Assessing anti-TNF failures: Using pharmacology to guide tools and tricks in the clinic

Stephen B. Hanauer, MD

Joseph B. Kirsner Professor of Medicine and Clinical Pharmacology
Chief, Section of Gastroenterology, Hepatology and Nutrition
University of Chicago Medicine
Chicago, IL

Biography

Statement of need

Since their introduction for the treatment of IBD we have learned a great deal about the efficacy and safety of anti-TNFα therapy. However, we are still learning how to assess and optimize both induction and maintenance strategies to ensure that the greatest proportion of patients gain clinical benefit from therapy. An essential part in the optimization of therapy is the effective identification and management of treatment failure during induction and maintenance. This Practice Pointer explores how pharmacological information can be used to identify the underlying cause of failure, and thus help direct effective management strategies.

Target audience

This CME activity has been developed to meet the educational needs of gastroenterologists and registered nurses who have an interest in optimizing the management of patients with inflammatory bowel disease.

Release date: August 30, 2013
Expiry date: August 30, 2014

Learning objectives

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

  • Identify clinical features associated with treatment failure
  • Summarize the principles of induction therapy to avoid primary treatment failure
  • Explain the clinical pharmacology of anti-TNF agents
  • Develop a diagnostic strategy to assess mechanisms of loss of response.

Syllabus disclosure statement

Disclosure of conflicts of interest

Postgraduate Institute for Medicine (PIM) requires instructors, planners, managers and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest (COI) they may have as related to the content of this activity. All identified COI are thoroughly vetted and resolved according to PIM policy. PIM is committed to providing its learners with high quality CME activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest.

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:

Name

Company

Relationship

Stephen B. Hanauer

Abbvie, Elan, Ferring, Janssen, Meda, Millenium Pharmaceuticals, Pfizer, Prometheus, Salix, Santarus, Shire, Takeda, UCB Pharma, Warner-Chilcott

Abbvie, Elan, Ferring, Janssen, Millenium Pharmaceuticals, Pfizer, Prometheus, Salix, Shire, Takeda, UCB Pharma, Warner-Chilcott

Consulting Fees



Clinical Research


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:

The following PIM planners and managers, Laura Excell, ND, NP, MS, MA, LPC, NCC; Trace Hutchison, PharmD, Samantha Mattiucci, PharmD; and Jan Schultz, RN, MSN, CCMEP; hereby state that they or their spouse/life partner do not have any financial relationships or relationships to products or devices with any commerical interest related to the content of this activity or any amount during the past 12 months.

The following SCI planners and managers, John Mitchell, PhD, and Ian Morgan, MSc, hereby state that they or their spouse/life partner do not have any financial relationships or relationships to products or devices with any commercial interest related to the content of this activity of any amount during the past 12 months.

Accreditation

Physician continuing education

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 through the joint sponsorship of Postgraduate Institute for Medicine and Strategic Consultants International. Postgraduate Institute for Medicine is accredited by the ACCME to provide continuing medical education for physicians.

Credit designation

The Postgraduate Institute for Medicine designates this enduring material for a maximum of 0.75 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Estimated time to complete activity: 45 minutes

Nursing continuing education

Credit designation

This educational activity for 0.7 contact hours is provided by Postgraduate Institute for Medicine.

Accreditation statement

Postgraduate Institute for Medicine is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.

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. The planners of this activity 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 the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Method of participation

There are no fees for participating and receiving CME credit for this activity. During the period of August 30, 2013, through August 30, 2014, participants must; (1) read the learning objectives and faculty disclosures, (2) participate in the educational activity, (3) complete the post-test by recording the best answer to each question, and (4) complete the online evaluation form. Upon successful completion of the post-test (70% or better) and online evaluation form, you will be provided with a CME Credit Summary. Please fax the CME Credit Summary to Postgraduate Institute for Medicine to the number provided on the Summary form. A statement of credit will be mailed to you within three weeks.

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 or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Jointly sponsored/co-provided by the Postgraduate Institute for Medicine
and Strategic Consultants International
PIM Logo SCI Logo
This activity is supported by educational grants from
Takeda Pharmaceuticals International, Inc., US Region,
and Prometheus Laboratories.
Takeda Pharmaceuticals         Prometheus