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CME: Interstitial Lung Disease with Progressive Lung Disease Phenotype (ILD-PF): Therapeutic Updates, Best Practices, and Emerging Therapies

Activity Description / Statement of Need:

In this online, self-learning activity:

Interstitial lung disease (ILD) is a collective term used to categorize more than 200 different types of diseases that affect the alveolar structures, the pulmonary interstitium, and small airways. The incidence and prevalence of ILD, as its own entity, are difficult to quantify because of number of different causes and the difficulty diagnosing patients. One form of ILD is associated with an overexpression of adenosine-2B receptor (A2BAR) has been linked to rapid progression of idiopathic pulmonary fibrosis (IPF), a type of IIP, and patients identified with this highly upregulated gene warrants closer monitoring of lung function and disease progression. Known as ILD with progressive lung phenotype (ILD-PF), patients with a number of diseases, such as rheumatoid arthritis and chronic hypersensitivity pneumonitis, are predisposed to this variant. This learning activity has been designed to bring HCPs’ knowledge of the strategies for treatment and management of ILD-PF up to date and to improve their competence and performance in treating it.

Target Audience:

The following HCPs: pulmonologists, rheumatologists, primary care physicians, pathologists, dermatologists; physician assistants, nurse practitioners, nurses, and pharmacists specializing in pulmonology; and any other HCPs who have an interest in or otherwise clinically encounter patients with ILD-PF.


This program is supported by an educational grant from Boehringer Ingelheim.


Release Date: January 27, 2019 -- Expiration Date: January 27, 2021

Faculty: Terese Hammond, MD

Agenda

Introduction, Disclosures

Cursory refresher and review on ILD epidemiology and diagnosis and introduction to the PF variant

  • Epidemiology, risk factors, and pathophysiology

o    Age, race, gender

o    Environmental factors

o    Genetics (A2BAR)

o    Autoimmune diseases

o    Immune dysfunction

o    Overactivation of fibroblasts

  • Clinical presentation

o    Dyspnea on exertion

o    Nonproductive cough

·         Diagnosis

o    HRCT scan vs. chest radiography

o    Lung biopsy

o    Serological testing

  • Patient case(s)

Treatment of ILD-PF

  • Treatment overview and goals of therapy
  • Current practice guidelines and standard care options
  • Pharmacogenetics
  • Pharmacotherapy

o    Corticosteroids

o    Immunomodulators

o    Nintedanib

o    Pirfenidone

  • Lung transplantation
  • Patient education
  • Patient case(s)

Summary, conclusions, and best practice recap

1

Introduction, Disclosures

13

Cursory refresher and review on ILD epidemiology and diagnosis and introduction to the PF variant [Learning Objectives #1-3]

  • Epidemiology, risk factors, and pathophysiology

o    Age, race, gender

o    Environmental factors

o    Genetics (A2BAR)

o    Autoimmune diseases

o    Immune dysfunction

o    Overactivation of fibroblasts

  • Clinical presentation

o    Dyspnea on exertion

o    Nonproductive cough

·         Diagnosis

o    HRCT scan vs. chest radiography

o    Lung biopsy

o    Serological testing

  • Patient case(s)

45

Treatment of ILD-PF [Learning Objectives #4 & 5]

  • Treatment overview and goals of therapy
  • Current practice guidelines and standard care options
  • Pharmacogenetics
  • Pharmacotherapy

o    Corticosteroids

o    Immunomodulators

o    Nintedanib

o    Pirfenidone

  • Lung transplantation
  • Patient education
  • Patient case(s)

1

Summary, conclusions, and best practice recap

Learning Objectives

By the end of the session the participant will be able to:

  • Describe the pathophysiology of and risk factors for ILD-PF such that it might inform treatment mechanisms and strategies
  • Identify signs and symptoms of ILD-PF (e.g., rheumatoid arthritis, chronic hypersensitivity pneumonitis, unclassified ILD)
  • Describe the prevalence, morbidity, and mortality, burden of illness associated with ILD-PF and, conversely, the benefits associated with early identification and treatment
  • Describe current treatment standards and monitoring parameters (HRCT, PFTs) of ILD-PF, including developments in clinical research and treatment guidelines, and apply them to patient cases
  • Discuss ways to improve clinician communication with their patients, including disease education

Accreditation

This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education through ScientiaCME. ScientiaCME is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation: ScientiaCME designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™ toward the AMA Physician's Recognition Award. Physicians should only claim credit commensurate with the extent of their participation in the activity.

