Swimming Upstream in Severe Asthma

This activity is jointly provided by Global Education Group and Integritas Communications.

This activity is supported by an independent educational grant from AstraZeneca.

MEDICAL COMMUNICATIONS INQUIRIES info@integritasgrp.com integritasgrp.com

Reynold A. Panettieri, Jr, MD Moderator

Professor of Medicine Robert Wood Johnson Medical School Vice Chancellor, Translational Medicine and Science Director, Rutgers Institute for Translational Medicine and Science Emeritus Professor of Medicine, University of Pennsylvania Child Health Institute of New Jersey Rutgers, The State University of New Jersey New Brunswick, New Jersey Dr. Reynold Panettieri is the inaugural Director of the Institute for Translational Medicine and Science and Vice Chancellor for Translational Medicine and Science at Rutgers University in New Brunswick, New Jersey. He previously served as the Director of the Airways Biology Initiative and the Deputy Director of the Center of Excellence in Environmental Toxicology at the University of Pennsylvania in Philadelphia, Pennsylvania.

Dr. Panettieri’s interests include the cellular and molecular mechanisms that regulate airway smooth muscle cell growth and the immunobiology of airway smooth muscle. Consequences of increases in airway smooth muscle growth promote the development of irreversible airflow obstruction and airway remodeling seen in patients with chronic severe asthma. His lab also focuses on cytosolic signaling pathways that mediate gene expression and alter myocyte growth.

In addition to his research and clinical interests, Dr. Panettieri served as chairperson of the National Institutes of Health (NIH) Lung Cellular, Molecular, and Immunobiology Study Section, is a member of the NIH Distinguished Editorial Panel, and is a member of the American Society for Clinical Investigation and Association of American Physicians. Dr. Panettieri earned his medical degree from the University of Pennsylvania.

He also completed his residency and fellowship at the Hospital of the University of Pennsylvania.

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FACULTY

FACULTY

Jonathan Corren, MD FACULTY

Associate Clinical Professor of Medicine and Pediatrics David Geffen School of Medicine University of California, Los Angeles Medical Director, Jonathan Corren M.D. and Associates Los Angeles, California

Dr. Jonathan Corren, a Los Angeles, California native, attended college at the University of California (UC) Los Angeles, medical school at UC San Diego, was resident in Internal Medicine at UC Davis and allergy fellow at National Jewish Hospital in Denver, Colorado.

After returning to UC Los Angeles (UCLA) as faculty, he served as Director of Clinical Allergy Services, the Nasal/Sinus Disease Center, and the Allergy/Immunology fellowship program. He later entered private practice and continued with clinical research, focusing on new therapies for severe asthma, and is currently chair of an NIH/ National Institute of Allergy and Infectious Diseases (NIAID) research program examining effects of combination biologic medication/allergy immunotherapy. He was volunteer director of the allergy/immunology clinic at a local free clinic and directed a non-profit aimed at improving asthma care in the inner city.

Dr. Corren teaches in the UCLA Allergy/Immunology Fellowship Program, is a mentor to UCLA undergraduates, and lectures frequently at local, state, national, and international meetings. He has been chair or member of multiple committees and interest sections of the American Academy of Allergy, Asthma & Immunology (AAAAI). His research has been published extensively, he has authored multiple chapters in the Middleton Textbook of Allergy, as well as other textbooks, and is currently UpToDate editor for Rhinitis/Sinusitis.

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Monica Kraft, MD

FACULTY

Professor of Medicine Chair, Department of Medicine The Robert and Irene Flinn Endowed Chair in Medicine University of Arizona (UA) College of Medicine – Tucson Deputy Director, UA Health Sciences Asthma and Airway Disease Research Center Tucson, Arizona Dr. Monica Kraft is a Professor of Medicine, Chair of the Department of Medicine, and The Robert and Irene Flinn Endowed Chair of Medicine at the University of Arizona (UA) College of Medicine in Tucson, Arizona. She also serves as Deputy Director of the UA Health Sciences Asthma and Airway Disease Research Center.

