Psoriatic Arthritis and Healthcare Outcomes - Case Vignettes

Rheumatology
Curriculum:
Psoriatic Arthritis
Credits:
1.0 AMA PRA Category 1 Credit(s)
Launch Date:
October 30, 2023
Expiration Date:
The accreditation for this activity has expired.

Primary Audience:

Rheumatology

Relevant Terms:

Psoriatic Arthritis

Allan Gibofsky, MD, JD

Professor of Medicine, Healthcare Policy and Research, Weill Cornell Medicine
Co-Director, of the Clinic for Inflammatory Arthritis and Biologic Therapy, Hospital for Special Surgery
New York, NY

Dr. Gibofsky received his undergraduate degree from Brooklyn College of the City University of New York, his medical degree from Weill Medical College of Cornell University and his law degree from Fordham University. He completed his internship in Pathology, followed by a residency in Medicine at New York Hospital. Dr. Gibofsky completed a fellowship in Rheumatology/Immunology jointly at the Hospital for Special Surgery at The Rockefeller University. He has authored or co-authored numerous papers and text chapters, primarily on the immunogenetics of rheumatic diseases and legal aspects of medical practice. Dr. Gibofsky is known for his work on mechanisms of host-microbe interactions in rheumatology, and, in particular for his basic and clinical studies on rheumatic fever.

Dr. Gibofsky is Professor of Medicine, Healthcare Policy and Research at Weill Cornell Medicine. He is an Attending Physician and Rheumatologist at both New York Presbyterian Hospital and Hospital for Special Surgery, where he is Co-Director of the Clinic for Inflammatory Arthritis and Biologic Therapy. Dr. Gibofsky has authored or coauthored numerous papers and text chapters, primarily on the immunogenetics of rheumatic diseases and the legal aspects of medical practice. Dr. Gibofsky is known for his work on mechanisms of host-microbe interactions in rheumatology, as well as his basic and clinical studies on rheumatic fever. Dr. Gibofsky is a Master and past President of the American College of Rheumatology, and a Consultant to the Arthritis Advisory Committee of the U.S. Food and Drug Administration.

He is Immediate Past President of the American College of Rheumatology and Secretary-Treasurer of The New York Rheumatism Association. Dr. Gibofsky is past-Chair of the Medical & Scientific Committee of the New York Chapter of The Arthritis Foundation and received its Physicians' Leadership Award in 1999. He also served as a member of the local and national Arthritis Foundation Board of Trustees and was Chair for Professional Education. Dr. Gibofsky has participated in numerous professional and public education programs, nationally and internationally.

He is a Jonas Salk Scholar of the City University and in 1997, was named Alumnus of the Year by Brooklyn College. Dr. Gibofsky is a member of the Health and Public Policy Committee of the American College of Physicians-American Society of Internal Medicine. He is also a past president of the American College of Legal Medicine, and is the current Chair of the American Board of Legal Medicine.

M. Elaine Husni, MD, MPH

Vice Chair and Director
Arthritis and Musculoskeletal Center
Department of Rheumatic and Immunologic Diseases, Cleveland Clinic
Assistant Professor
Cleveland Clinic Lerner College of Medicine of Case Western University
Cleveland, Ohio

Dr. Husni is Vice Chair and Director, Arthritis and Musculoskeletal Center in the Department of Rheumatic and Immunologic Diseases at the Cleveland Clinic. As a graduate of Boston College and Boston University School of Medicine and School of Public Health. She completed her Rheumatology fellowship at Brigham and Women's hospital. Dr. Husni is formally trained in Rheumatology and Epidemiology / Health Service Research. She is an assistant professor at Cleveland Clinic Lerner College of Medicine of Case Western Reserve University and she holds a joint appointment in the Departments of Rheumatology and Orthopedics.

Dr. Husni's interest and expertise is in the area of examining health outcomes and comorbidities of patients with rheumatoid arthritis, psoriasis, and psoriatic arthritis, with a specific focus in the area of accelerated cardiovascular disease. Her philosophy has always incorporated wellness and prevention in the care of her patients. She has been given several awards for her academic work from the American College of Rheumatology (ACR), National Psoriasis Foundation, and the Arthritis National Research Foundation for this research. She is involved in a number of rheumatology clinical trials at the Cleveland Clinic focusing on osteoarthritis, psoriatic arthritis, and rheumatoid arthritis. Dr. Husni also has a research focus on orthopedic outcomes with a specific research interest in the use of clinical pathways in patients undergoing total joint arthroplasty and knee osteoarthritis. She is a past recipient of the Physician Scientist Development Award by the ACR for this research.

