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Caring for Patients with Severe Asthma Evolving Best Practices to Optimize Outcomes

Eugene R. Bleecker, MD; Sidney S. Braman, MD, FCCP; Richard J. Martin, MD

Jointly provided by the Elsevier Office of Continuing Medical Education and Integritas Communications.

Faculty

Eugene R. Bleecker, MD
Professor and Co-Chief
Division of Genetics, Genomics, and Precision Medicine
Department of Medicine
Co-Director, Division of Pharmacogenomics
Center for Applied Genetics and Genomics Medicine
University of Arizona College of Medicine
Tucson, Arizona

Sidney S. Braman, MD, FCCP
Professor of Medicine
Division of Pulmonary, Critical Care, and Sleep Medicine
Icahn School of Medicine at Mount Sinai
New York, New York

Richard J. Martin, MD
Professor of Medicine
Pulmonary Disease Section
University of Colorado Health Sciences Center
Chair, Department of Medicine
Edelstein Chair in Pulmonary Medicine
National Jewish Health
Denver, Colorado

Course Description

This CME-accredited Clinical Research UpdatesTM program is intended for allergists/clinical immunologists, pulmonologists, and other healthcare providers involved in the identification, evaluation, and treatment of patients with severe asthma. During the activity, a panel of expert faculty discuss and debate the latest evidence for severe asthma phenotypes, the clinical utility of various disease biomarkers, and the profiles of current and emerging biologic therapies, with a focus on individualizing treatment plans. Faculty also incorporate the perspectives of patients with asthma, including the burdens of severe disease, hidden challenges to good long-term outcomes, and the benefits of shared decision-making.

Target Audience

This activity has been designed to meet the educational needs of clinical immunologists, pulmonologists, and other clinician specialists involved in the management of patients with severe asthma.

Educational Objectives

Upon completion of this activity, participants will be better able to do the following:

  • Describe the pathophysiologic underpinnings of severe asthma, including current insights into disease subtypes and therapeutic targets for biologic medications
  • Identify patients with severe asthma based on an understanding of epidemiologic data and comprehensive evaluations of symptoms, phenotypes, and treatment history
  • Compare the mechanisms of action and clinical profiles of cytokine-targeting biologic medications in the treatment of severe asthma
  • Tailor therapy for patients with severe asthma to address ongoing symptoms, biomarker evaluations, exacerbation risks, and treatment responses
  • Dialogue with patients with severe asthma about therapeutic choices, asthma action plans, and treatment adherence

Disclosure of Conflicts of Interest

It is the policy of the Elsevier Office of Continuing Medical Education that all faculty, instructors, and planners disclose any real or apparent conflicts of interest relating to the topics of this educational activity.

The faculty reported the following financial relationships or relationships to products or devices they or their spouses/life partners have with commercial interests related to the content of this CME activity:

Eugene R. Bleecker, MD: Nothing to disclose

Sidney S. Braman, MD, FCCP: Consultant/Advisor: Sunovion Pharmaceuticals Inc., Speakers Bureau: AstraZeneca; Boehringer Ingelheim GmbH, Inc; Genentech, Inc.

Richard J. Martin, MD: Consultant/Advisor: AstraZeneca; PMD Healthcare., Grant/Research Support: CHIESI Farmaceutici S.p.A; National Heart, Lung, and Blood Institute Asthma Network., Royalties/Patents: UpToDate, Inc.

Non-faculty

Rose O’Connor, PhD; Jim Kappler, PhD; Sandy Breslow; Alison Kemp; and Bernard M. Abrams, MD, hereby state that neither they nor their spouses/life partners have any financial relationships to products or devices with any commercial interest related to the content of this activity of any amount during the past 12 months.

Financial Support

This activity has been supported by an independent educational grant from AstraZeneca.

Provider Information

Jointly provided by the Elsevier Office of Continuing Medical Education and Integritas Communications.

CME Credit (Physicians) 

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the Elsevier Office of Continuing Medical Education and Integritas Communications. The Elsevier Office of Continuing Medical Education is accredited by the ACCME to provide continuing medical education for physicians. 

The Elsevier Office of Continuing Medical Education designates this enduring activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

CME Inquiries/Special Needs

For all CME inquiries or special needs, please contact elsevierCME@elsevier.com.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the US Food and Drug Administration. The Elsevier Office of Continuing Medical Education, Integritas Communications, and AstraZeneca do not recommend the use of any agent outside of the labeled indications. 

