Advances in Pulmonary Hypertension

Introduction to this self-study CME activity

Program Overview

Pulmonary arterial hypertension (PAH), an incurable disease, is characterized by medial hypertrophy, intimal fibrosis, and in situ thrombi in small muscular pulmonary arteries PAH was considered a rapidly fatal illness with a median survival of 2.8 years in the 1980s when no proven therapies were available. Since then the treatment of this disease has made tremendous advances, and the last 10 years have seen the discovery of new medications that have positively influenced the prognosis and survival of PAH patients.

This self-study activity is based on three articles that review the latest information on new treatments, combinations of therapies, and data from phase 1 and 2 clinical trials.

This activity is jointly sponsored by the University of Michigan Medical School and the Pulmonary Hypertension Association and supported by an unrestricted education grant from Actelion Pharmaceuticals US, Inc., Encysive Pharmaceuticals, Inc., Gilead Sciences, Inc., Pfizer, Inc., and United Therapeutics Corporation.

Audience

This self-study activity is appropriate for cardiologists, pulmonologists, and rheumatologists and other physicians who treat patients with pulmonary hypertension.

Learning Objectives

Upon completion of this activity participants will be able to:

Describe the 2007 ACCP consensus guidelines for evidence-based treatment of PAH of WHO class II, III, and IV and be able to apply them to PAH patients.
Summarize controversial areas in the 2007 ACCP guidelines, and recent PAH clinical trial data that were not included in the guidelines.
Discuss the rationale and emerging evidence supporting combination therapy for PAH.
Summarize the nature of ongoing phase 2 and 3 PAH clinical trials.

Faculty

Co-Chair
James Maloney, MD
Division of Pulmonary Sciences and Critical Care Medicine
University of Colorado Health Sciences Center
Denver, Colorado

Co-Chair
Todd Bull, MD
Division of Pulmonary Sciences and Critical Care Medicine
University of Colorado Health Sciences Center
Denver, Colorado

Contributing Authors

Iona R. Preston, MD
Pulmonary, Critical Care and Sleep Division
Tufts University School of Medicine
Tufts-New England Medical Center
Boston, Massachusetts

Jeremiah P. Depta, MD
Department of Internal Medicine
The Cleveland Clinic
Cleveland, Ohio

Richard A. Krasuski, MD
Division of Cardiovascular Medicine
The Cleveland Clinic
Cleveland, Ohio

Zeenat Safdar, MD
Department of Medicine
Section of Pulmonary, Critical Care, and Sleep Medicine
Baylor College of Medicine
Houston, Texas

Oversite and Accreditation

Arlene Bradford, BA
Assistant Director
Office of CME
University of Michigan Medical School

Disclosures

The Accreditation Council for Continuing Medical Education and the Association of American Colleges have standards and guidelines to ensure that individuals participating in CME activities are aware of relationships between authors and commercial companies that could potentially affect the information presented. The University of Michigan Medical School follows these national policies to ensure balance, independence, objectivity, and scientific rigor in all its CME activities. Each author was asked to complete a disclosure information form for this activity. Disclosures are reported below.

Todd Bull, MD, receives grant/research support from United Therapeutics.

James Maloney, MD, has no relevant personal financial relationships to disclose.

Zeenat Safdar, MD, serves as a consultant for United Therapeutics, Gilead, Actelion, and Encysive, and is on the Speaker’s Bureau of these companies.

Jeremiah Depta, MD, has no relevant personal financial relationship to disclose.

Richard A. Krasuski, MD, serves as a consultant for Acterlion and is on Speaker’s Bureau of Actelion, Pfizer, and Roche.

Ioana R. Preston, MD, serves as a consultant for and is on the Speaker's Bureau of Actelion, United Therapeutics and Gilead. She also receives grant/research support from Actelion, Pfizer, United Therapeutics, and Gilead.

Arlene Bradford, BA, has no relevant personal financial relationships to disclose.

CME Reviewer

Kevin M. Chan, MD
Assistant Professor of Medicine
Division of Pulmonary and Critical Care Medicine
University of Michigan Health Systems
Ann Arbor, Michigan

Accreditation Statement

This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the University of Michigan Medical School and the Pulmonary Hypertension Association. The University of Michigan is accredited by the ACCME to provide continuing medical education to physicians.

Credit Designation

The University of Michigan Medical School designates this activity for a maximum of 2.0 AMA PRA Category 1 credits™. Physicians should claim credit commensurate with the extent of their participation in the activity.

Instructions for Earning Credit

This activity is a self-study program; a self-assessment examination is to help physicians review important points. Completion of this activity involves reading the journal and completing the self-assessment examination and evaluation form, which may take up to 2 hours. Credits for this self-study program are available from May 1, 2008 through May 1, 2009. There is no fee for this program.

Method of Participation

View the web pages. You may print the self-study text to read off-line.
Complete the on-line learning assessment test. It will be electronically scored and the correct answers returned immediately for your review.
Complete the electronic credit request and activity evaluation. An electronic certificate of participation will be provided immediately.
Print the certificate of participation for your personal records.

