Cornerstones IBD Roundtables 2016 Program

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cornerstoneshealth.org

Inflammatory Bowel Disease Roundtables2016


Inflammatory Bowel Disease Roundtables 2016 ™

We are excited to offer a special program for your education in inflammatory bowel disease. Cornerstones Health is a non-profit medical education company founded by gastroenterologists with a mission of delivering original and highly customized education to our colleagues and trainees. Using a unique roundtable format and workbooks instead of didactic slides, our trained expert faculty will facilitate a highly interactive program for you that will provide this information using a curriculum that includes both basic and cutting edge concepts in the diagnosis and management of IBD patients.

Facilitated by

This is a competency-based curriculum that has been developed by our faculty to meet the needs of our colleagues and answer some of the most challenging questions. Because of our non-profit status and our multiple sponsors, this program should satisfy the requirements of the most rigorous institutional industry-academic policies. Whether your training program provides you with a structured and comprehensive curriculum in IBD or has more of a “catch as catch can” approach to IBD education, this program will be invaluable. We look forward to sharing this exciting program with you.

For more information about this Roundtable event, please call 323-482-1123 or email info@cornerstoneshealth.org

Continuing Medical Education Marla C. Dubinsky, MD

David T. Rubin, MD

Co-Founders, Cornerstones Health, Inc.

Objectives After attending this Roundtable, clinicians and practitioners should be able to: Incorporate advances in therapeutic options for the treatment of IBD, with specific emphasis on biologics and immunomodulators in Crohn’s disease and 5-ASA therapies in ulcerative colitis.

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 AGA Institute and Cornerstones Health Inc. The AGA Institute is accredited by the ACCME to provide continuing medical education for physicians. The AGA Institute designates this live educational activity for a maximum 2.0 of AMA PRA Category 1 Credits.TM Physicians should only claim credit commensurate with the extent of their participation in the activity.

Incorporate emerging therapies and their possible place in the future of IBD management. Consider the implications for short and long-term outcomes in IBD based on clinical presentation and treatment strategy. Incorporate quality measures to improve patient outcomes. Incorporate knowledge of new information on role of dysplasia and cancer screening. Appreciate the complexities of risk benefit discussions and incorporate tools to improve communication. Appreciate the role of the human microbiome in IBD and its potential for future approaches to diagnosis and treatment.

Who Should Attend This activity is intended for gastroenterologists, gastroenterology fellows, trainees, and allied healthcare professionals with an interest in treating pediatric and adult patients with IBD.

cornerstoneshealth.org

Faculty Disclosure Statement In accordance with the ACCME’s Standards for Commercial Support of Continuing Medical Education, all faculty and planning partners must disclose any financial relationship(s) or other relationship(s) held within the past 12 months. The AGA Institute implements a mechanism to identify and resolve all conflicts of interest prior to delivering the educational activity to learners.

Corporate Support This educational activity is supported by independent medical educational grants from: AbbVie Takeda Pharmaceuticals Janssen Biotech UCB Pharma Prometheus Labs Salix, a division of Valeant Pharmaceuticals

8721 Santa Monica Blvd. #108, Los Angeles, CA 90069 323.482.1123 PHONE | 323.446.7424 FAX | info@cornerstoneshealth.org


Inflammatory Bowel Disease Roundtables 2016 ™

Table of Contents 1

What are the Treatment Options for Crohn’s Disease?

2

What are the New Treatment Options for Mild to Moderate Ulcerative Colitis?

– What are the existing therapies? – What are the emerging theapies?

– Why is my patient not responding to their 5-ASA therapy?

– Is there evidence to favor 4.8g/d PO mesalamine versus 2.4 g/d PO mesalamine for mild to moderate ulcerative colitis?

3

– How can I improve adherence to therapy?

What are the Treatment Options for Moderate to Severe Ulcerative Colitis?

– What are the existing therapies?

– What are the emerging therapies?

4

Can Non-invasive Imaging and Biomarkers be Used to Monitor Our Patients for Control of Disease and Prevention of Relapse?

5

Should We Use Concomitant Immunomodulators with Anti-TNF Therapies?

6

Can We De-escalate Therapy in Some Patients?

