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Renal and Nonrenal Flares in Systemic Lupus Erythematosus: Meeting the Clinical Challenge

A supplement to Rheumatology News International supported by an unrestricted educational grant from Aspreva Pharmaceuticals. This supplement was jointly sponsored by Elsevier/International Medical News Group and Boston University School of Medicine, an ACCME accredited provider.
The articles in this supplement are based on a continuing medical education symposium held November 15, 2006, in Washington, DC.


Topics
Faculty
Target Audience
Statement of Need
Educational Objectives
Accreditation

Medical Education Library
To view the supplement, click the image above. To take the CME test, download and print out the PDF file, and follow the test instructions on page 12.

Topics

Introduction

Flares and Remissions: The Characteristic Course of SLE

Clinical Features and Complications of SLE

Managing Flares I: Treatment Options for Nonrenal SLE Flares

Managing Flares II: Treatment Options for Renal Flares

Faculty

Robert Lafyatis, MD, Course Director
Associate Professor of Medicine
Department of Rheumatology
Boston University School of Medicine
Dr. Lafyatis has received grant/research support from Biogen Idec, Genentech, Inc., and Millennium Pharmaceuticals, Inc. He is a consultant to Actelion Pharmaceuticals US, Inc., Biogen Idec, Genentech and Encysive Pharmaceuticals.

Bevra H. Hahn, MD, Chair
Chief, Division of Rheumatology
Professor of Medicine
UCLA David Geffen School of Medicine
University of California, Los Angeles
Dr. Hahn has received grant/research support from Aspreva. She is a consultant to Aspreva, Bristol-Myers Squibb, Genentech, and Teva Pharmaceutical. She plans to discuss the off-label/investigational uses of a commercial product.

Michelle Petri, MD, MPH
Professor, Division of Rheumatology
Department of Medicine
Johns Hopkins University School of Medicine
Baltimore
Dr. Petri has received grant/research support from Bristol-Myers Squibb, Immunomedics, MedImmune, and Teva and is a consultant to Genelabs, Genentech, and MedImmune. She does not plan to discuss off-label/investigational uses of a commercial product.

Joan T. Merrill, MD
OMRF Professor of Medicine
University of Oklahoma Health Sciences Center
Head, Clinical Pharmacology Research Program
Oklahoma Medical Research Foundation
Oklahoma City
Dr. Merrill has received grant/research support from Abbott Laboratories, Amgen, Aspreva, Biogen, Bio-Rad Laboratories, Inc., Bristol-Myers Squibb, DuPont, Genelabs Technologies, Inc., Genentech, Human Genome Sciences, La Jolla Pharmaceutical Company, MedImmune Inc., Nabi Biopharmaceuticals, National Institute of Arthritis and Musculoskeletal and Skin Diseases, and Otsuka America Pharmaceutical, Inc. She is a consultant to Abbott, Biogen Idec, Bio-Rad, Bristol-Myers Squibb, Dynavax Technologies Corporation, Eisai Co., Ltd., Genelabs, Genentech, Human Genome Sciences, Immunomedics, Inc., La Jolla, the Lupus Foundation of America, Medarex, Inc., MedImmune, Otsuka, Teva, and Wyeth. She is on the speaker's bureau for Bristol-Myers Squibb and Genentech. Dr. Merrill plans to discuss the off-label/investigational uses of a commercial product.

Ellen M. Ginzler, MD, MPH
Professor of Medicine
Chief of Rheumatology
SUNY Downstate Medical Center
Brooklyn
Dr. Ginzler has received grant/research support from and is a consultant for Amgen Inc., Aspreva Pharmaceuticals Corporation, Bristol-Myers Squibb Company, Genentech, Human Genome Sciences, Inc., and Teva Pharmaceutical Industries Ltd. She plans to discuss the off-label/investigational uses of a commercial product.

Target Audience

This activity has been developed for rheumatologists involved in the care of patients with systemic lupus erythematosus (SLE), including the complications of SLE such as lupus nephritis.

Statement of Need

Systemic lupus erythematosus (SLE) is a chronic, inflammatory autoimmune disease that may affect the skin, heart, lungs, blood, kidneys, and/or musculoskeletal system, often beginning with one organ system at the onset of the disease and possibly involving other systems as the disease progresses. Because many of the manifestations of the disease in the various organ systems may mimic the symptoms of a wide range of diseases, the diagnosis of SLE can be a clinical challenge. SLE may be mild or remittent, or in some patients, the symptoms may be severe and life-threatening.

SLE is characterized by flares and remission of disease, and treatment must effectively address the various phases: induction of remission, maintenance of remission, and management of flares. Renal complications—lupus nephritis—develop in 50% of patients with SLE. Unless lupus nephritis is well controlled, the disease can progress to end-stage renal disease, with the need for dialysis and/or organ transplantation.

Clinicians must remain updated on the most recent results of ongoing research on the diagnosis of SLE and its complications, but most particularly on advances in pharmacologic therapy. This program provides practitioners with information of practical clinical use and on therapies currently in clinical trials that may result in treatment advances.

Educational Objectives

At the conclusion of this supplement, the participants should be able to:

• list the signs, symptoms, and clinical impact of SLE.

• outline the clinical course of SLE, the importance of renal and nonrenal flares, and how flares are defined.

• state the treatment options for both nonrenal and renal flares and explain the importance and benefits of early treatment.

• describe the management of nonrenal clinical features of SLE.

Accreditation

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 Boston University School of Medicine and International Medical News Group. Boston University School of Medicine is accredited by the ACCME to provide continuing medical education for physicians.

Boston University School of Medicine designates this educational activity for a maximum of 1 AMA/PRA Category 1 Credit. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Term of Approval: February 15, 2007-February 15, 2008.

Copyright © 2007 Elsevier Inc.