NEXT > Self-Study

	Continuing Medical Education (CME) UNIVERSITY OF MICHIGAN MEDICAL SCHOOL

CME Home Course Calendar Self Study CME Attendance Reports CME Credit Approval for U-M Activities Maps & Directions FAQ About Us Contact Us	Advances in Pulmonary Hypertension Introduction to this self-study CME activity Program Overview Pulmonary arterial hypertension (PAH), an incurable disease, is characterized by medial hypertrophy, intimal fibrosis, and in situ thrombi in small muscular pulmonary arteries PAH was considered a rapidly fatal illness with a median survival of 2.8 years in the 1980s when no proven therapies were available. Since then the treatment of this disease has made tremendous advances, and the last 10 years have seen the discovery of new medications that have positively influenced the prognosis and survival of PAH patients. This self-study activity is based on three articles that review the latest information on new treatments, combinations of therapies, and data from phase 1 and 2 clinical trials. This activity is jointly sponsored by the University of Michigan Medical School and the Pulmonary Hypertension Association and supported by an unrestricted education grant from Actelion Pharmaceuticals US, Inc., Encysive Pharmaceuticals, Inc., Gilead Sciences, Inc., Pfizer, Inc., and United Therapeutics Corporation. Audience This self-study activity is appropriate for cardiologists, pulmonologists, and rheumatologists and other physicians who treat patients with pulmonary hypertension. Learning Objectives Upon completion of this activity participants will be able to: Describe the 2007 ACCP consensus guidelines for evidence-based treatment of PAH of WHO class II, III, and IV and be able to apply them to PAH patients. Summarize controversial areas in the 2007 ACCP guidelines, and recent PAH clinical trial data that were not included in the guidelines. Discuss the rationale and emerging evidence supporting combination therapy for PAH. Summarize the nature of ongoing phase 2 and 3 PAH clinical trials. Faculty Co-Chair James Maloney, MD Division of Pulmonary Sciences and Critical Care Medicine University of Colorado Health Sciences Center Denver, Colorado Co-Chair Todd Bull, MD Division of Pulmonary Sciences and Critical Care Medicine University of Colorado Health Sciences Center Denver, Colorado Contributing Authors Iona R. Preston, MD Pulmonary, Critical Care and Sleep Division Tufts University School of Medicine Tufts-New England Medical Center Boston, Massachusetts Jeremiah P. Depta, MD Department of Internal Medicine The Cleveland Clinic Cleveland, Ohio Richard A. Krasuski, MD Division of Cardiovascular Medicine The Cleveland Clinic Cleveland, Ohio Zeenat Safdar, MD Department of Medicine Section of Pulmonary, Critical Care, and Sleep Medicine Baylor College of Medicine Houston, Texas Oversite and Accreditation Arlene Bradford, BA Assistant Director Office of CME University of Michigan Medical School Disclosures The Accreditation Council for Continuing Medical Education and the Association of American Colleges have standards and guidelines to ensure that individuals participating in CME activities are aware of relationships between authors and commercial companies that could potentially affect the information presented. The University of Michigan Medical School follows these national policies to ensure balance, independence, objectivity, and scientific rigor in all its CME activities. Each author was asked to complete a disclosure information form for this activity. Disclosures are reported below. Todd Bull, MD, receives grant/research support from United Therapeutics. James Maloney, MD, has no relevant personal financial relationships to disclose. Zeenat Safdar, MD, serves as a consultant for United Therapeutics, Gilead, Actelion, and Encysive, and is on the Speaker’s Bureau of these companies. Jeremiah Depta, MD, has no relevant personal financial relationship to disclose. Richard A. Krasuski, MD, serves as a consultant for Acterlion and is on Speaker’s Bureau of Actelion, Pfizer, and Roche. Ioana R. Preston, MD, serves as a consultant for and is on the Speaker's Bureau of Actelion, United Therapeutics and Gilead. She also receives grant/research support from Actelion, Pfizer, United Therapeutics, and Gilead. Arlene Bradford, BA, has no relevant personal financial relationships to disclose. CME Reviewer Kevin M. Chan, MD Assistant Professor of Medicine Division of Pulmonary and Critical Care Medicine University of Michigan Health Systems Ann Arbor, Michigan Accreditation Statement This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the University of Michigan Medical School and the Pulmonary Hypertension Association. The University of Michigan is accredited by the ACCME to provide continuing medical education to physicians. Credit Designation The University of Michigan Medical School designates this activity for a maximum of 2.0 AMA PRA Category 1 credits™. Physicians should claim credit commensurate with the extent of their participation in the activity. Instructions for Earning Credit This activity is a self-study program; a self-assessment examination is to help physicians review important points. Completion of this activity involves reading the journal and completing the self-assessment examination and evaluation form, which may take up to 2 hours. Credits for this self-study program are available from May 1, 2008 through May 1, 2009. There is no fee for this program. Method of Participation View the web pages. You may print the self-study text to read off-line. Complete the on-line learning assessment test. It will be electronically scored and the correct answers returned immediately for your review. Complete the electronic credit request and activity evaluation. An electronic certificate of participation will be provided immediately. Print the certificate of participation for your personal records. NEXT > Self-Study

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