Prior to joining UA in 2014, Dr. Kraft served as chief of the Division of Pulmonary, Allergy, and Critical Care, as the Charles C. Johnson, MD, Distinguished Professor of Medicine, and as director of the Duke Asthma, Allergy and Airway Center at Duke University in Durham, North Carolina.

As vice chair for research in the Duke University Department of Medicine from 2009-2013, Dr. Kraft implemented several important initiatives to support the department’s research endeavors and was instrumental in the re-submission and renewal of Duke’s NIH-funded Clinical Translational Science Award (CTSA).

Dr. Kraft has previously served as Director of the Carl and Hazel Felt Laboratory in Adult Asthma Research and as Medical Director of the pulmonology physiology unit at the National Jewish Medical and Research Center in Denver, Colorado. She received her undergraduate degree in chemistry from the UC Davis and her medical degree from UC San Francisco. She served as chief resident at Harbor-UCLA Medical Center in Torrance, California, and completed her fellowship at the University of Colorado Health Sciences Center, Division of Pulmonary Sciences and Critical Care Medicine in Aurora, Colorado.

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TARGET AUDIENCE

The educational design of this activity addresses the needs of pulmonologists, clinical immunologists, and other specialist clinicians who treat patients with severe asthma.

EDUCATIONAL OBJECTIVES

Upon completion of this activity, participants should be better able to:

PREAMBLE

• Describe clinically relevant pathophysiologic processes in severe asthma, including implications for new targeted treatment options • Comprehensively assess patients with asthma for disease severity, lung function, and treatment responses • Discuss the mechanisms of action and clinical profiles of new and emerging targeted therapies for severe asthma • Individualize treatment regimens for patients with severe asthma based on symptoms, phenotypes, and patient preferences

PROGRAM DESCRIPTION

This virtual live Interactive Exchange™ severe asthma program will provide a blended educational format that promotes opportunities for various interactions and dialogue among presenting faculty and participants. The program will begin with expert presentations that impart foundational information—including key upstream inflammatory pathways, the role of the epithelium in asthma development, mechanisms underlying characteristic phenotypes, and the rationale for targeted biologic therapies—for the interactive discussions that will follow.

Faculty will focus on key topics, such as recent clinical trial evidence for emerging pharmacotherapies that target type 2 (T2)–low disease, evolving evidence-based treatment algorithms, and potential strategies for effectively managing patients with uncontrolled, severe disease. This multimedia experience will deliver optimized participant engagement while ensuring the sharing of experiences surrounding challenging clinical topics in today’s severe asthma landscape.

PHYSICIAN ACCREDITATION STATEMENT

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Global Education Group (Global) and Integritas Communications.

Global is accredited by the ACCME to provide continuing medical education for physicians.

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PHYSICIAN CREDIT DESIGNATION

Global designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit ™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Global Education Group (Global) adheres to the policies and guidelines, including the Standards for Integrity and Independence in Accredited CE, set forth to providers by the Accreditation Council for Continuing Medical Education (ACCME) and all other professional organizations, as applicable, stating those activities where continuing education credits are awarded must be balanced, independent, objective, and scientifically rigorous. All persons in a position to control the content of an accredited continuing education program provided by Global are required to disclose all financial relationships with any ineligible company within the past 24 months to Global. All financial relationships reported are identified as relevant and mitigated by Global in accordance with the Standards for Integrity and Independence in Accredited CE in advance of delivery of the activity to learners. The content of this activity was vetted by Global to assure objectivity and that the activity is free of commercial bias.

All relevant financial relationships have been mitigated.

