Medical Crossfire®: Patient and Caregiver Connection™ Getting Beneath the Surface: Addressing Patient Concerns in Moderate to Severe Atopic Dermatitis

Acknowledgement of Commercial Support

This activity is supported by independent educational grant from Sanofi Genzyme and Regeneron Pharmaceuticals.

This activity is provided by Physicians’ Education Resource®, LLC.


Dates of Certification: December 29, 2017 - December 29, 2018

Moderator 

Paul P. Doghramji, MD, FAAFP
Attending Physician, Collegeville Family Practice
Medical Director, Health Services, Ursinus College, Collegeville, PA
Cofounder, Brookside Family Practice and Pediatrics
Assistant Medical Director, Health Services, Hill School, Pottstown, PA
Disclosure: No relevant financial relationships with commercial interests

Chair

Peter Lio, MD
Assistant Clinical Professor
Dermatology and Pediatrics
Northwestern University, Feinberg School of Medicine
Chicago, Illinois
Disclosure: Grant/Research Support: AOBIOME, Pierre-Fabre; Consultant: AOBiome, Anacor, L’Oreal, Pfizer, Regeneron/Sanofi, Theraplex, Valeant; Speakers Bureau: L’Oreal, Pfizer, Regeneron/Sanofi

Faculty

Christine Go, MMS, PA-C
Leone Dermatology
Arlington Heights, Illinois
Disclosure: No relevant financial relationships with commercial interests
 
Pamela P. Fantus, RN, MSN
Patient
Disclosure: No relevant financial relationships with commercial interests

Activity Overview

Atopic dermatitis is a chronic, relapsing skin disease which places a significant burden on patients, resulting in a lower quality of life.  In moderate-to-severe disease, patients also suffer from high levels of psychological distress, increased prevalence of psychiatric diseases, and increased risk of cardiometabolic comorbidities.  During this Medical Crossfire®, dermatology experts will engage in a multidisciplinary roundtable moderated by a family physician with the additional perspective of a patient’s treatment journey as video clips throughout the discussion. Topics covered include disease manifestations, diagnostic criteria, pathophysiology of moderate-to-severe atopic dermatitis and treatment approaches with both current and new and emerging therapies.  Faculty will emphasize the importance of individualized treatment plans in a patient-centered approach.

Target Audience

This activity is directed to dermatologists, allergists, immunologists, rheumatologists, primary care physicians, researchers; other healthcare professionals interested in the treatment of Atopic Dermatitis are invited to participate. 

Educational Objectives

At the completion of this activity, you should be better prepared to:
  • Outline the burden of atopic dermatitis (AD) on patients.
  • Discuss the most recent information on the epidemiology and pathogenesis of AD, and how this is likely to affect the management of patients with AD. 
  • Analyze how older and newer therapies fit into the AD treatment paradigm.
  • Clarify how a multidisciplinary, patient-centered, approach to care may improve patient outcomes in AD.

Accreditation/Credit Designation

Physicians' Education Resource®, LLC is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
 
Physicians' Education Resource®, LLC 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.
 
Physicians' Education Resource®, LLC is approved by the California Board of Registered Nursing, Provider #16669, for 1.0 Contact Hour.

Disclosure Policy and Resolution of Conflicts of Interest (COI)

As a sponsor accredited by the ACCME, it is the policy of PER® to ensure fair balance, independence, objectivity, and scientific rigor in all of its CME activities. In compliance with ACCME guidelines, PER® requires everyone who is in a position to control the content of a CME activity to disclose all relevant financial relationships with commercial interests. The ACCME defines “relevant financial relationships” as financial relationships in any amount occurring within the past 12 months that creates a COI. Additionally, PER® is required by ACCME to resolve all COI. PER® has identified and resolved all COI prior to the start of this activity by using a multistep process.
The staff of Physicians' Education Resource®, LLC have no relevant financial relationships with commercial interests to disclose.

