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 Clinical Courier - Maximizing the Management of Pediatric Asthma: Today's Management Tomorrow's Potential
  Course Information Back to Catalog   



Target Audience

Allergists/Immunologists, Pulmonologists, General Practitioners, Internists, Pediatricians, and Allied Healthcare professionals.


Needs Assessment

Asthma is the most common serious chronic disease of childhood. Its prevalence, which doubled between 1980 and the late 1990s, has plateaued, but at a historically high level. Asthma affected an estimated 6.5 million US children in 2005. Whereas asthma mortality among children has been decreasing since 1999, other measures of the disease remain at the highest levels recorded. In 2004, there were 198,000 hospitalizations for pediatric asthma, representing essentially no improvement over the past 15 years. Data from long-term studies indicate that most patients with persistent asthma first display symptoms in early life and that early allergic sensitization is an important risk factor for persistence. Furthermore, most of the decline in lung function related to childhood asthma occurs in children whose symptoms begin during the first 3 years of life. The understanding of pediatric asthma as a disease entity is distinct from adult-onset asthma. Anatomic differences between children and adults, such as smaller airway size and lower inspiratory flow rate, may restrict medication deposition and affect outcomes. Thus, early diagnosis and appropriate interventions are crucial.

Although National Asthma Education and Prevention Program (NAEPP) guidelines have been available for more than a decade, undertreatment is common. The NAEPP recommends inhaled corticosteroids (ICSs) as the preferred long-term control medication for children of all ages with persistent asthma. One reason for insufficient treatment may be the uncertainty about how ICSs affect growth velocity. In 2001, the Food and Drug Administration issued guidelines about how clinical trials should be conducted to assess this effect. Clinical trials sponsored by the National Institutes of Health suggest that, at recommended doses, ICSs do not have clinically significant or irreversible effects on growth.

This continuing medical education activity has been designed to educate clinicians to identify the natural history of pediatric asthma and the importance of early disease recognition and intervention, recognize the value of treatment guidelines, evaluate the risks and benefits of pharmacotherapies (including special considerations regarding safety and growth issues), and apply strategies that emphasize patient education as a means to improve outcomes.


Goals and Objectives

After reading this newsletter, participants should be able to:

  • Review the importance of the appropriate diagnosis of asthma and institution of the correct therapy
  • Discuss special considerations in the treatment of pediatric asthma as it relates to safety and growth issues
  • Describe the evidence of the natural history of asthma and longterm outcomes in the pediatric population
  • List the risks and benefits of available classes of pharmacotherapies and differentiate among inhaled corticosteroid therapies
  • Discuss the pros and cons of asthma treatment guidelines, how they may evolve, and the concepts of first-line therapy and “stepwise” approaches to treatment
  • Define and explain strategies that emphasize the importance of asthma control and improve patient compliance/adherence to therapy

Accreditation and Designation 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 National Jewish Medical and Research Center and IMED Communications. National Jewish Medical and Research Center is accredited by the ACCME to provide continuing medical education for physicians.

National Jewish Medical and Research Center designates this educational activity for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.


Steering Committee

Matthew J. Fenton, PhD
Chief, Asthma, Allergy, and Inflammation Branch
National Institute of Allergy and Infectious Diseases
National Institutes of Health
Department of Health and Human Services
Bethesda, Maryland

George P. Giacoia, MD
Program Scientist for the Pediatric Pharmacology
Research Unit Network
Obstetric and Pediatric Pharmacology Branch
Center for Research for Mothers and Children
National Institute of Child Health and Human Development
National Institutes of Health
Rockville, Maryland


Program Chair

Erwin W. Gelfand, MD
Chairman, Department of Pediatrics
National Jewish Medical and Research Center
Professor of Pediatrics and Immunology
University of Colorado Health Sciences Center
Denver, Colorado


Program Faculty

Leonard Fromer, MD, FAAFP, FABFP
Assistant Clinical Professor
UCLA School of Medicine, Los Angeles
Prairie Medical Group
Santa Monica, California

