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Application of Top-Down Versus Step-Up Treatment Strategy in Crohn’s Disease

Release Date: Dec 01, 2008
Expiration Date: Dec 31, 2009

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A fundamental question in the treatment of Crohn’s disease is whether early treatment with biologics is a more effective strategy than the use of traditional steroid therapy followed by biologic therapy. Recent clinical data suggest that some patients may benefit from a “top-down” approach or early biologic treatment, whereas others are more suited to a “step-up” approach. The Pod Pearl&trade will discuss these recent data and evaluate which patients may benefit from early biologic therapy. In addition, the advantages and disadvantages of the use of steroids and immunosuppressants will be detailed in light of the new clinical data.





Educational Overview

A fundamental question in the treatment of Crohn’s disease is whether early treatment with biologics is a more effective strategy than the use of traditional steroid therapy followed by biologic therapy. Recent clinical data suggest that some patients may benefit from a “top-down” approach or early biologic treatment, whereas others are more suited to a “step-up” approach. The Pod Pearl&trade will discuss these recent data and evaluate which patients may benefit from early biologic therapy. In addition, the advantages and disadvantages of the use of steroids and immunosuppressants will be detailed in light of the new clinical data.


Learning Objectives

Following completion of this activity, participants should be able to:

  • Discuss the role of earlier biologic treatment in the management of Crohn’s disease
  • Evaluate the risk/benefit/cost of newer therapies and how it should factor into clinical decision making


Target Audience

This educational activity is designed for gastroenterologists and other health care professionals interested in or involved with the management of patients with inflammatory bowel disease.



Method of Instruction

Participants should read the learning objectives and listen to the activity in its entirety. After reviewing the activity, print out and mail or fax the evaluation, and a letter of credit awarding American Medical Association Physician’s Recognition Award Category 1 Credit(s) will be sent 3 to 4 weeks after receipt of the evaluation.

Estimated time to complete this activity as designed is 0.5 hour(s).



Accreditation Statement

Temple University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing medical education for physicians.

Temple University School of Medicine is an approved provider of continuing nursing education by the Pennsylvania State Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.



Certification Statement

Temple University School of Medicine designates this educational activity for a maximum of 0.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Temple University School of Medicine designates this educational activity for a maximum of 0.5 Nursing Contact Hours.



Disclosure Policy

It is the policy of Temple University School of Medicine, The Albert J. Finestone, M.D., Office for Continuing Medical Education to ensure balance, independence, objectivity, and scientific rigor in all of its sponsored or jointly sponsored educational programs. All faculty participating in programs sponsored or jointly sponsored by Temple University School of Medicine are expected to disclose to the program audience any real or apparent conflict(s) of interest related to the content of their presentation(s).

The information presented in this CME activity represents the views and opinions of the individual presenters and does not constitute the opinion or endorsement of, or promotion by, Temple University School of Medicine, Temple University Health System, or its affiliates. Reasonable efforts have been taken intending for educational subject matter to be presented in a balanced, unbiased fashion and in compliance with regulatory requirements. However, each program attendee must always use his/her own personal and professional judgment when considering further application of this information, particularly as it may relate to patient diagnostic or treatment decisions including, without limitation, US Food and Drug Administration—approved uses and any off-label uses.



Faculty Disclosure Declarations

Remo Panaccione, MD, has been a consultant for AstraZeneca LP; Ferring Pharmaceuticals Inc.; and Schering-Plough Corp. He has received grant/research support from Axcan Pharma U.S., Inc.; Centocor, Inc.; Millennium Pharmaceuticals, Inc.; and Elan Pharmaceuticals, Inc. He is a member of the speakers bureau for AstraZeneca LP; Abbott Laboratories; Solvay Pharmaceuticals, Inc.; Axcan Pharma US, Inc.; Janssen, LP; Schering-Plough Corp; Novartis Pharmaceuticals Corp; Centocor, Inc.; and Elan Pharmaceuticals, Inc.

David T. Rubin, MD, has been a consultant for Procter & Gamble Pharmaceuticals, Inc.; Salix Pharmaceuticals, Inc.; Prometheus Laboratories, Inc.; Abbott Laboratories; UCB, Inc.; Given Imaging Ltd.; Shire US Inc.; and Axcan Pharma US, Inc. He has received grant/research support from Procter & Gamble Pharmaceuticals, Inc.; Salix Pharmaceuticals, Inc.; Prometheus Laboratories, Inc.; and Shire US Inc. He is a member of the speakers bureau for Procter & Gamble Pharmaceuticals, Inc.; Salix Pharmaceuticals, Inc.; Prometheus Laboratories, Inc.; Abbott Laboratories; and Centocor, Inc.

Stephen B. Hanauer, MD, has been a consultant for Abbott Laboratories; Amgen Inc.; Bristol-Myers Squibb Co.; Centocor, Inc.; Elan Pharmaceuticals, Inc.; Genentech, Inc.; and Millennium Pharmaceuticals, Inc. He has received grant/research support from Abbott Laboratories; Centocor, Inc.; Elan Pharmaceuticals, Inc.; Genentech, Inc.; and UCB, Inc.

Copyright 2008 Temple University School of Medicine



Planning Committee Disclosures

Temple University School of Medicine:
Arnold Meyer, Ed.D.
Melinda Somasekhar, PhD

No commercial relationships to disclose.

Healthcare First:
Donna Bonura
Andrew Finan
David Lepping

No commercial relationships to disclose.




 
Presented by Presented by Temple University School of Medicine and HealthcareFirst
Supported by This activity is supported by an educational grant from Centocor Ortho Biotech Inc.
Moderator HeaderSTEPHEN B. HANAUER, MD

STEPHEN B. HANAUER, MD

  • Professor of Medicine and Clinical Pharmacology
  • University of Chicago
  • Chicago, Illinois
Panelist HeaderREMO PANACCIONE, MD, FRCPC

REMO PANACCIONE, MD, FRCPC

  • Director, Inflammatory Bowel Disease Clinic
  • Director, Gastroenterology Training Program
  • Associate Professor, Department of Medicine
  • Division of Gastroenterology
  • University of Calgary
  • Calgary, Alberta, Canada
Panelist HeaderDAVID T. RUBIN, MD

DAVID T. RUBIN, MD

  • Associate Professor of Medicine
  • Program Director, Fellowship in Gastroenterology, Hepatology, and Nutrition
  • University of Chicago Pritzker School of Medicine
  • Co-Director, University of Chicago Inflammatory Bowel Disease Center
  • Chicago, Illinois