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	Asthma Clinical Dialogue: Understanding Asthma in the Context of Diagnosis, Control, and Disease Heterogeneity This activity has expired. The accredited provider can no longer issue certificates for this activity.

Program Overview Asthma is a complex disease that affects children as well as patients of all ages. Although new treatment guidelines were released in 2007 to facilitate the management of asthma in the clinical setting, each patient is unique, and formulating an appropriate individualized treatment plan can be complex. This activity focuses on diagnosing asthma and understanding the heterogeneity of disease and controlling symptoms through use of appropriate pharmacotherapy and environmental controls. In addition, factors that may further complicate diagnosis and treatment, including comorbid and differential diagnoses, are discussed in detail along with pharmacogenomic, demographic, and external factors that may affect treatment response. The activity concludes with a comprehensive panel discussion about these issues and the physician's role in the ongoing management of patients with asthma.

Target Audience This activity has been designed to meet the educational needs of primary care physicians, pediatricians, and ancillary health care professionals who treat patients with asthma.

Learning Objectives Identify 1 sign to look for and 1 assessment to perform when evaluating a patient for asthma. Determine 3 differential diagnoses to consider when evaluating a pediatric patient with possible asthma. State 2 factors associated with poor adherence to asthma medications and name 2 approaches to improving adherence. Describe the role of the Arg/Arg polymorphism in asthma in terms of ethnicity and response to therapy. Name 1 potential benefit and 1 potential limitation of each of the 4 categories of asthma controller therapy.

Faculty Paula Busse, MD Assistant Professor Department of Medicine Division of Clinical Immunology Mount Sinai School of Medicine New York, New York Lawrence DuBuske, MD Consultant in Allergy Brigham and Women’s Hospital Harvard Medical School Boston, Massachusetts Monica Kraft, MD Professor of Medicine Division of Pulmonary Allergy, and Critical Care Medicine Director Duke Asthma, Allergy and Airway Center Duke University Medical Center Durham, North Carolina Andrew Liu, MD Associate Professor National Jewish Health and Research Center University of Colorado at Denver, School of Medicine Denver, Colorado Gailen Marshall, Jr, MD, PhD Professor of Medicine and Pediatric Vice Chair for Faculty Development Director Division of Clinical Immunology and Allergy The University of Mississippi Medical Center Jackson, Mississippi David Rosenstreich, MD Professor Department of Medicine Albert Einstein College of Medicine Director Division of Allergy and Immunology Montefiore Medical Center Bronx, New York

Accreditation Statement Albert Einstein College of Medicine is accredited by the ACCME to provide continuing medical education for physicians. Med Learning Group is also accredited by the ACCME and serves as co-sponsor for this educational activity.

Credit Designation Albert Einstein College of Medicine designates this educational activity for a maximum of 3.25 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity. This CME activity was planned and produced in accordance with the ACCME Essentials. For CME questions, please contact: Center for Continuing Medical Education, Albert Einstein College of Medicine 718-920-6674. Contact this CME provider at Albert Einstein College of Medicine for privacy and confidentiality policy statement information at http://www.mecme.org/site/privacy.php.

Method of Participation There are no fees for participating and receiving CME credit for this activity. During the period October 29, 2009 through October 28, 2010, participants must: Read the educational objectives and faculty disclosures Study all parts of the educational activity Complete the posttest by recording the best answer to each question in the answer key and complete the evaluation form. Submit the evaluation form online via iQueue. To participate in this activity, please view the presentation and take the posttest. Fill in the answer sheet and evaluation form and submit online via iQueue. CME credit will be awarded if a score of 70% or better is achieved. You will receive your certificate instantly.