Meyer Kattan, MD
Professor of Pediatric Medicine
Mount Sinai School of Medicine
Chief, Pediatric Pulmonary and Critical Care
Mount Sinai Hospital
New York, New York

Peter J. Gergen, MD, MPH
Medical Officer
Asthma, Allergy, and Inflammation Branch
Division of Allergy, Immunology, and Transplantation
National Institute of Allergy and Infectious Diseases
National Institutes of Health
Bethesda, Maryland

David P. Skoner, MD
Professor of Pediatrics
Drexel University College of Medicine
Director, Pediatric Allergy, Asthma, Immunology
Allegheny General Hospital
Pittsburgh, Pennsylvania

Theresa Guilbert, MD
Assistant Professor of Pediatrics
Pediatric Pulmonologist
University of Wisconsin–Madison
Madison, Wisconsin

Stuart W. Stoloff, MD
Clinical Professor
Family and Community Medicine
University of Nevada School of Medicine–Reno
Carson City, Nevada

Stanley J. Szefler, MD
Professor of Pediatrics and Pharmacology,
Helen Wohlberg and Herman Lambert Chair in Pharmacokinetics
National Jewish Medical and Research Center
University of Colorado Health Clinical Sciences Center
Denver, Colorado


Discussant

Craig Jones, MD
Assistant Professor
LAC-USC Medical Center
Calabasas, California


Cooperating Organization Representatives

American Academy of Allergy, Asthma & Immunology
Peyton A. Eggleston, MD
Professor of Pediatrics
Johns Hopkins University
Baltimore, Maryland

American College of Chest Physicians
Christopher L. Carroll, MD
Assistant Professor, Pediatrics
University of Connecticut School of Medicine
Pediatric Intensivist
Connecticut Children’s Medical Center
Hartford, Connecticut

American Academy of Pediatrics
Stanley J. Szefler, MD
Professor of Pediatrics and Pharmacology
University of Colorado Health Sciences Center
Helen Wohlberg and Herman Lambert Chair in Pharmacokinetics
National Jewish Medical and Research Center
Denver, Colorado

New Jersey Academy of Family Physicians
Elisabeth Spector, MD, MPH
Assistant Director
Somerset Family Medical Residency
Faculty Preceptor
NJ Medical School, University of Medicine and Dentistry of New Jersey
New Brunswick, New Jersey

American College of Allergy, Asthma & Immunology
William K. Dolen, MD
Professor of Pediatrics and Medicine
Medical College of Georgia
Augusta, Georgia


Faculty Disclosure

All faculty in a position to control the content of this activity are expected to disclose any or no significant financial interest or other relationship with any proprietary entity producing healthcare goods or services, with the exception of nonprofit or governmental organizations and non–healthcare-related companies. Our goal is to ensure that there is no compromise of the ethical relationship that exists between those in a position to control the content of the activity and those attending the activity and their respective professional duties.

Significant financial interest is defined as receiving, or in the past 12 months having received, a salary, royalty, intellectual property rights, consulting fee, honoraria, ownership interest (eg, stocks, stock options, or other ownership interest, excluding diversified mutual funds), or other financial benefit.

Christopher L. Carroll, MD, has no significant financial interest.

William K. Dolen, MD, is on the speakers’ bureau for DEY.

Peyton A. Eggleston, MD, is a consultant for Chlorine Chemistry Council, Church & Dwight, Merck, and Procter & Gamble, and is on the speakers’ bureau for AstraZeneca, GlaxoSmithKline, and Merck.

Matthew J. Fenton, PhD, has no significant financial interest.

Leonard Fromer, MD, FAAFP, FABFP, receives speaker honoraria from Phadia, Quest Diagnostics, sanofi-aventis, and Schering-Plough.

Erwin W. Gelfand, MD, is a consultant for Merck, Novartis, and Schering-Plough.

Peter J. Gergen, MD, MPH, has no significant financial interest.

George P. Giacoia, MD, has no significant financial interest.

