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This activity is intended for healthcare professionals practicing in
managed care environments.
This activity is supported by
educational grants from
Bristol Myers Squibb and Takeda Pharmaceuticals
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. According to the Crohn’s and Colitis Foundation of
America, there are as many as 70,000 new cases diagnosed in a year.
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 and corticosteroids can
be used, as they are rapid-acting anti-inflammatory agents which are
indicated for acute flares. 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. 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.
Upon completion of this
activity, participants will be able to:
Apply current guidelines and
evidence to inform treatment decisions for inflammatory bowel
disease (IBD) patients
Explore different indications of
proper diagnostic testing to determine appropriate treatment
Analyze ways to pursue clinical
remission in IBD with treat-to-target strategies, including data
for targeted biologic and small molecule treatments
Incorporate personalized approaches
with a multidisciplinary team to provide optimal care in the
management of IBD
Examine strategies for anticipating,
recognizing, and managing adverse events and other challenges
present in IBD management
Discuss the managed care
considerations of current and emerging therapies by exploring
where these agents fit into the IBD management paradigm
||Francis A. Farraye, MD,
Director, Inflammatory Bowel Disease Center
Professor of Medicine
Department of Gastroenterology and Hepatology
serves on an advisory board for BMS, Braintree Labs,
Gilead, Ferring, GI Reviewers, GSK, Iterative Scopes,
Janssen, Pfizer, and Sebela. He owns stock in Innovation
Pharmaceuticals. 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
Bristol Myers Squibb and Takeda Pharmaceuticals
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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