The faculty have the following relevant financial relationships with ineligible companies: Jonathan Corren, MD Consulting Fees: AstraZeneca plc, Regeneron Pharmaceuticals, Inc., sanofi-aventis U.S. LLC; Contracted Research: AstraZeneca plc, Genentech, Inc., Novartis Pharmaceuticals Corporation, OptiNose US, Inc., Regeneron Pharmaceuticals, Inc., sanofiaventis U.S. LLC, Teva Pharmaceutical Industries Ltd.; Speakers Bureau: AstraZeneca plc, Genentech, Inc., Regeneron Pharmaceuticals, Inc., sanofi-aventis U.S. LLC Monica Kraft, MD Consultant/Independent Contractor: AstraZeneca plc, sanofi-aventis U.S. LLC; Grant/Research Support: AstraZeneca plc, Chiesi USA, Inc., sanofi-aventis U.S. LLC Reynold A. Panettieri, Jr, MD Grant/Research Support: AstraZeneca plc, Equillium, Inc., Evelo Biosciences, Inc., Genentech, Inc., Johnson & Johnson, Maven, MedImmune, LLC, Novartis Pharmaceuticals Corporation, OptiKira, LLC, Theravance Biopharma, Inc.; Consultant/ Advisory Board: AstraZeneca plc, Bayer AG, Equillium Inc., Genentech, Inc., Regeneron Pharmaceuticals, Inc., sanofi-aventis U.S. LLC, Theravance Biopharma, Inc.; Speakers Bureau: AstraZeneca plc, Genentech, Inc., Regeneron Pharmaceuticals, Inc., sanofi-aventis U.S. LLC

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PREAMBLE

DISCLOSURE OF CONFLICTS OF INTEREST

The following planners and managers have no relevant financial relationships with ineligible companies: Lindsay Borvansky, Andrea Funk, Liddy Knight, Ashley Cann, Celeste Collazo, MD, Rose O’Connor, PhD, CHCP, Jim Kappler, PhD

DISCLOSURE OF UNLABELED USE

PREAMBLE

This educational activity may contain discussion of published and/ or investigational uses of agents that are not indicated by the US Food and Drug Administration. Global and Integritas Communications 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 any organization associated with this activity. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

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

INSTRUCTIONS TO RECEIVE CREDIT

In order to receive credit for this activity, the participant must attend the webinar and complete the posttest and program evaluation.

GLOBAL CONTACT INFORMATION

For information about the accreditation of this program, please contact Global at 303-395-1782 or cme@globaleducationgroup.com.

FEE INFORMATION & REFUND/CANCELLATION POLICY There is no fee for this educational activity.

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AMERICANS WITH DISABILITIES

Any activity registrant who feels s/he may need accommodations based on the impact of a disability should contact Integritas Communications at info@exchangecme.com to discuss their specific needs.

INTEGRITAS CONTACT INFORMATION

PREAMBLE

For information about this program, please contact us at info@exchangecme.com.

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CLINICAL PRACTICE GUIDELINES

» Global Strategy for Asthma Management and Prevention.

Global Initiative for Asthma, 2021. https://ginasthma.org/wp-content/uploads/2021/04/GINA-2021-Main-Report_ FINAL_21_04_28-WMS.pdf

» Management of severe asthma: a European Respiratory Society/ American Thoracic Society guideline.

Holguin F, et al. Eur Respir J. 2020;55(1):1900588. https://erj.ersjournals.com/content/55/1/1900588.long

CLINICAL PRACTICE TOOLS

» Centers for Disease Control and Prevention (CDC) Asthma Action Plans These tools for asthma control were created following the evidencebased guidance published by the National Institutes of Health. https://www.cdc.gov/asthma/actionplan.html

» Asthma Control Test (ACT) This 5-question test evaluates asthma control over the past 4 weeks on a 5-point Likert scale. A score of <20 on the ACT suggests asthma that is uncontrolled.

Nathan RA, et al. J Allergy Clin Immunol. 2004;113(1):59-65. https://getasthmahelp.org/documents/ACT_AdultEng.pdf

RESOURCE CENTER

» Asthma Control Questionnaire (ACQ) This 7-question assessment tool measures asthma control over the past 7 days. Six questions are self-administered by the patient, and 1 question requires a clinician’s input. Scores range from 1 (totally controlled) to 6 (severely uncontrolled).

Juniper EF, et al. Eur Respir J. 1999;14(4):902-907. https://erj.ersjournals.com/content/erj/14/4/902.full.pdf

» Asthma Therapy Assessment Questionnaire (ATAQ) This 4-question test assesses asthma control over the past 4 weeks.

Each question has a possible score of 0 or 1; if the sum of the 4 question scores is >1, the patient’s asthma may be uncontrolled.

