Home Registration Module 1 Module 2 Module 3 Contact Us Best Practices in Managing Established Gout Tuesday, February 2, 2010 or Thursday, February 11, 2010 7:00 PM - 7:40 PM EST Arthur L. Weaver, MD, MS, FACP, MACR Clinical Professor of Medicine Emeritus, University of Nebraska Medical Center, Omaha, NE Program Overview Gout progresses from sporadic acute flares to the development of chronic gout, and if not treated appropriately, this can lead to deforming tophi. One of the first signs of gout is increased serum urate and joint inflammation. Termination of the acute inflammatory gout attack does not address the issues of recurrence and underlying metabolic problem of accumulated urate stores. Thus, life-long urate-lowering therapy is required to reduce and maintain serum urate at a target level of <6.0 mg/dL, the level that is associated with disappearance of urate crystals in the joint space and elimination of gout flares. Gout is primarily managed by primary care physicians, and the increasing incidence and prevalence of gout is making it more essential to have a greater awareness of this progressive disease and of the different treatment options now available. This on-line web-workshop will provide guidance on how to treat patients with poorly controlled gout, and address why patient education and good patient compliance plays an important role in the successful long-term management of gout. Target Audience This activity was developed for physicians, physicians assistants, nurses and other healthcare professionals responsible for the care of patients with gout and/or hyperuricemia. Learning Objectives Upon completion of this activity, participants should be able to: Make an in-office diagnosis of gout based on patient’s symptoms and clinical presentation, and recognize ‘red flags’ which may necessitate referral to a rheumatologist for further investigations Describe the management of acute gout flares and the appropriate use of prophylactic treatment such as NSAIDs or colchicine Identify that the long-term goal of treatment is to reduce serum urate to <6.0 mg/dL and to define the key steps in selecting and individualizing urate-lowering therapy (ULT) according to disease stage; together with recognizing the importance of monitoring serum urate levels Educate patients that successful management with ULT includes their long-term commitment to adherence with the recommended life-style and drug interventions Explain how gout management may require modification in special patient populations who have various co-morbidities Faculty Biography Arthur L. Weaver, MD, MS, FACP, MACR Clinical Professor of Medicine Emeritus University of Nebraska Medical Center Omaha, NE Arthur L. Weaver graduated with honors at the University of Nebraska. He received his medical degree from Northwestern University in Evanston, IL. He completed his medical internship at the University of Michigan Hospitals in Ann Arbor, MI, and his residency and fellowship at the Mayo Graduate School of Medicine in Rochester, MI. At the Mayo Graduate School of Medicine, he received the Philip S. Hench Award for excellence in rheumatology and earned a Masters degree in medicine from the University of Minnesota. From 1966 to 1968 Dr. Weaver was a commissioned captain on active duty in the Medical Corps, U.S. Army Reserve, serving as assistant chief of General Medical Service and Chief of Rheumatology at Fitzsimons General Hospital in Denver, CO. He practiced and was Director of Clinical Research at the Arthritis Center of Nebraska in Lincoln, NE, for 34 years and now serves as a Clinical Professor of Medicine Emeritus at the University of Nebraska Medical Center in the Division of Rheumatology. Dr. Weaver has been very active in rheumatology clinical research and has been a primary investigator on more than 115 research protocols. He has made over 1600 scientific presentations and authored over 150 papers/abstracts in the field of clinical rheumatology. He also serves on the Nebraska Chapter of the Arthritis Foundation and has been a delegate-at-large to the National Arthritis Foundation on several occasions. He is a fellow of the American College of Physicians (ACP) and received the Nebraska ACP Laureate Award in 1996. An active participant and fellow in the American College of Rheumatology (ACR) for many years, Dr. Weaver was a member of the Board of Directors from 1987 until 1997 and served as president of the ACR in 1995/96. In 1989, he was the first recipient of the ACR's Paulding Phelps Award for Outstanding Service on Behalf of Clinical Rheumatologists and in 2001 was elected a Master of the ACR. CME/CE Information CME/CE Evaluation Form CME/CE Evaluation Form-Module 2 To receive CME/CE credit, click on the above link and complete the form. Once completed fax to (949) 824-3037 . Certification Statement Physicians 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 University of California, Irvine School of Medicine and Strategic Consultants International. University of California, Irvine School of Medicine is accredited by the ACCME to provide continuing medical education for physicians. The University of California, Irvine School of Medicine designates the educational activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)TM. Physicians should only claim credit commensurate with the extent of their participation in the activity. Nurses Contact hours for registered nurses are provided by the University of California, Irvine College of Health Sciences, Program in Nursing Science as approved by the California Board of Registered Nursing, Provider Number 11349 for 1.0 contact hours. Credit Designation Statement Physicians Maximum of 1.0 AMA PRA Category 1 Credit(s)TM. Nurses 1.0 Nursing Contact Hour(s) (0 contact hours are in the area of pharmacology). All other healthcare professionals completing continuing education credit for this activity will be issued a certificate of participation. Method of participation There are no fees for participating in and receiving credit for this activity. The participant must 1) read the learning objectives and faculty disclosures; 2) study the educational activity; 3) complete the -pre / -mid / and -post test questions by recording the best answer to each question during the activity; 4) complete the evaluation form; and mail to: University of California Irvine Shool of Medicine, Building 802, Room 120H, Irvine, CA 92697-4089 ; or fax to (949) 824-3037 . Estimated time of completion This activity should take approximately 1.0 hour to complete. The time allocated includes the completion of reading the material and completing the post-test and evaluation. Disclosure of unlabeled use The contents of some CME activities may contain discussions of non-approved or off-label uses of some of the agents mentioned. Please consult the prescribing information for full disclosure of approved uses. IL-1 antagonists - acute gout flares Pegloticase - treatment-failure gout California Assembly Bill 1195 California Assembly Bill 1195 requires continuing medical education activities with patient care components to include curriculum in the subjects of cultural and linguistic competency. It is the intent of the bill, which went into effect on July 1, 2006, to encourage physicians and surgeons, CME providers in the state of California, and the Accreditation Council for Continuing Medical Education to meet the cultural and linguistic concerns of a diverse patient population through appropriate professional development. The planners, speakers and authors of this CME activity have been encouraged to address issues relevant in their topic area. Additional resources and information about AB1195 can be found on our website at http://www.cme.uci.edu. Disclosure Statements This activity has been peer reviewed for evidence base and fair balance. Authors Dr Weaver serves as a consultant and member of the advisory board for Savient Pharmaceuticals, Inc. and Takeda Pharmaceuticals North America, Inc.; and is a member of the speaker’s bureau for Takeda Pharmaceuticals North America, Inc. Staff Alka Amin, Senior Associate Project Director, Strategic Consultants International, Hemel Hempstead, Herts, England Vicki Evans, Project Manager, Strategic Consultants International, Hemel Hempstead, Herts, England Rebecca Yamarik, MD, Peer Reviewer, UCI School of Medicine, Irvine, California Bonnie Carroll, Director of CME, UCI School of Medicine, Irvine, California The planning staffs at UCI School of Medicine and Strategic Consultants International have nothing to disclose.