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CME: Updates in the pharmacotherapeutic management of familial hypercholesterolemia (FH): present and emerging treatment options

Activity Description / Statement of Need:

In this online, self-learning activity:

Familial hypercholesterolemia (FH), also known as type II hyperlipoproteinemia, is an autosomal dominant disorder characterized by elevated plasma LDL-C levels in the absence of hypertriglyceridemia (or if triglycerides are elevated, they are so independently of FH). There are over 1,600 different mutations associated with FH, and the condition arises from a significant reduction in functional LDL-C receptors (LDL-Rs) – half in the case of heterozygous patients and practically none in the case of homozygous patients – and an attendant reduced rate of LDL-C clearance that predisposes an individual to premature atherosclerotic cardiovascular disease. If the LDL-C levels in a patient are greater than the 95th percentile for age and sex, it is likely that the person has a genetic cause for their hypercholesterolemia and the treatment goal is to prevent cardiovascular disease and cardiovascular related events. Analyses of data from the National Health and Nutrition Examination Survey (NHANES) suggest that the prevalence of FH in the U.S. is about 1 in every 299 persons.

Target Audience:

The following healthcare professionals: cardiology and primary care physicians; physician assistants, nurse practitioners, nurses, and pharmacists who practice in cardiology; and any other clinicians with an interest in FH.


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


Release Date: October 22, 2018 -- Expiration Date: October 22, 2020

Faculty: John A. Tayek, MD

Agenda

Faculty introduction, disclosures

Introduction content: cursory refresher and review of FH

  • Updates in statistics
  • Homozygous and heterozygous FH
  • Xanthoma development, vascular disease occurrence

Treatment and management of FH

  • Clinical trial findings and guideline remarks
  • Pharmacotherapy
  • Conventional therapy
  • PCSK-9 inhibitors
  • Lomitapide
  • Mipomersen
  • Other clinical pearls
  • Emerging and future therapies
  • Barriers to optimal care in patients with FH
  • Best practice: putting it all together
  • Patient case(s)

Summary, conclusions, and best practice recap

Learning Objectives

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

  • Describe the pathophysiology and genetics of FH such that they might inform treatment mechanisms
  • Describe presently available and emerging treatment options for FH and apply them to patient cases
  • Evaluate a FH treatment plan and suggest modifications for improvement
  • Describe clinical and logistical challenges associated with treating and educating patients with FH

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.

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 # 0574-0000-18-038-H01-P.  ACPE Accreditation effective 10/30/2018, expires 10/30/2020. 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 Disclosure: John A. Tayek, M.D., Professor of Medicine-In Residence David Geffen School of Medicine at UCLA Harbor-UCLA Medical Center, has received research support from Ajinomoto and Amarin Pharma.

 

Disclosures of Educational Planners: Charles Turck, PharmD, BCPS, BCCCP has no relevent financial disclosures.

 

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

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.