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This activity is intended for healthcare professionals practicing in
managed care environments.
This activity is supported by
an educational grant from
Takeda Pharmaceuticals USA
Inflammatory bowel disease (IBD) is a chronic, frequently
progressive condition that affects approximately 1.6 million people
in the United States. This lifelong, systemic autoimmune illness
often strikes patients at a young age and must be managed across a
lifetime. The diagnosis of IBD is most commonly based on imaging to
assess the portions of the small bowel that are inaccessible to
optical endoscopic visualization, which may also include a
combination of endoscopy and histopathology. Imaging plays a
critical role in the initial diagnosis and ongoing evaluation of IBD
patients. The treatment goal for IBD is to reduce the inflammation,
in hopes of achieving reduced symptoms and possibly remission.
Immediate goals are to control the symptoms, induction of remission,
and to help improve a patient’s quality of life, while long-term
goals include maintenance of a corticosteroid-free clinical
remission, mucosal healing, endoscopic remission, prevention or cure
of complications, restoration, and maintenance of proper nutrition.
The first step for IBD treatment is aminosalicylates, which are
useful for treating flares of IBD and for maintaining remission.
There is also the use of antibiotics to treat bacterial infections
that may result from abscesses or fistulas. Corticosteroids can be
used, as they are rapid-acting anti-inflammatory agents, are
indicated for acute flares of disease only and have no role in the
maintenance of remission. Immunomodulators have a slower onset of
action and work to reduce patients’ overactive immune system but
unlike corticosteroids, they can be used as a long-term treatment.
And the fifth way to treat IBD is with biologics, which are proteins
that stop certain molecules in the body from causing inflammation in
the GI tract. These are usually prescribed to those living with
moderate to severe cases of IBD who have not responded to other
types of treatment.
Advances in IBD treatment have improved outcomes for many patients
but personalizing therapy and predicting response to therapy
continues to be a big challenge. This has led to underutilization of
effective regimens, undertreatment, and suboptimal outcomes.
Addressing new and emerging clinical decision support tools can help
providers bridge this gap by predicting individualized disease
complication risk and appropriate responses to therapy. Currently,
there are several approved biologics and small molecules available
through the FDA and other regulatory organizations around the world.
One of these treatments is the tumor necrosis factor (TNF)
inhibitors. Another treatment pathway is blocking interleukin
(IL)-12 and -23 through the use of ustekinumab. A completely
different mechanism is blocking the adhesion molecules to the
integrin inhibitors. Then, more recently there have been advances in
the first oral agents which consist of the Janus kinase (JAK)
inhibitors. New updates in these treatments, as well as the presence
of biologic therapies, has changed goals and expectations of
inflammatory bowel disease management and gives patients a better
chance of achieving remission.
Upon completion of this
activity, participants will be able to:
Analyze the safety and efficacy of
current and emerging treatments to inform treat-to-target
strategies in the management of inflammatory bowel disease (IBD)
Explore different indications of
proper diagnostic testing to determine optimal customized
Incorporate the use of biologics,
combination therapies, and emerging agents with novel mechanisms
of action in the current IBD treatment paradigm
Discuss challenges in IBD management
and how to overcome issues concerning adherence and adverse
Evaluate managed care strategies and
guidelines to help account for evolving management strategies in
||Miguel Regueiro, MD
Chair, Department of Gastroenterology, Hepatology &
Professor, Department of Medicine
Cleveland Clinic Lerner College of Medicine of Case
Western Reserve University
Regueiro serves on an advisory board and as a consultant
for AbbVie, Janssen, UCB, Takeda, Pfizer, Miraca Labs,
Amgen, Celgene, Seres, Allergan, Genentech, Gilead,
Salix, and Prometheus. He has received grants/research
support from AbbVie, Janssen, Pfizer and Takeda. His
presentation has been peer reviewed for any bias.
MD has no real or perceived financial relationships to
Jeremy Williams has no real or perceived financial
relationships to disclose.
Jacqueline Cole, RN, MS, CMCN has no real or perceived
financial relationships 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 an educational grant from
Takeda Pharmaceuticals USA
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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