Estimated Time of Completion

1 hour, 45 minutes

Description

This newsletter series will cover several important issues related to the use of B-cell–directed therapy in autoimmune rheumatic diseases. Discussion will include information about the efficacy and safety of vaccination in patients being treated with B-cell–directed therapy as well as other nonbiologic disease modifying antirheumatic drugs. Expert commentary will be provided on newly emerging studies that examine the viability of possible rituximab treatment regimens such as dosing on a fixed retreatment schedule or rituximab use in biologic-naïve patients. Also, data will be presented from recent studies examining the effects of B-cell–directed therapy on the treatment of systemic lupus erythematosus (SLE). For example, recent results from clinical trials examining the efficacy of B- and T-cell–directed therapy in SLE will be compared.

Objectives

At the conclusion of this activity, the participants will be able to:

1. Define and describe immunocompetency as well as what effects current B-cell–directed therapies may have on vaccine efficiency in patients with autoimmune disease.
2. Recount the recommendations for vaccinations of patients with rheumatoid arthritis (RA) receiving disease modifying antirheumatic drugs (DMARDs).
3. Evaluate the results of recent data regarding the use of B-cell–directed therapy in patients naïve to biologic DMARDs.
4. Evaluate the efficacy and safety of fixed retreatment schedules of B-cell–directed therapy.
5. Describe the current nonrandomized and randomized clinical results for B-cell–directed treatment of systemic lupus erythematosus (SLE).
6. Discuss possible approaches to the management of patients with SLE given the lack of positive randomized clinical results with B-cell–directed therapy.
7. Compare the recent randomized clinical data regarding the use of currently available B- and T-cell–directed therapies for the treatment of SLE.
8. Evaluate some of the challenges inherent to a successful clinical trial for SLE.

Target Audience

Rheumatologists, immunologists, clinical researchers, and allied health care professionals, including nurses, nurse practitioners, and physician assistants, who care for patients with autoimmune diseases.

Accreditation

The Cleveland Clinic Foundation Center for Continuing Education is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The Cleveland Clinic Foundation Center for Continuing Education designates this educational activity for a maximum of 1.75 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

This activity may be submitted for American Osteopathic Association Continuing Medical Education credit in Category 2.

Activity Director / Faculty

Leonard H. Calabrese, DO
Professor of Medicine
Cleveland Clinic Lerner College of Medicine
  of Case Western Reserve University
RJ Fasenmyer Chair of Clinical Immunology
Theodore F Classen DO Chair of Osteopathic Research
   and Education
Vice Chairman, Department of Rheumatic and
   Immunologic Diseases
Cleveland, Ohio

Editorial Board

Marc D. Cohen, MD
Professor of Medicine
Chief of Rheumatology
National Jewish Medical
  and Research Center
Denver, Colorado

Jonathan Kay, MD
Associate Clinical
  Professor of Medicine
Harvard Medical School
Director of Clinical Trials
Rheumatology Unit
Massachusetts General
  Hospital
Boston, Massachusetts

Gregg J. Silverman, MD
Director, Laboratory of
  B-Cell Immunology
Professor of Medicine
Division of Rheumatology,
  Allergy, and Immunology
University of California
  San Diego School of
  Medicine
La Jolla, California

Faculty Disclosure

In accordance with the Standards for Commercial Support issued by the Accreditation Council for Continuing Medical Education (ACCME), The Cleveland Clinic Foundation Center for Continuing Education requires resolution of all faculty conflicts of interest to ensure CME activities are free of commercial bias.

The following faculty have indicated they may have a relationship, which in the context of their presentation(s), could be perceived as a potential conflict of interest:

The Cleveland Clinic Foundation Center for Continuing Education acknowledges an educational grant for support of this activity from:

Genentech, Inc. and Biogen Idec.