Disclosure of Conflicts of Interest Disclosure Policy Statement: The “Conflict of Interest Disclosure Policy” of Albert Einstein College of Medicine requires that faculty participating in any CME activity disclose to the audience any relationship(s) with a pharmaceutical, product, or device company. Any presenter whose disclosed relationships prove to create a conflict of interest with regard to their contribution to the activity will not be permitted to present. Disclosure of Conflicts of Interest: Paula Busse, MD Assistant Professor Department of Medicine Division of Clinical Immunology Mount Sinai School of Medicine New York, New York Disclosure: Paula Busse, MD, is a consultant for Viro Pharma. She receives grant/research funding from Viro Pharma. Dr. Busse also receives other funding from GlaxoSmithKline. Lawrence DuBuske, MD Consultant in Allergy Brigham and Women’s Hospital Harvard Medical School Boston, Massachusetts Disclosure: Lawrence DuBuske, MD, is a consultant for Allergy Therapeutics, Genentech, GlaxoSmithKline, Novartis Pharmaceuticals, Schering-Plough, and Sepracor. He receives grant/research funding from Alcon, Allergy Therapeutics, Genentech, Novartis Pharmaceuticals, Schering-Plough, and Wyeth Pharmaceuticals. Dr. DuBuske is on the speakers’ bureaus for Alcon, Genentech, GlaxoSmithKline, Merck & Co., Inc, Novartis Pharmaceuticals, Schering-Plough, and Sepracor. Monica Kraft, MD Professor of Medicine Division of Pulmonary, Allergy, and Critical Care Medicine Director Duke Asthma, Allergy and Airway Center Duke University Medical Center Durham, North Carolina Disclosure: Monica Kraft, MD, is a consultant for Novartis Pharmaceuticals and Sepracor. She receives grant/research funding from Asthmatx, Inc., Biomark, Bronchus, GE Healthcare, Genentech, GlaxoSmithKline, and Novartis Pharmaceuticals. Dr. Kraft is on the speakers’ bureaus for GlaxoSmithKline. Andrew Liu, MD Associate Professor National Jewish Health and Research Center University of Colorado at Denver School of Medicine Denver, Colorado Disclosure: Andrew Liu, MD, is a consultant for AstraZeneca, GlaxoSmithKline, and Phadia. He receives grant/research funding from Novartis Pharmaceuticals. Dr. Liu is on the speakers’ bureaus for Aerocrine, AstraZeneca, GlaxoSmithKline, Merck & Co., Inc, and Phadia. Gailen Marshall, Jr, MD, PhD Professor of Medicine and Pediatrics Vice Chair for Faculty Development Director Division of Clinical Immunology and Allergy The University of Mississippi Medical Center Jackson, Mississippi Disclosure: Gailen Marshall, Jr, MD, PhD has nothing to disclose. David Rosenstreich, MD Professor, Department of Medicine Albert Einstein College of Medicine Director Division of Allergy and Immunology Montefiore Medical Center Bronx, New York Disclosure: David Rosenstreich, MD receives grant/research funding from Genentech and GlaxoSmithKline. He is on the speakers’ bureaus for Genentech, GlaxoSmithKline, and Merck & Co., Inc. The planners and managers reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity: Mildred Shields Adighiuzor of Albert Einstein College of Medicine, Center for Continuing Medical Education has nothing to disclose. Tara Hun-Dorris, MMC, ELS, of THD Editorial, Inc., is a consultant for Victory Pharma, Inc. Kelly Kraines of Med Learning Group has nothing to disclose. Christopher Cahill of Med Learning Group has nothing to disclose.

Disclosure of Unlabeled Use The Albert Einstein College of Medicine requires that faculty participating in any CME activity disclose to the audience when discussing any unlabeled or investigational use of any commercial product or device not yet approved for use in the United States.

Disclaimer The Center for Continuing Medical Education of Albert Einstein College of Medicine makes every effort to develop CME activities that are scientifically based. This activity is designed for health care professionals for educational purposes. Conclusions drawn by the participants should be derived from careful consideration of all available scientific information. The participant should use his/her clinical judgment, knowledge, experience, and diagnostic decision-making before applying any information, whether provided here or by others, for any professional use.