheumatology
University of Southern California, Los Angeles
Keck School of Medicine
Los Angeles, California

Daniel J. Wallace, MD, FACP, FACR
Clinical Professor of Medicine
David Geffen School of Medicine
University of California, Los Angeles
Associate Director, Rheumatology Fellowship Program
Cedars-Sinai Medical Center
Los Angeles, California

Accreditation Statement

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 Global Education Group (Global) and Integritas Communications. Global is accredited by the ACCME to provide continuing medical education for physicians.

Physician Credit Designation

Global Education Group designates this live activity 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.

Instructions for Obtaining Credit

In order to receive credit, participants must complete the pre-activity questionnaire, posttest and program evaluation. Participants must also score at least 70 % on the posttest and submit it, along with the credit application and evaluation form, to the address/ fax number indicated. Statements of credit will be mailed within 4 to 6 weeks following the program.
For information about the accreditation of this program, please contact Global at 303-395-1782 or inquire@globaleducationgroup.com

System Requirements

PC
Microsoft Windows 2000 SE or above.
Flash Player Plugin (v7.0.1.9 or greater)
Internet Explorer (v8.0 or greater), Chrome, or Firefox

MAC
MAC OS 10+
Flash Player Plugin (v7.0.1.9 or greater)
Safari

Fee Information & Refund/Cancellation Policy

There is no fee for this educational activity.

Disclosure of Conflicts of Interest

Global Education Group (Global) requires instructors, planners, managers and other individuals and their spouse/life partner who are in a position to control the content of this activity to disclose any real or apparent conflict of interest they may have as related to the content of this activity. All identified conflicts of interest are thoroughly vetted by Global for fair balance, scientific objectivity of studies mentioned in the materials or used as the basis for content, and appropriateness of patient care recommendations.

The faculty reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:

• Jill P. Buyon, MD Consultant/Independent Contractor: Baxter, Exagen, Novo Nordisk; Stock Shareholder: UV Therapeutics
• Michelle Petri, MD, MPH Consultant/Independent Contractor: Bristol-Myers Squibb, Genentech; Grant/Research Support: Medimmune, Teva, Anthera, UCB, HGS/GSK, Sanofi, Pfizer
• William Stohl, MD, PhD Consultant/Independent Contractor: Eli Lilly, Novartis, Celgene; Grant/Research Support: Xencor
• Daniel J. Wallace, MD, FACP, FACR Consultant/Independent Contractor: GSK, Pfizer, Merck, Sanofi; Honoraria: GSK, Pfizer, Merck, Sanofi; Speakers Bureau: GSK, Pfizer

The planners and managers reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:

• Jim Kappler, PhD Nothing to disclose
• Ashley Marostica, RN, MSN Nothing to disclose
• Amanda Glazar, PhD Nothing to disclose

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. Global Education Group (Global) and Integritas Communications do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of any organization associated with this activity. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed in this activity should not be used by clinicians without evaluation of patient conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.