7

What is the Role of Mucosal Healing in the Management of Patients?

8

How Do We Treat a Patient Who is Losing Response to TNF-Inhibitor Therapy?

9

How Can We Incorporate Therapeutic Drug Monitoring Into Our Practices?

– Should we treat to endoscopic healing?

10 How Do We Approach the Postoperative Treatment of a Patient who Underwent Ileocecectomy? 11 How Do We Reconcile Risk Versus Benefit When Making Decisions About Treatments for Patients? 12

What Can We Learn from Studies of IBD in Pediatric Patients?

13

What Treatments are Safe for Pregnant Patients with IBD?

14

What is the Update Regarding the Management of Dysplasia and the Prevention of Colorectal Cancer in Patients with IBD?

– Is chromoendoscopy the standard of care now?

15

What is the Optimal Treatment Approach to Pouchitis?

16

Psychosocial Considerations in IBD

– Management of depression and anxiety – Optimizing psycho-behavioral outcomes


Inflammatory Bowel Disease Roundtables 2016 ™

Dear Colleague, Thank you for participating in this Cornerstones Inflammatory Bowel Disease RoundtableTM educational activity. We know that you will find this innovative format and discussion to be highly relevant to your clinical practice and for your patients with inflammatory bowel disease. Cornerstones is a non-profit company founded to develop creative and patient-centric educational programs. The company was created in order to address a need to bring our expert colleagues and outstanding educators to the individual practices of busy clinicians, while at the same time avoiding the potential for industry bias or perceptions of conflict in this area. We welcome your candid evaluations and additional feedback and hope you plan to make a Cornerstones Inflammatory Bowel Disease Roundtable part of your annual practice update. To schedule future programs, please contact us at 323.482.1123 or info@cornerstoneshealth.org Sincerely,

David T. Rubin, MD

Maria C. Dubinsky, MD

Co-Founders, Cornerstones Health, Inc.


Inflammatory Bowel Disease Roundtables 2016 ™

Learning Objectives After attending this Roundtable, clinicians and practitioners should be able to: Incorporate advances in therapeutic options for the treatment of IBD, with specific emphasis on biologics and immunomodulators in Crohn’s disease and 5-ASA therapies in ulcerative colitis. Incorporate emerging therapies and their possible place in the future of IBD management. Consider the implications for short and long-term outcomes in IBD based on clinical presentation and treatment strategy. Incorporate quality measures to improve patient outcomes. Incorporate knowledge of new information on role of dysplasia and cancer screening. Appreciate the complexities of risk benefit discussions and incorporate tools to improve communication. Appreciate the role of the human microbiome in IBD and its potential for future approaches to diagnosis and treatment.

Continuing Medical Education 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 AGA Institute and Cornerstones Health Inc. The AGA Institute is accredited by the ACCME to provide continuing medical education for physicians. The AGA Institute designates this live educational activity for a maximum 2.0 of AMA PRA Category 1 Credits.TM Physicians should only claim credit commensurate with the extent of their participation in the activity.


Inflammatory Bowel Disease Roundtables 2016 ™

Attendee Sign-In Sheet

Name Of Group Roundtable Date

Faculty Name

Printed Name

Signature

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Inflammatory Bowel Disease Roundtables 2016 ™

Faculty Expense Report Faculty Name

Roundtable Date

Address

Address 2

City

State

Postal Code

Faculty Daytime Telephone

(

)

Expenses Attach Original Receipts if over $25.00

Signature x

Mileage

miles x 54¢ =

$

Parking/Tolls

$

Taxi

$

Meals

$

AirTravel

$

Lodging

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Other

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Total Expense

$

Date


Inflammatory Bowel Disease Roundtables 2016 ™

Request for Credit If you wish to receive acknowledgement of participation for this activity, please complete and return this form to the roundtable faculty upon conclusion of the meeting. We need current and complete information to assure delivery of participation acknowledgement. Please do not use abbreviations. Degree (please mark appropriate box and circle appropriate degree)

MD or DO

Pharm or RPh

Last Name

RN or NP

PA

RD

Other

First Name

Address

Address 2

City

Telephone

State

(

Fax

)

(

Postal Code

)

AGA Member Number (if known)

Email Address

Specialty

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 AGA Institute and Cornerstones Health Inc. The AGA Institute, is accredited by the ACCME to provide continuing medical education for physicians. The AGA Institute designates this live educational activity for a maximum 2.0 of AMA PRA Category 1 Credits.TM Physicians should only claim credit commensurate with the extent of their participation in the activity. I participated in:

the entire

only part of the activity and claim:

credits

Signature is required to receive statement of credit Signature x

Date Please return this form to the Roundtable faculty.


