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CME: Medical and nutritional management of eosinophilic esophagitis in adolescents and adults: therapeutic updates and best practices

Activity Description / Statement of Need:

In this online, self-learning activity:

Eosinophilic esophagitis (EoE) is a chronic immune-mediated disease characterized by clinical features of esophageal dysfunction and eosinophil inflammation. EoE is mediated by type 2 helper T cell activity and precipitated primarily by dietary antigens. It may affect people of all ages and races, but the prevalence is highest amongst middle-aged Caucasian males. Approximately 30 out of every 100,000 adults in the U.S. are thought to have the condition.

EoE’s diagnostic criteria consider the following major features: positive endoscopic findings, concomitant atopy, positive findings on esophageal biopsy, and whether non-EoE are contributing factors. Gastroesophageal reflux disease (GERD) is at the top of EoE’s list of differential diagnoses, and food hypersensitivity is the most common cause, and the hallmark clinical symptom in adults is dysphagia. Among patients who visit the emergency department, EoE is the leading cause of food impaction, comprising more than 50% of cases.

Target Audience:

The following healthcare professionals: allergists, immunologists, pediatricians, and primary care physicians; physician assistants, nurse practitioners, nurses, and pharmacists who specialize in the aforementioned fields; and any other healthcare professionals with an interest in or who may clinically encounter patients with EoE.


Commercial Support Disclosure: This activity is supported by an educational grant from Shire.

Learners may participate in this activity free of charge.


Release Date: February 15, 2020 -- Expiration Date: February 15, 2022

Faculty: John Clarke, MD

Agenda

Introduction, Disclosures

Introduction content: cursory refresher and review

  • Epidemiological statistics
  • Pathophysiology
  • Clinical presentation and symptoms
  • Complications
  • Diagnosis

Updates on current practices available for EoE

  • Pharmacological therapy: acid-suppressive therapy, topical corticosteroids including investigational SHP 621
  • Other experimental pharmacotherapies
  • Nutritional management, including step-up elimination diet, amino acid-based diet
  • Allergy testing effectiveness
  • 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 patholophysiology of EoE in adults and adolescents such that it informs treatment mechanisms
  • Describe the clinical presentation, complications associated with, and diagnosis EoE in adults and adolescents.
  • Identify current drug treatment options and dietary strategies available for the management of EoE, including strengths and weaknesses of each, and apply them to patient cases using evidence-based medicine.
  • Identify issues with current practices for EoE and strategies to address them.

Accreditation

This activity has been planned and implemented in accordance with the accreditation requirements 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  1.00 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 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 this section, 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 activity is approved for 1.00 hours (0.10 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 # 0574-0000-20-005-H01-P.  CPE credit effective 2/25/20 and expires 2/25/22. This is a Knowledge (K)-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 AAMA 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 Clarke, MD, Stanford University,has no relevant conflicts of interest to disclose.

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

Commercial Support Disclosure: This activity is supported by an educational grant from Shire.

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.

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.