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of the patient’s conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Course Instructions

In order to claim credit, participants must complete the following:

  1. Read the educational objectives, accreditation information, and faculty disclosures at the beginning of this activity.
  2. Complete the Pre-Activity Questions.
  3. Read or review the activity content.
  4. Complete the Post-Activity Test Questions and Evaluation.
  5. A physician who achieves a grade of 70% or better on the Post-Activity Test and who completes the Evaluation will receive a CME Certificate.
  6. Any other participant who achieves a grade of 70% or better on the Post-Activity Test Questions and who completes the Evaluation will receive a Certificate of Participation.

Click "Begin Activity" to acknowledge that you have reviewed the preamble information for this activity.

Begin Activity

expiration 05/03/2018

type Webcast


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Query Count Total (s) Avg. (s) Min. (s) Max. (s)
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SELECT * FROM `activities` `t` WHERE `t`.`id`=59 LIMIT 1
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1 0.001557 0.001557 0.001557 0.001557
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SHOW COLUMNS FROM `users`
1 0.001244 0.001244 0.001244 0.001244
select id, status from activities where FIND_IN_SET(:shortAddress, shortAddress)
2 0.001236 0.000618 0.000263 0.000973
SHOW COLUMNS FROM `resources`
1 0.001125 0.001125 0.001125 0.001125
SELECT * FROM `users` `t` WHERE session=:session LIMIT 1
2 0.001078 0.000539 0.000489 0.000589
SHOW COLUMNS FROM `view_log`
1 0.001073 0.001073 0.001073 0.001073
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SHOW COLUMNS FROM `interactions`
1 0.000999 0.000999 0.000999 0.000999
SELECT `t`.`id` AS `t0_c0`, `t`.`group_id` AS `t0_c1`, `t`.`resource_id` AS `t0_c2`, `t`.`title` AS `t0_c3`, `t`.`type` AS `t0_c4`, `t`.`facultyNames` AS `t0_c5`, `t`.`shortDescription` AS `t0_c6`, `t`.`fullDescription` AS `t0_c7`, `t`.`creditAmount` AS `t0_c8`, `t`.`shortAddress` AS `t0_c9`, `t`.`creditType` AS `t0_c10`, `t`.`startDate` AS `t0_c11`, `t`.`finishDate` AS `t0_c12`, `t`.`sponsors` AS `t0_c13`, `t`.`status` AS `t0_c14`, `t`.`createDate` AS `t0_c15`, `t`.`image` AS `t0_c16`, `t`.`image_featured` AS `t0_c17`, `t`.`archived` AS `t0_c18`, `t`.`managers_list` AS `t0_c19`, `t`.`is_send_pp_email` AS `t0_c20`, `t`.`muvi_sync_date` AS `t0_c21`, `t`.`expert_questions` AS `t0_c22`, `interaction`.`id` AS `t1_c0`, `interaction`.`activity_id` AS `t1_c1`, `interaction`.`title` AS `t1_c2`, `interaction`.`link` AS `t1_c3`, `interaction`.`type` AS `t1_c4`, `interaction`.`status` AS `t1_c5`, `interaction`.`createDate` AS `t1_c6` FROM `activities` `t` LEFT OUTER JOIN `interactions` `interaction` ON (`interaction`.`activity_id`=`t`.`id`) WHERE (`t`.`id`=59)
1 0.000744 0.000744 0.000744 0.000744
SELECT `activity_id` AS `c`, COUNT(*) AS `s` FROM `user_activitiesstatus` `t` WHERE (user_id=:user AND isFinished=1) AND (`t`.`activity_id`=59) GROUP BY `activity_id`
1 0.000598 0.000598 0.000598 0.000598
SELECT * FROM `questionnaires` `t` WHERE t.activity_id=:id AND t.type=:type LIMIT 1
1 0.000543 0.000543 0.000543 0.000543
SHOW CREATE TABLE `activities`
1 0.000436 0.000436 0.000436 0.000436
SHOW CREATE TABLE `events`
1 0.000344 0.000344 0.000344 0.000344
SHOW CREATE TABLE `users`
1 0.000328 0.000328 0.000328 0.000328