CME-MOC Badge

ABIM MOC Recognition Statement: Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

Physicians: For applicable courses, to attain maintenance of certification (MOC) credit, you must enter your board certification ID # and birth date correctly.  It is the learner's responsibility to provide this information completely and accurately at the completion of the activity. Without providing it, the learner will NOT receive MOC credit for this activity. Please note: not all activities on this site provide MOC credit. If this activity does not specify that it provides MOC credit in the "Accreditation" section on this page, then it does NOT provide MOC credit.

Pharmacists

ScientiaCME is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmaceutical education. This program is approved for 1.0 hours (0.1 CEUs) of continuing education. Proof of participation will be posted to your NABP CPE profile within 4 to 6 weeks to participants who have successfully completed the post-test. Participants must participate in the entire presentation and complete the course evaluation to receive continuing pharmacy education credit. ACPE # 0574-0000-19-001-H01-P. ACPE Accreditation effective 2/8/19 expires 2/8/21. This is a Application (A)-type activity.

Pharmacists: You must enter your NABP # and birth date correctly so that proof of participation can be posted to your NABP CPE profile. It is the learner's responsibility to provide this information completely and accurately at the completion of the activity. Without providing it, the learner will NOT receive CPE credit for this activity.

Nurse Practitioners (NPs): The American Academy of Nurse Practitioners accepts AMA PRA Category 1 Credit(s)™ from organizations accredited by the ACCME.  ScientiaCME will provide NPs who successfully complete each activity with a certificate of participation indicating that the activity was designated for AMA PRA Category 1 Credit(s)™.

Physician Assistants: The American Academy of Physician Assistants accepts AMA PRA Category 1 Credit(s)™ from organizations accredited by the ACCME.


Faculty Disclosure and Resolution of COI

As a provider of continuing medical education, it is the policy of ScientiaCME to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. In accordance with this policy, faculty and educational planners must disclose any significant relationships with commercial interests whose products or devices may be mentioned in faculty presentations, and any relationships with the commercial supporter of the activity. The intent of this disclosure is to provide the intended audience with information on which they can make their own judgments. Additionally, in the event a conflict of interest (COI) does exist, it is the policy of ScientiaCME to ensure that the COI is resolved in order to ensure the integrity of the CME activity. For this CME activity, any COI has been resolved thru content review ScientiaCME.

Faculty Disclosures:

Dr. Terese C. Hammond,  MD, Clinical Professor, University of Southern California, Los Angeles, CA has no relevant conflicts of interest to disclose.

Disclosures of Educational Planners: Charles Turck, PharmD has no relevant conflicts of interest to disclose.

Commercial Support Disclosure: This program is supported by an educational grant from Boehringer Ingelheim.

Instructions

  • Read the learning objectives above
  • Take the Pre-Test (optional). Completion of the pre-test will help us evaluate the knowedge gained by participating in this CME activity.
  • View the online activity. You may view this is in more than one session, and may pause or repeat any portion of the presentation if you need to.
  • Take the post-test
  • Complete the activity evaluation and CME registration. A CE certificate will be emailed to you immediately.

Cultural and Linguistic Competence

System Requirements

PC
Windows 7 or above
Internet Explorer 8
*Adobe Acrobat Reader
MAC
Mac OS 10.2.8
Safari or Chrome or Firefox
*Adobe Acrobat Reader
Internet Explorer is not supported on the Macintosh

*Required to view Printable PDF Version


Perform Pre-Test (optional)

Please take a few minutes to participate in the optional pre-test. It will help us measure the knowledge gained by participating in this activity.