Systemic Pathology of Rheumatoid Arthritis

Faculty

Needs Statement

Rheumatoid arthritis (RA) afflicts 2.1 million Americans. A progressive disease of the joints with a recognized autoimmune component, RA is often associated with debilitating pain and stiffness, and eventual loss of joint function in many patients. In addition, RA may be associated with serious extraarticular disease, and significant comorbidities, best revealed by studies identifying a 10-15 year shorter lifespan for patients with RA. RA can adversely affect the cardiovascular system, renal and pulmonary function, as well as the mucosa of the mouth and eyes. The disease has also served as a model for the low hemoglobin levels characteristic of the anemia of chronic disease. Patients with RA frequently manifest additional autoimmune dysfunction, and are at increased risk of early mortality. The results of one study, conducted in over 3,000 RA patients followed for up to 35 years, revealed a greater than 2-fold mortality ratio for RA patients, with most deaths attributed to cardiac and cerebrovascular events. The present activity is designed to address the prevalence, risk factors, etiology, and current management strategies for two major comorbid conditions associated with RA; cardiovascular disease and the anemia of chronic disease. The activity will include a review of the effects of RA-associated cytokines and antirheumatic therapies on cardiovascular risk factors and on blood hemoglobin levels. The goal is to raise awareness of systemic inflammatory comorbidities among patients with RA, and to promote surveillance and early intervention.

Target Audience

This educational activity is designed to educate rheumatologists, infusion nurses, and pharmacists concerning the prevalence, risk factors, consequences, and management of the effects of rheumatoid arthritis on cardiovascular health and on the maintenance of hemoglobin levels.

 

Objectives

1. Describe how inflammation is related to the development of cardiovascular disease and low hemoglobin levels, in patients with RA;
2. Differentiate the low hemoglobin levels associated with the inflammation of rheumatoid arthritis from iron deficiency anemia;
3. Explain how cytokines and treatments for RA may affect the development and outcome of cardiovascular disease and low hemoglobin levels.

Accreditation

Medicine
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 the University of Kentucky College of Medicine and CTI Clinical Trial & Consulting Services. The University of Kentucky College of Medicine is accredited by the ACCME to provide continuing medical education for physicians.

The University of Kentucky College of Medicine designates this educational activity for a maximum of 1.00 AMA PRA Category 1 Credits™. Each physician should claim only those hours of credit actually spent in the educational activity.

The University of Kentucky College of Medicine presents this activity for educational purposes only. Participants are expected to utilize their own expertise and judgment while engaged in the practice of medicine. The content of the presentations is provided solely by presenters who have been selected for presentations because of recognized expertise in their field.

Pharmacy
The University of Kentucky College of Pharmacy is approved by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

This activity has been assigned ACPE # 022-999-07-137-H04-P and will award up to 1.20 contact hours (0.12 CEUs) of continuing pharmacy education credit in states that recognize ACPE providers.

Statements of credit will indicate hours and CEUs based on participation and will be issued online at the conclusion of the activity. Successful completion includes completing the activity, its accompanying evaluation and/or posttest and requesting credit online at conclusion of the activity. The College complies with the Criteria for Quality for continuing education programming.

Nursing
Educational Review Systems is an approved provider of continuing education in nursing by ASNA, an accredited provider by the ANCC/Commission on Accreditation and designates this educational activity for a maximum of 1.00 hour(s). Provider # 05-115-07-068

Educational Review Systems is also approved for nursing continuing education by the state of California and the District of Columbia.

Faculty Disclosure

Dr. Kremer receives contract research support from Abbott, Amgen, Bristol-Myers Squibb, Genentech, and Roche. He receives consultation fees from Abbott, Amgen, Bristol-Myers Squibb, Genentech, and Roche.

Dr. Abramson receives consultation fees from Abbott, Amgen, GlaxoSmithKline, Novartis, and Pfizer.

 

Activity Sponsorship

This activity is jointly sponsored by the University of Kentucky and CTI Clinical Trial & Consulting Services. Supported by an unrestricted educational grant from Roche Laboratories Inc..