SHOW CREATE TABLE `interactions`
1 0.000319 0.000319 0.000319 0.000319
SHOW CREATE TABLE `view_log`
1 0.000308 0.000308 0.000308 0.000308
SHOW CREATE TABLE `resources`
1 0.000305 0.000305 0.000305 0.000305
SHOW CREATE TABLE `questionnaires`
1 0.000305 0.000305 0.000305 0.000305
SHOW CREATE TABLE `user_activitiesstatus`
1 0.000304 0.000304 0.000304 0.000304
SELECT `resource`.`id` AS `t1_c0`, `resource`.`shortAddress` AS `t1_c1`, `resource`.`status` AS `t1_c2`, `resource`.`title` AS `t1_c3`, `resource`.`type` AS `t1_c4`, `resource`.`image` AS `t1_c5`, `resource`.`slides` AS `t1_c6`, `resource`.`linkedResources` AS `t1_c7`, `resource`.`reading` AS `t1_c8`, `resource`.`shortDescription` AS `t1_c9`, `resource`.`fullDescription` AS `t1_c10`, `resource`.`link` AS `t1_c11`, `resource`.`createDate` AS `t1_c12`, `resource`.`archived` AS `t1_c13` FROM `resources` `resource` WHERE (`resource`.`id`=:ypl0)
1 0.000296 0.000296 0.000296 0.000296
# Query Time (s)
0
select id, status from activities where FIND_IN_SET(:shortAddress, shortAddress)
0.000973
1
SHOW COLUMNS FROM `activities`
0.001557
2
SHOW CREATE TABLE `activities`
0.000436
3
SHOW COLUMNS FROM `users`
0.001244
4
SHOW CREATE TABLE `users`
0.000328
5
SELECT * FROM `users` `t` WHERE session=:session LIMIT 1
0.000489
6
INSERT INTO `users` (`role`, `sendEmails`, `sendSms`, `source`, `session`, `lastLogin`, `phone`, `createDate`) VALUES (:yp0, :yp1, :yp2, :yp3, :yp4, :yp5, :yp6, :yp7)
0.004365
7
SELECT * FROM `users` `t` WHERE session=:session LIMIT 1
0.000589
8
UPDATE `users` SET `lastLogin`=:yp0 WHERE `users`.`id`=2491935
0.002968
9
SELECT * FROM `activities` `t` WHERE `t`.`id`=59 LIMIT 1
0.000506
10
SHOW COLUMNS FROM `events`
0.001475
11
SHOW CREATE TABLE `events`
0.000344
12
SELECT `event`.`id` AS `t1_c0`, `event`.`group_id` AS `t1_c1`, `event`.`shortAddress` AS `t1_c2`, `event`.`resource_id` AS `t1_c3`, `event`.`type` AS `t1_c4`, `event`.`addType` AS `t1_c5`, `event`.`title` AS `t1_c6`, `event`.`shortDescription` AS `t1_c7`, `event`.`facultyNames` AS `t1_c8`, `event`.`faculty` AS `t1_c9`, `event`.`calendarDate` AS `t1_c10`, `event`.`creditAmount` AS `t1_c11`, `event`.`creditType` AS `t1_c12`, `event`.`shortWhen` AS `t1_c13`, `event`.`fullWhen` AS `t1_c14`, `event`.`venue` AS `t1_c15`, `event`.`shortWhere` AS `t1_c16`, `event`.`fullWhere` AS `t1_c17`, `event`.`createDate` AS `t1_c18`, `event`.`status` AS `t1_c19`, `event`.`description` AS `t1_c20`, `event`.`image` AS `t1_c21`, `event`.`linkout` AS `t1_c22`, `event`.`registrationEnabled` AS `t1_c23`, `event`.`activity_id` AS `t1_c24`, `event`.`adobe_connect_sco` AS `t1_c25`, `event`.`adobe_connect_datetime` AS `t1_c26`, `event`.`users_limit` AS `t1_c27`, `event`.`adobe_connect_duration` AS `t1_c28`, `event`.`calendar_description` AS `t1_c29` FROM `events` `event` WHERE (`event`.`activity_id`=:ypl0)
0.001974
13
select id, status from activities where FIND_IN_SET(:shortAddress, shortAddress)
0.000263
14
SELECT * FROM `activities` `t` WHERE `t`.`id`=59 LIMIT 1
0.000289
15