In addition, Dr. Husni has an active role as an educator. She serves as Director of Clinical Outcomes and Director of the Fellow's Research Committee. She presents nationally and internationally on a variety of topics related to inflammatory arthritis and comorbidities. She has served in several leadership roles including Medical board member for the National Psoriasis Foundation, Medical and Scientific Committee of the Arthritis Foundation, and Journal of Publications committee for the ACR. Dr. Husni has had the opportunity to mentor both rheumatology and orthopedic research trainees and this has been one of her most rewarding experiences.

Susan J. Lee, MD

Professor of Medicine
Rheumatology Fellowship Training Director
Division of Rheumatology, Allergy, and Immunology
University of California San Diego

Dr. Lee is a board-certified rheumatologist who received her MD degree from the Case Western Reserve University School of Medicine in Cleveland, Ohio in 1997. She completed her internship, residency, and rheumatology fellowship at the University of California San Diego. 
 
She has held a number of positions over the past 27 years at UC San Diego where she currently is a Professor of Medicine in the Division of Rheumatology, Allergy, and Immunology. She is also their Rheumatology Fellowship Training Director. For the past 20+ years, she has served as a PI and sub-investigator on more than 100 clinical trials at the Center for Innovative Therapy. The focus of her research has been evaluating methods to improve the quality of care for patients with inflammatory and non-inflammatory arthritis such as rheumatoid arthritis, gout, and osteoarthritis, and more recently Long COVID/Post-Acute Sequelae of COVID-19 (PASC). She is currently also serving as the UCSD ACTRI (Altman Clinical and Translational Research Institute) Trials Innovations Network Liaison to promote collaboration between researchers. 
 
Dr. Lee is a member of the American College of Rheumatology and the Arthritis Foundation.
1. Apply knowledge of current PsA treatment guidelines, management options and an appreciation of patient-level knowledge and perceptions to real-world case scenarios.
2. Have an up-to-date working knowledge of the management of psoriatic arthritis including knowledge of guidelines, therapeutic options and common co-morbidities
3. Practice a more informed approach to patient education with the goal of reaching treatment accord with more patients, thus raising the level of patient involvement and satisfaction with their care.

Activity Overview

This case-based activity is the second in a series of two activities focused on the management of patients with psoriatic arthritis (PsA). The activity reviews key aspects in the evidence- and guidelines-based diagnosis and treatment of patients with psoriatic arthritis and provides learners the opportunity to explore several common clinical scenarios.

For those who have not completed the first module in the curriculum, Psoriatic Arthritis - Mastery Assessment Program (MAP), we encourage you to do so. The MAP module provides a brief, but broad assessment of key issues related to psoriatic arthritis and its impact on our ability to maintain guideline-recommended treatment for many of our chronic disease patients.

Specialist and primary care physicians are faced with an opportunity to impact, not just psoriatic disease understanding and management, but overall patient wellbeing. There is a significant opportunity for specialist and primary care physicians to collaborate in the management of the overall health of psoriatic patients and there is an important need for physicians to routinely screen psoriatic patients for the multiple susceptibility risk factors and co-morbidities.

Accreditation

The University of California San Diego School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

AMA: The University of California San Diego School of Medicine designates this enduring material 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.

AAPA: AAPA accepts certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by the ACCME or a recognized state medical society. Physician assistants may receive a maximum of 1.0 hour of Category 1 credit for completing this program. 

Nurses: For the purpose of recertification, the American Nurses Credentialing Center accepts AMA PRA Category 1 Credits™ issued by organizations accredited by the ACCME. For the purpose of relicensure, the California Board of Registered Nursing accepts AMA PRA Category 1 Credit™ (report up to 1.0 hour of credit and list "CME Category 1" as the provider number).

Pharmacists: The California Board of Pharmacy accepts as continuing education for pharmacists coursework which meets the standard of relevance to pharmacy practice and is accepted as continuing education by the Medical Board of California.