Inflammatory Bowel Disease Roundtables 2016 ™

Pre-Activity Survey Roundtable Date

Roundtable Faculty

Cornerstones Health respects and appreciates your opinions. To assist us in evaluating the effectiveness of this activity and to make recommendations for future educational offerings, please take a few minutes to complete this survey. Your answers and suggestions are confidential.

PART I. Tell us about yourself Occupation

  

Physician Fellow

  

Nurse Practioner Physician Assistant

Other, please indicate

Practice Type

 

 

Specialty

Group

Single

Gastroenterology Internal Medicine

 

Family Medicine Pediatrics

Other, please indicate

Approximately how many patients with inflammatory

Other, please indicate

bowel disease do you see in a week?

Tell us about your expectaions for this CME activity BEFORE this CME activity begins, please think about what you expect from it. Indicate how important each statement below is to you by circling a number from 1 to 7 (scale: 1= low importance, 7 = high importance)*

CME EXPECTATION

IMPORTANCE TO ME IN THIS CME ACTIVITY Low Importance

High Importance

Address my most pressing questions

1 2 3 4 5 6 7

Address competencies identified by my specialty

1

Provide fair and balanced content

1 2 3 4 5 6 7

Provide clear evidence to support content

1 2 3 4 5 6 7

Include opportunities to learn interactively

1 2 3 4 5 6 7

Provide me with supporting materials or tools

1

Include opportunities to solve relevant cases

1 2 3 4 5 6 7

Translate evidence to practice

1 2 3 4 5 6 7

Address barriers to optimal performance

1 2 3 4 5 6 7

Allow me to assess what I have learned

1

2

2

2

3

3

3

4

4

4

5

5

5

*assessment items attributable to CME QUAL (Shewchuck RM, et al. J Contin Educ Health Prof. 2007:27:173).

6

6

6

7

7

7


Inflammatory Bowel Disease Roundtables 2016 ™

Use fecal markers to predict disease course in IBD

Use combination therapy in immunomodulator-naïve patients

Treat to mucosal healing in IBD

Measure infliximab trough levels and ATI concentration in IBD

Switch within class for patients with positive anti-drug antibodies

Choose therapy based on endoscopic findings when managing a patient who is post-op from an ileocecectomy

Routinely explore each patient’s understanding of the risks of their IBD therapy versus the risks of untreated disease and disease progression

Evaluate for growth failure in pediatric IBD patients

Apply a multidisciplinary approach to the management of pouchitis

Consider the impact of psychosocial factors on the management of IBD patients

AL W AY S

O

SO

FT

M

EN

ET

IM

RY VE T O

N

N

EV

ER

How often do you CURRENTLY do each of the following for your patients with inflammatory bowel disease?

ES

O

FT

EN

PART II. Tell us about your your current practice strategies


Inflammatory Bowel Disease Roundtables 2016 ™

Post-Activity Survey Roundtable Date

Roundtable Faculty

PART I. Tell us about your perceptions of this CME activity After having participated in this CME activity, think about your perceptions of it. Indicate how well each statement below characterizes your perceptions by circling a number. (scale: 1= minimally met expectations, 7 = completely met expectations)*

CME EXPECTATION

THIS CME ACTIVITY MET MY EXPECTATIONS Minimally

Completely

Addressed my most pressing questions

1 2 3 4 5 6 7

Addressed competencies identified by my specialty

1

Provided fair and balanced content

1 2 3 4 5 6 7

Provided clear evidence to support content

1 2 3 4 5 6 7

Included opportunities to learn interactively

1 2 3 4 5 6 7

Provided me with supporting materials or tools

1

2

2

3

4

3

5

4

6

5

6

7

7

Included opportunities to solve relevant cases 1 2 3 4 5 6 7 Translated evidence to practice

1 2 3 4 5 6 7

Addressed barriers to optimal performance

1 2 3 4 5 6 7

Allowed me to assess what I have learned

1

2

3

4

5

6

7

*assessment items attributable to CME QUAL (Shewchuck RM, et al. J Contin Educ Health Prof. 2007:27:173).

