Advances in Managing Fistulizing Crohn’s Disease

Faculty

Amy L. Lightner, MD
Director, Center for Regenerative Medicine and Surgery
Associate Professor of Colorectal Surgery, Digestive Disease Institute
Associate Professor of Inflammation and Immunity, Lerner Research Institute
Core Member in the Center for Immunotherapy
Cleveland Clinic
Cleveland, Ohio

Bruce E. Sands, MD, MS
Dr. Burrill B. Crohn Professor of Medicine
Icahn School of Medicine at Mount Sinai
Chief, Division of Gastroenterology
Mount Sinai Health System
New York, New York

Program Description

The presence of fistulizing Crohn’s disease (FCD) reflects a distinct, aggressive phenotype of CD and indicates a challenging and complicated disease course necessitating an early, intense, and multidisciplinary approach to treatment. Compared with patients without perianal involvement, patients with perianal FCD have higher rates of hospitalization, surgery, and use of immunosuppressive medications and are at higher risk of complications, including anal and rectal cancer. Further, despite recent advances in pharmacologic therapies and surgical techniques, complete healing occurs in only half of cases. Even if healing is achieved, the risk of fistula recurrence remains high regardless of the treatment approach. This multimedia IBD eHealth Source™ activity, composed of 4 chapters, will provide published clinical evidence and guideline recommendations surrounding the evaluation, medical and surgical treatment, and longitudinal assessment of FCD. Clinical data will be augmented with insights from expert faculty to provide actionable recommendations for the multidisciplinary and shared decision-making approach to care.

Target Audience

The educational design of this activity addresses the needs of gastroenterologists, colorectal surgeons, and specialist NPs and PAs.

Learning Objectives

After completing this activity, participants will be better prepared to:

• Assess the type, severity, and disease burden of FCD
• Compare and contrast the clinical trial data on current and emerging agents, including biologics and stem cells, for the medical treatment of perianal FCD (PFCD)
• Optimize the combination of medical therapy with surgical techniques to treat PFCD lesions of various types and severity with a goal of optimizing patient outcomes
• Employ a multidisciplinary and shared decision-making approach to managing patients with PFCD that includes medical therapy, surgical treatment approaches, as well as incorporation of patient preferences

Physician Accreditation Statement

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Global Education Group and Integritas Communications. Global Education Group is accredited by the ACCME to provide continuing medical education for physicians.

Physician Credit Designation

Global Education Group 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.

Nurse Practitioner Continuing Education

This activity has been planned and implemented in accordance with the Accreditation Standards of the American Association of Nurse Practitioners (AANP) through the joint providership of Global Education Group and Integritas Communications. Global Education Group is accredited by the American Association of Nurse Practitioners as an approved provider of nurse practitioner continuing education. Provider number: 110121. This activity is approved for 1.0 contact hour(s) (which includes 0.0 hour(s) of pharmacology).

Disclosure of Conflicts of Interest

Global Education Group adheres to the policies and guidelines, including the Standards for Integrity and Independence in Accredited CE, set forth to providers by the ACCME and all other professional organizations, as applicable, stating those activities where continuing education credits are awarded must be balanced, independent, objective, and scientifically rigorous. All persons in a position to control the content of an accredited continuing education program provided by Global are required to disclose all financial relationships with any ineligible company within the past 24 months to Global. All financial relationships reported are identified as relevant and mitigated by Global in accordance with the Standards for Integrity and Independence in Accredited CE in advance of delivery of the activity to learners. The content of this activity was vetted by Global to assure objectivity and that the activity is free of commercial bias.

All relevant financial relationships have been mitigated.

The faculty have the following relevant financial relationships with ineligible companies:

Amy L. Lightner, MD - Consulting Fee(s): Boomerang Medical, Inc., Mesoblast Limited, Ossium Health, Inc., Takeda Pharmaceuticals U.S.A., Inc.

Bruce E. Sands, MD, MS - Consulting Fee(s): AbbVie, Amgen, Arena Pharmaceuticals, AstraZeneca, Boehringer-Ingelheim, Bristol Myers Squibb, Celltrion Healthcare, Genentech, Glaxo SmithKline, Janssen, Lilly, Merck & Co., Pfizer, Sun Pharma Global, Takeda Pharmaceuticals International, Teva Branded Pharmaceutical Products R&D, Contracted Research: Arena Pharmaceuticals, Janssen, Bristol Myers Squibb, Honoraria: Janssen, Pfizer, Takeda, Stock Option Holder: Ventyx Biosciences

The planners and managers at Global and Integritas Communications have no relevant financial relationships 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 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.

Instructions to Receive Credit

In order to receive credit, participants must complete the following:

1. Read the educational objectives, accreditation information, and faculty disclosures at the beginning of this activity.
2. Complete the Preactivity Questions.
3. Review the activity content.
4. Achieve a grade of 70% on the Postactivity Test Questions and complete the Evaluation.

Fee Information & Refund/Cancellation Policy

There is no fee for this educational activity.

Global Education Group Contact Information

For information about the accreditation of this program, please contact Global Education Group at 303-395-1782 or cme@globaleducationgroup.com.