Psychologists: The California Board of Psychology recognizes and accepts AMA PRA Category 1 Credit(s)™ for license renewal. Psychologists outside of California should check with their state and local boards to ensure that ACCME accredited activities are acceptable for renewal.


Cultural & Linguistic Competency and Implicit Bias

Continuing medical education (CME) providers are required by state Assembly Bills 1195 and 241, and the standards created by the California Medical Association (CMA), to include components that address cultural and linguistic competency and implicit bias in CME/CPD activities. The planners and presenters of this activity has been asked to provide meaningful consideration of these standards in the selection and presentation of content.  Additional information and resources are available on the UC San Diego CPD website at https://medschool.ucsd.edu/education/cme/tools/Pages/Cultural-Competency.aspx


Disclosure of Financial Relationships 

It is the policy of University of California San Diego Continuing Medical Education to ensure that the content of accredited continuing education and related materials is accurate, balanced, objective, and scientifically justified. Education must be free of the influence or control of ineligible companies, and protect learners from promotion, marketing, and commercial bias.  All persons in a position to control the content of accredited continuing education must disclose all financial relationships held with ineligible companies, prior to assuming a role in the activity. Those relationships deemed relevant to the education are mitigated prior to the activity through one of the following strategies, depending on the nature of relationship and the role of the person: 1) divesting the financial relationship, 2) altering the individual’s control over content, and/or 3) validating the planning decisions and/or content through independent peer review. All relevant financial relationships are mitigated prior to the activity and mitigation strategies and necessary steps for implementation are communicated to individuals prior to them assuming their role in the activity. Persons who refuse or fail to disclose are disqualified from participating in the activity.  Activities are evaluated by participants and peer reviewers to determine if the content was free of bias and met acceptable scientific standards. This information is considered in future activity planning. All relevant financial relationships and the nature of those relationships are noted below.  All relevant financial relationships have been mitigated.

Susan J Lee, MD has no financial disclosures.

Allan Gibofsky, MD, JD reports that he is a speaker for AbbVie Inc; and, Pfizer Inc. He is a consultant to AbbVie Inc.; Acquist Therapeutics, Inc.; Novartis; Pfizer Inc.; and Biosplice Therapeutics. He is a stock shareholder (directly purchased) for AbbVie Inc.; Johnson & Johnson; Pfizer Inc.; and Regeneron Pharmaceuticals, Inc.

M. Elaine Husni, MD, MPH discloses the following:

  • AbbVie Pharmaceuticals, Consulting, Advisor or review panel participant
  • Amgen, Consulting, Advisor or review panel participant
  • Bristol-Myers Squibb Co., Consulting, Advisor or review panel participant
  • Celgene Corporation, Advisor or review panel participant
  • Genentech, Consulting
  • Genzyme/Sanofi, Consulting, Advisor or review panel participant 
  • Janssen, Consulting, Advisor or review panel participant
  • Lilly, Consulting, Advisor or review panel participant
  • Novartis Pharmaceuticals, Consulting, Advisor or review panel participant, Teaching and Speaking
  • Pfizer, Inc., Advisor or review panel participant
  • UCB, Inc., Consulting
  • Regeneron, Consulting, Advisor or review panel participant
  • WebMD, Consulting, Teaching and Speaking


Persons in control of content of this educational activity who are not specifically identified by name above, such as (but not limited to) course directors, faculty, CME staff, planners, editorial staff, peer reviewers, and CME committee reviewers do not have any relevant financial relationships.

Acknowledgement

This activity is supported by an educational grant from Pfizer.

COURSE VIEWING REQUIREMENTS

Supported Browsers:
Microsoft Edge
Google Chrome 60 or higher
Mozilla Firefox 60 or higher
Apple Safari 11.0 or higher
For video, install the latest version of Quicktime.
Supported Phones & Tablets:
iOS 9.3 and higher
Android 7.0 (Nougat or higher)
Microsoft Windows 8
Chrome OS


 
Additional Recommendations and Requirements
Display Resolution & Color Depth Resolution
- 960 X 768 minimum
- 1024 X 768 recommended min.

Color Depth
- 8 bits (256 colors) minimum
- 16 bits (High colors) minimum
Audio - Microphone
- Speakers or headphones
- Audio recording support
Word Processing Software that can open, modify, and save documents in Rich Text Format (RTF). Microsoft Word and PowerPoint are recommended.