    

    

    

    

    

Choose therapy based on endoscopic findings when managing a patient who is post-op from an ileocecectomy

Routinely explore each patient’s understanding of the risks of their IBD therapy versus the risks of untreated disease and disease progression

Evaluate for growth failure in pediatric IBD patients

  

  

  

  

  

Use fecal markers to predict disease course in IBD Use combination therapy in immunomodulator-naïve patients Treat to mucosal healing in IBD Measure infliximab trough levels and ATI concentration in IBD Switch within class for patients with positive anti-drug antibodies

Apply a multidisciplinary approach to the management of pouchitis Consider the impact of psychosocial factors on the management of IBD patients

AL W AY S

O

SO

FT

M

EN

ET

IM

RY VE T O

N

N

EV

ER

After participating in this CME activity, how often do you NOW PLAN to do each of the following for your patients with inflammatory bowel disease?

ES

O

FT

EN

Part II. Tell us about the impact of this CME activity


Inflammatory Bowel Disease Roundtables 2016 ™

Please identify up to three practice changes you are considering as a result of participating in this Cornerstones Inflammatory Bowel Disease Roundtable: 1 2 3

PART III. Tell us about your future CME needs Please indicate any barriers or challenges you find in clinical practice (that you feel you are not able to address appropriately or to your satisfaction) regarding the diagnosis or treatment of patients with IBD:

Please use this space for any additional comments about this Cornerstones IBD Roundtable:


Inflammatory Bowel Disease Roundtables 2016 ™

Course Directors

Faculty

Marla C. Dubinsky, MD

David G. Binion, MD

Cornerstones Co-Founder New York, NY

David T. Rubin, MD

Cornerstones Co-Founder Chicago, IL

University of Pittsburgh

Adam Cheifetz, MD

Beth Israel Deaconess Medical Center

Russell D. Cohen, MD

University of Chicago Medical Center

Raymond Cross, MD

University of Maryland School of Medicine

Stephen B. Hanauer, MD

University of Chicago Medical Center

Peter Higgins, MD

University of Michigan Health System

Asher A. Kornbluth, MD

Mount Sinai School of Medicine

Scott D. Lee, MD

University of Washington

In accordance with the ACCME’s Standards for Commercial Support of Continuing Medical Education, all faculty and planning partners must disclose any financial relationship(s) or other relationship(s) held within the past 12 months. The AGA Institute implements a mechanism to identify and resolve all conflicts of interest prior to delivering the educational activity of learners.

James D. Lewis, MD

University of Pennsylvania

Edward V. Loftus, Jr., MD Mayo Clinic Rochester

Uma Mahadevan-Velayos, MD

University of California at San Francisco

Gil Melmed, MD

Cedars-Sinai Medical Center

Miguel Regueiro, MD

University of Pittsburgh School of Medicine

William J. Sandborn, MD

University of California at San Diego

David A. Schwartz, MD

Vanderbilt University Medical Center

Corey A. Siegel, MD

Dartmouth-Hitchcock Medical Center

Thomas A. Ullman, MD

Mount Sinai School of Medicine

Fernando Velayos, MD

University of California at San Francisco

Douglas C. Wolf, MD

Emory University School of Medicine


Inflammatory Bowel Disease Roundtables 2016 ™

Notes



Supported by independent educational grants from: AbbVie Janssen Biotech Salix, a division of Valeant Pharmaceuticals Takeda Pharmaceuticals UCB Pharma Prometheus Labs

cornerstoneshealth.org

8721 Santa Monica Blvd. #108, Los Angeles, CA 90069 323.482.1123 PHONE | 323.446.7424 FAX | info@cornerstoneshealth.org

cornerstoneshealth.org


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