Vollmer WM, et al. Am J Respir Crit Care Med. 1999;160(5 Pt 1):1647-1652. http://getasthmahelp.org/documents/2007Guidelines_ValidatedQuestionnaires.pdf

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» Shared Decision-Making Tool The CHEST Foundation, Allergy and Asthma Network, and American College of Allergy, Asthma & Immunology (ACAAI) have developed a shared decision-making tool for adults with severe asthma so that they may work collaboratively with clinicians to improve self-management skills, choose the best treatment plan, and increase adherence. http://asthma.chestnet.org/sdm-tool/

PATIENT ADVOCACY ORGANIZATIONS AND RESOURCES » Asthma and Allergy Foundation of America (AAFA)

AAFA is dedicated to improving the quality of life for people with asthma and allergic diseases through education, advocacy, and research. http://www.aafa.org/page/asthma.aspx

» American College of Allergy, Asthma & Immunology (ACAAI) The ACAAI fosters a culture of collaboration and congeniality in which members work toward the common goals of patient care, education, advocacy, and research. https://acaai.org/asthma

» American Lung Association The American Lung Association is the leading organization working to save lives by improving lung health and preventing lung disease through education, advocacy, and research. http://www.lung.org/lung-health-and-diseases/lung-disease-lookup/asthma/

» American Thoracic Society (ATS) The mission of the ATS is to improve health worldwide by advancing research, clinical care, and public health in respiratory disease, critical illness, and sleep disorders.

» Chest Foundation The CHEST Foundation creates trusted patient education resources and disease awareness campaigns that empower patients to engage in better managing their health. foundation.chestnet.org/patient-education-resources/asthma/

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RESOURCE CENTER

https://www.thoracic.org/patients/patient-resources/

SUGGESTED READING

» Understanding asthma phenotypes, endotypes, and mechanisms of disease.

Kuruvilla ME, et al. Clin Rev Allergy Immunol. 2019;56(2): 219-233.-233. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6411459/

» New targeted therapies for uncontrolled asthma.

Corren J. J Allergy Clin Immunol Pract. 2019;7(5):1394-1403 https://pubmed.ncbi.nlm.nih.gov/31076057/

» Oral corticosteroid exposure and adverse effects in asthmatic patients.

Sullivan PW, et al. J Allergy Clin Immunol. 2018;141(1):110-116.e7. https://www.ncbi.nlm.nih.gov/pubmed/28456623

» T2-“low” asthma: overview and management strategies.

Fitzpatrick AM, et al. J Allergy Clin Immunol Pract. 2020;8(2):452-463. https://pubmed.ncbi.nlm.nih.gov/32037109/

» Treatment options in type-2 low asthma.

Hinks TSW, et al. Eur Respir J. 2021;57(1):2000528. https://erj.ersjournals.com/content/57/1/2000528

» Tezepelumab in Adults with Uncontrolled Asthma.

Corren J, et al. N Engl J Med. 2017;377(10):936-946. https://pubmed.ncbi.nlm.nih.gov/28877011/

RESOURCE CENTER

» Efficacy and safety of tezepelumab in adults and adolescents with severe, uncontrolled asthma: results from the phase 3 NAVIGATOR study.

Menzies-Gow A, et al. J Allergy Clin Immunol. 2021;147(2):AB249. https://els-jbs-prod-cdn.jbs.elsevierhealth.com/pb/assets/raw/Health%20 Advance/journals/ymai/AAAAI_2021_LateBreaking_Abstracts.pdf

» Astegolimab (anti-ST2) efficacy and safety in adults with severe asthma: a randomized clinical trial.

Kelsen SG, et al. J Allergy Clin Immunol. 2021;S0091-6749(21)00609-6. https://pubmed.ncbi.nlm.nih.gov/33872652/

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» Randomized, double-blind, placebo-controlled study of brodalumab, a human anti-IL-17 receptor monoclonal antibody, in moderate to severe asthma.

Busse WW, et al. Am J Respir Crit Care Med. 2013;188(11):1294-1302.

RESOURCE CENTER

https://pubmed.ncbi.nlm.nih.gov/24200404/

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NOTES

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Please visit the CLINICAL RESOURCE CENTER for additional information and resources

www.ExchangeCME.com/ SevereAsthmaResource

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