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This activity is intended for healthcare professionals practicing in
managed care environments.
This activity is supported by
educational grants from
AbbVie and Novartis Pharmaceuticals Corporation
Ankylosing spondylitis (AS) is an immune-mediated chronic
inflammatory disease that typically affects the sacroiliac (SI)
joints. Patients with AS suffer from debilitating pain and joint
fusion that severely limits their mobility and functional capacity.
AS is a form of axial spondyloarthritis (axSpA), in which SI
structural damage is visible on X-rays; the other form is
non-radiographic axSpA, in which structural damage has not occurred.
It is estimated that AS affects approximately 1.6 million people in
the United States. Due to an aging population, declining number of
rheumatologists, and limited access to care, care for patients with
AS is suboptimal and costly. Fortunately for patients with this
disease, recent advances in pathogenesis have led to an increased
understanding of the disease, which has subsequently led to the
development of novel targeted agents shown to slow its progression,
including options targeting IL-17/IL-23 pathways. These new options
have dramatically changed the treatment paradigm.
The goals of treatment are to minimize symptoms, maintain spinal
flexibility and normal posture, reduce functional limitations,
maintain work ability, and prevent the development of disease
complications. While tumor necrosis factor alpha inhibitors (TNFi)
changed the clinical trajectory of this disease, the benefits are
only demonstrated in patients who respond to TNFis. Between 40% and
50% of patients with AS do not respond to TNFis, and in patients who
do, long-term efficacy with disease remission is rarely achieved,
which brought about a need for newer options showing improved
efficacy and safety. These novel options have produced great benefit
for patients who do not respond to a TNFi or who have progressed on
that therapy. Additionally, clinicians have recently been finding
that novel treatment options, including janus kinase (JAK)
inhibitors, are promising. These new options have shown improved
efficacy and safety in AS, and healthcare professionals must be
educated on these agents and the potential risks that come along
with any treatment option. However, both practicing physicians and
managed care physicians are likely less familiar with these newer
therapies in AS and may have safety concerns and cost concerns.
Upon completion of this
activity, participants will be able to:
Examine current unmet clinical and
economic needs in the management of ankylosing spondylitis (AS)
Apply current guideline
recommendations to the diagnosis and treatment of AS
Evaluate the latest data on the
efficacy, safety, and mechanisms of action of novel biologic
therapies for AS
Identify the role of IL-17, IL-23,
and JAK inhibitors in the treatment of AS
Assess multidisciplinary strategies
to overcome and manage treatment-related challenges associated
with novel targeted options in the management of AS
Discuss the managed care
considerations of novel treatments by exploring where these
agents fit in the current AS management paradigm
||Joerg Ermann, MD
Division of Rheumatology, Immunology and Allergy
Brigham and Women’s Hospital
Instructor in Medicine
Harvard Medical School
serves on an advisory board for Lilly, Novartis, Pfizer,
and UCB. He has received Grants/Research Support from
Boehringer Ingelheim, AbbVie, Novartis, and Pfizer. His
presentation has been peer reviewed for any bias.
MD has no financial relationships with ineligible
companies to disclose.
Jeremy Williams has no financial relationships with
ineligible companies to disclose.
Jacqueline Cole, RN, MS, CMCN has no financial
relationships with ineligible companies to disclose.
NAMCP and/or the presenter
has copyright or has received permissions for use of
materials provided in this activity.
Accreditation & Designation
This activity has been planned and implemented in accordance with
the accreditation requirements and policies of the Accreditation
Council for Continuing Medical Education (ACCME) through the joint
providership of the National Association of Managed Care Physicians
(NAMCP) and American Association of Managed Care Nurses (AAMCN). The
National Association of Managed Care Physicians is accredited by the
ACCME to provide continuing medical education for physicians.
NAMCP designates this enduring material for a maximum of 1 AMA
PRA Category 1 credit(s)TM. Each
physician should claim credit commensurate with the extent of their
participation in the activity.
The American Association of Managed Care Nurses is accredited as a
provider of nursing continuing professional development by the
American Nurses Credentialing Center's Commission on Accreditation.
Nurses who complete this activity and achieve a passing score will
receive 1 hour in nursing continuing professional development.
This activity has been approved by the American Board of Managed
Care Nursing for 1.0 contact hours toward CMCN recertification
This activity is supported by educational grants from
AbbVie and Novartis Pharmaceuticals Corporation
NAMCP and/or this website does not
provide medical advice, diagnosis or treatment. NAMCP does not
endorse or imply endorsement of the content on any linked website.
This website is to be used as an informational resource. With any
health related concern, consult with your physician or healthcare
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