Off-Label Disclosure and Disclaimer

This CME activity may or may not discuss investigational, unapproved, or off-label use of drugs. Participants are advised to consult prescribing information for any products discussed. The information provided in this CME activity is for continuing education purposes only, and is not meant to substitute for the independent medical judgment of a physician or nurse relative to diagnostic, treatment, or management options for a specific patient's medical condition.
The opinions expressed in the content are solely those of the individual faculty members and do not reflect those of PER® or any of the companies that provided commercial support for this activity.

CME Provider Contact Information

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PER Pulse Recap

Recap 1 of 3: Atopic Dermatitis: Disease Burden and Risk Factors

Atopic dermatitis is a chronic skin disease that occurs mostly in children, but also in adults.1 It is a pruritic, inflammatory disease that follows a relapsing course. The hallmark of atopic dermatitis is pruritus, which is responsible for much of the disease burden. Of the patients who develop atopic dermatitis as children, 10% to 30% of patients do not have disease resolution by adulthood. The pathophysiology is not completely understood; however, immunologic, genetic, and environmental factors contribute to skin barrier dysfunction and immunologic dysregulation.2 Clinical findings include erythema, edema, xerosis, erosions/excoriations, oozing, crusting, and lichenification.1

The 2 biggest risk factors for the development of atopic dermatitis are a positive family history and loss of function mutations in the filaggrin (FLG) gene.1 There is a positive family history in approximately 70% of patients with atopic dermatitis, with a maternal history possibly more predictive of disease. Filaggrin degradation proteins play a role in formation of the skin barrier. Byproducts of FLG contribute to epidermal hydration. Not all patients with atopic dermatitis will have loss of function mutations in the FLG gene. Environmental risk factors and microbial exposure may also contribute to the development of atopic dermatitis.3 Advances in the identification of risk factors may result in early, aggressive therapy for patients who are diagnosed at the beginning stages of the disease process.

Living with atopic dermatitis can have a significant negative impact on the patient and caregivers.4 Changes in physical appearance can result in social and emotional stress. Sleep disturbance, anxiety, and depression are not uncommon in these patients and their families. In a study comparing quality of life and absenteeism in individuals with and without atopic dermatitis, the incidence of depression, anxiety, sleep disturbance, and absenteeism was significantly higher in individuals with atopic dermatitis.5 Annual costs in the United States associated with atopic dermatitis are approximately $5.297 billion, which is a conservative estimate.6 As we learn more about atopic dermatitis, new and emerging therapies, including targeted therapies, will have a significant impact on disease management.

References
 
  1. Eichenfield LF, Tom WL, Chamlin SL, et al. Guidelines of care for the management of atopic dermatitis. Part 1: Diagnosis and assessment of atopic dermatitis. J Am Acad Dermatol. 2014;70(2):338-351. doi: 10.1016/j.jaad.2013.10.010.
  2. Montes-Torres A, Llama-Velasco M, Pérez-Plaza, A, Solano-López G, Sánchez-Pérez J. Biologic treatments in atopic dermatitis. J Clin Med. 2015;4(4):593-613. doi: 10.3390/jcm4040593.
  3. Nutten S. Atopic dermatitis: global epidemiology and risk factors. Ann Nutr Metab. 2015;66(suppl 1):8-16. doi: 10.1159/000370220.
  4. Lifschitz C. The impact of atopic dermatitis on quality of life. Ann Nutr Metab. 2015;66(suppl 1):34-40. doi: 10.1159/000370226.
  5. Eckerd L, Gupta S, Amand C, et al. Impact of atopic dermatitis on health-related quality of life and productivity in adults in the United States: an analysis using the National Health and Wellness Survey. J Am Acad Dermatol. 2017;77(2):274-279.e3. doi: 10.1016/j.jaad.2017.04.019.
  6. Drucker AM, Wang AR, Li WQ, Sevetson E, Block JK, Qureshi AA. The burden of atopic dermatitis: summary of a report for the National Eczema Association. J Invest Dermatol. 2017;137(1):26-30. doi: 10.1016/j.jid.2016.07.012.






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