This "virtual" program is divided into two brief didactic programs, followed by a comprehensive Q&A segment. The Didactic portion features an overview of the 2008 American College of Rheumatology guidelines, which focus on the treatment of patients with both biologic and nonbiologic disease-modifying anti-rheumatic drugs. The presentation includes discussion of different algorithms for treatment, including criteria for choosing appropriate therapy. The other didactic portion features an overview of key safety issues that have emerged along with increased use of biologic therapy. These include understanding adverse event risks and reporting, risks of infections and malignancies associated with biologics, tuberculosis screening, and vaccinations. The Q&A segment includes a discussion of hot topics in treatment of rheumatoid arthritis including when to use methotrexate and biologics.

This activity has been designed to meet the educational needs of rheumatologists, infusion nurses and physicians that treat rheumatoid arthritis.

• Identify the three main components of the ACR 2008 guidelines used in the selection of DMARD therapy and apply these to clinical practice.
• Describe the goal of treatment in rheumatoid arthritis and name the objective assessment most frequently used to measure disease activity.
• Name the appropriate steps to take to help rule out infection, including tuberculosis, prior to initiating DMARD therapy and incorporate these into clinical practice.
• Identify the vaccine protocol that should be the followed in patients commencing biologic therapy.

Course Director
Peter Barland, MD
Emeritus Professor
Medicine & Pathology
Albert Einstein College of Medicine
Attending and Director of Immunodiagnostic Laboratory
Montefiore Medical Center
Bronx, New York

Allan Gibofsky, MD, JD
Professor, Medicine and Public Health
Weill Medical College of Cornell University
Rheumatologist
Hospital for Special Surgery
New York, New York

Yusuf Yazici, MD
Assistant Professor of Medicine, Rheumatology
New York University School of Medicine
Director, Seligman Center for Advanced Therapeutics
New York University Hospital for Joint Diseases
New York, New York

Kathleen Kenny-Riley, APRN, BC, PNP
Pediatric Nurse Practitioner
Pediatric Rheumatology
Montefiore Medical Center
Bronx, New York

Albert Einstein College of Medicine of Yeshiva University is accredited by the ACCME to provide continuing medical education for physicians.

Albert Einstein College of Medicine designates this educational activity for a maximum of 1.5 AMA PRA Category 1 Credit(s)^TM. 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.

Course Code: 6575

Med Learning Group is also accredited by the ACCME and serves as co-sponsor for this educational activity.

Montefiore Medical Center, Division of Education & Organizational Development is an approved provider of continuing nursing education by the New York State Nurses Association, an accredited approver by the American Nurses Credentialing Center's Commission on Accreditation.

It has been assigned code 6TLUE-PRV-196

For CME questions, please contact: Center for Continuing Medical Education Albert Einstein College of Medicine at 718-920-6674. For Nursing CE questions, please contact Montefiore Medical Center Division of Educational & Organizational Development at (718) 920-8580.

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

There are no fees for participating and receiving CME credit for this activity. During the period March 24, 2010 through March 24, 2011, participants must:

1. Read the educational objectives and faculty disclosures
2. Study all parts of the educational activity
3. Complete the posttest by recording the best answer to each question in the answer key and complete the evaluation form.
4. Submit the evaluation from 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.

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 or who fails to disclose will not be permitted to present.

Course Director
Peter Barland, MD
Emeritus Professor
Medicine & Pathology
Albert Einstein College of Medicine
Attending and Director of the Immunodiagnostic Laboratory
Montefiore Medical Center
Bronx, New York

Disclosures: Peter Barland, MD, is a consultant for Merck & Co., Inc.

Allan Gibofsky, MD, JD
Professor, Medicne and Public Health
Weil Medical College of Cornell University
Rheumatologist
Hospital for Special Surgery
New York, New York

Disclosure: Allan Gibofsky, MD, is a consultant for Abbot, Amgen, Bristol-Myers Squibb, UCB Pharma Inc. and Wyeth Pharmaceuticals. Dr. Gibofsky is on the speakers' bureaus for Abbot, Amgen, Bristol-Myers Squibb, UCB Pharma Inc. and Wyeth Pharmaceuticals. Dr. Gibofsky is a stockholder in Abbot, Amgen, Bristol-Myers Squibb, UCB Pharma Inc. and Wyeth Pharmaceuticals.

Yusuf Yazici, MD
Assistant Professor of Medicine, Rheumatology
New York University School of Medicine
Director, Seligman Center for Advanced Therapeutics
New York University Hospital for Joint Diseases
New York, New York

Disclosures: Yusuf Yazici, MD, is a consultant for Bristol-Myers Squibb, Celgene Corporation, Roche and UCB Pharma Inc. Dr. Yazici is on the speakers' bureaus for Bristol-Myers Squibb and UCB Pharma Inc.

Kathleen Kenny-Riley, APRN, BC, PNP
Pediatric Nurse Practitioner
Pediatric Rheumatology
Montefiore Medical Center
Bronx, New York

Disclosure: Kathleen Kenny-Riley has nothing to disclose.

The planners and managers reported the following financial 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.

Mary McLoughlin RN-BC, MSN, CEN of Montefiore Medical Center Division of Education and Organizational Development, has nothing to disclose.

Tara Hun-Dorris, MMC, ELS, of THD Editorial, Inc., is a consultant for Victory Pharma Inc.

Christopher Cahill of Med Learning Group has nothing to disclose.

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.

The Center for Continuing Medical Education of Albert Einstein College of Medicine and Montefiore Medical Center Division of Education and Organizational Development make 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 judgement, knowledge, experience, and diagnostic decision-making before applying any information, whether provided here or by others, for any professional use.

Sponsored by Albert Einstein College of Medicine, Med Learning Group, and Montefiore Medical Cener Division of Education and Orginizational Development (with logos from Einstein, Montefiore, and Med Learning)

Supported by an educational grant from Bristol-Myers Squibb.