Theresa Guilbert, MD, is a consultant for Astra- Zeneca and GlaxoSmithKline; is on the speakers’ bureau for Antidote Medical Education, AstraZeneca, GlaxoSmithKline, and Novartis; and has a patent pending in genetics of controller response at the CARE Network of the National Heart, Lung, and Blood Institute.

Craig Jones, MD, is a consultant for Genentech, Merck, and sanofi-aventis; receives grant support from Genentech and Merck; and is on the speakers’ bureau for Genentech, Merck, Novartis, and sanofi-aventis.

Meyer Kattan, MD, is on the speakers’ bureau for AstraZeneca.

David P. Skoner, MD, is a consultant for Merck; receives grant support from AstraZeneca, Glaxo- SmithKline, Greer Laboratories, Merck, Novartis, and sanofi-aventis; and is on the speakers’ bureau for AstraZeneca, GlaxoSmithKline, Merck, Novartis, sanofi-aventis, and Schering-Plough.

Elisabeth Spector, MD, MPH, is a consultant for Merck.

Stuart W. Stoloff, MD, is a consultant for ALTANA, AstraZeneca, GlaxoSmithKline, Merck, sanofi-aventis, and Schering-Plough and is on the speakers’ bureau for AstraZeneca, GlaxoSmithKline, sanofi-aventis, and Schering-Plough.

Stanley J. Szefler, MD, is a consultant for AstraZeneca, Genentech, GlaxoSmithKline, Merck, Novartis, and Ross; receives grant support from Ross; and receives speaker honoraria from Merck.


Product Disclosure

Faculty members are required to inform the audience when they are discussing off-label or unapproved uses of devices or drugs. Devices or drugs that are still undergoing clinical trials are identified as such and should not be portrayed as standard, accepted therapy. Please consult the full prescribing information before using any product mentioned in the newsletter. When using drugs in an investigational, off-label manner, it is the responsibility of the prescribing physician to monitor the medical literature to determine recommended dosages and uses of the drugs. Neither the publisher nor the sponsor promotes the use of any agent outside of approved labeling. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings. The following product is not US Food and Drug Administration–approved for the treatment of asthma: ciclesonide.


Brought To You By

This Clinical Courier® is published under an educational grant from sanofi-aventis and developed and produced by IMED Communications. The publishers reserve copyright on all published materials, and such materials may not be reproduced in any form without written permission of IMED Communications.

This material was developed from a roundtable meeting and based on a review of multiple sources of information, but is not exhaustive of the subject matter. The participant must always use his or her own personal and professional judgment when considering further application of this information, particularly as it relates to patient diagnostic or treatment decisions including, without limitation, US Food and Drug Administration–approved uses and any off-label uses. Healthcare professionals and other individuals should review and consider other publications and material about the subject and not rely solely on the information contained within this publication.

The opinions expressed in this Clinical Courier® are those of the contributing faculty and do not necessarily reflect the views or policies of the National Jewish Medical and Research Center, IMED Communications, or the program grantor, sanofi-aventis.

Please direct all correspondence to: Editor, Clinical Courier® IMED Communications 405 Trimmer Road PO Box 458 Califon, NJ 07830



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AMA - Physicians Only Accreditation
 
To receive educational credit, participants must complete an online evaluation form and pass the online assessment with a score of 80% or better. If you do not receive a minimum score of 80% or better, you are permitted 1000 retake(s). After passing the assessment, you can view, print and track your statements of credit online. There is no fee to participate in this activity.

AMA - Non Physician Accreditation
 
To receive educational credit, participants must complete an online evaluation form and pass the online assessment with a score of 80% or better. If you do not receive a minimum score of 80% or better, you are permitted 1000 retake(s). After passing the assessment, you can view, print and track your statements of credit online. There is no fee to participate in this activity.

The material presented here does not reflect the views of Pharmacy Choice, Inc., RxSchool, or the companies providing educational content. These materials may discuss uses and dosages for therapeutic products, processes, procedures and inferred diagnoses that have not been approved by the United States Food and Drug Administration. A qualified health care professional should be consulted before using any therapeutic product discussed. All readers and continuing education participants should verify all information and data before treating patients or employing any therapies described in this continuing education activity.







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