SELECT `event`.`id` AS `t1_c0`, `event`.`group_id` AS `t1_c1`, `event`.`shortAddress` AS `t1_c2`, `event`.`resource_id` AS `t1_c3`, `event`.`type` AS `t1_c4`, `event`.`addType` AS `t1_c5`, `event`.`title` AS `t1_c6`, `event`.`shortDescription` AS `t1_c7`, `event`.`facultyNames` AS `t1_c8`, `event`.`faculty` AS `t1_c9`, `event`.`calendarDate` AS `t1_c10`, `event`.`creditAmount` AS `t1_c11`, `event`.`creditType` AS `t1_c12`, `event`.`shortWhen` AS `t1_c13`, `event`.`fullWhen` AS `t1_c14`, `event`.`venue` AS `t1_c15`, `event`.`shortWhere` AS `t1_c16`, `event`.`fullWhere` AS `t1_c17`, `event`.`createDate` AS `t1_c18`, `event`.`status` AS `t1_c19`, `event`.`description` AS `t1_c20`, `event`.`image` AS `t1_c21`, `event`.`linkout` AS `t1_c22`, `event`.`registrationEnabled` AS `t1_c23`, `event`.`activity_id` AS `t1_c24`, `event`.`adobe_connect_sco` AS `t1_c25`, `event`.`adobe_connect_datetime` AS `t1_c26`, `event`.`users_limit` AS `t1_c27`, `event`.`adobe_connect_duration` AS `t1_c28`, `event`.`calendar_description` AS `t1_c29` FROM `events` `event` WHERE (`event`.`activity_id`=:ypl0)
0.000271
16
SELECT * FROM `activities` `t` WHERE `t`.`id`=59 LIMIT 1
0.000296
17
UPDATE activities SET archived=1 WHERE finishDate<now();
0.006628
18
SHOW COLUMNS FROM `view_log`
0.001073
19
SHOW CREATE TABLE `view_log`
0.000308
20
INSERT INTO `view_log` (`source`, `unique_id`, `resource_id`, `type`) VALUES (:yp0, :yp1, :yp2, :yp3)
0.003561
21
SHOW COLUMNS FROM `user_activitiesstatus`
0.001035
22
SHOW CREATE TABLE `user_activitiesstatus`
0.000304
23
SHOW COLUMNS FROM `interactions`
0.000999
24
SHOW CREATE TABLE `interactions`
0.000319
25
SELECT `t`.`id` AS `t0_c0`, `t`.`group_id` AS `t0_c1`, `t`.`resource_id` AS `t0_c2`, `t`.`title` AS `t0_c3`, `t`.`type` AS `t0_c4`, `t`.`facultyNames` AS `t0_c5`, `t`.`shortDescription` AS `t0_c6`, `t`.`fullDescription` AS `t0_c7`, `t`.`creditAmount` AS `t0_c8`, `t`.`shortAddress` AS `t0_c9`, `t`.`creditType` AS `t0_c10`, `t`.`startDate` AS `t0_c11`, `t`.`finishDate` AS `t0_c12`, `t`.`sponsors` AS `t0_c13`, `t`.`status` AS `t0_c14`, `t`.`createDate` AS `t0_c15`, `t`.`image` AS `t0_c16`, `t`.`image_featured` AS `t0_c17`, `t`.`archived` AS `t0_c18`, `t`.`managers_list` AS `t0_c19`, `t`.`is_send_pp_email` AS `t0_c20`, `t`.`muvi_sync_date` AS `t0_c21`, `t`.`expert_questions` AS `t0_c22`, `interaction`.`id` AS `t1_c0`, `interaction`.`activity_id` AS `t1_c1`, `interaction`.`title` AS `t1_c2`, `interaction`.`link` AS `t1_c3`, `interaction`.`type` AS `t1_c4`, `interaction`.`status` AS `t1_c5`, `interaction`.`createDate` AS `t1_c6` FROM `activities` `t` LEFT OUTER JOIN `interactions` `interaction` ON (`interaction`.`activity_id`=`t`.`id`) WHERE (`t`.`id`=59)
0.000744
26
SELECT `activity_id` AS `c`, COUNT(*) AS `s` FROM `user_activitiesstatus` `t` WHERE (user_id=:user AND isFinished=1) AND (`t`.`activity_id`=59) GROUP BY `activity_id`
0.000598
27
SELECT `event`.`id` AS `t1_c0`, `event`.`group_id` AS `t1_c1`, `event`.`shortAddress` AS `t1_c2`, `event`.`resource_id` AS `t1_c3`, `event`.`type` AS `t1_c4`, `event`.`addType` AS `t1_c5`, `event`.`title` AS `t1_c6`, `event`.`shortDescription` AS `t1_c7`, `event`.`facultyNames` AS `t1_c8`, `event`.`faculty` AS `t1_c9`, `event`.`calendarDate` AS `t1_c10`, `event`.`creditAmount` AS `t1_c11`, `event`.`creditType` AS `t1_c12`, `event`.`shortWhen` AS `t1_c13`, `event`.`fullWhen` AS `t1_c14`, `event`.`venue` AS `t1_c15`, `event`.`shortWhere` AS `t1_c16`, `event`.`fullWhere` AS `t1_c17`, `event`.`createDate` AS `t1_c18`, `event`.`status` AS `t1_c19`, `event`.`description` AS `t1_c20`, `event`.`image` AS `t1_c21`, `event`.`linkout` AS `t1_c22`, `event`.`registrationEnabled` AS `t1_c23`, `event`.`activity_id` AS `t1_c24`, `event`.`adobe_connect_sco` AS `t1_c25`, `event`.`adobe_connect_datetime` AS `t1_c26`, `event`.`users_limit` AS `t1_c27`, `event`.`adobe_connect_duration` AS `t1_c28`, `event`.`calendar_description` AS `t1_c29` FROM `events` `event` WHERE (`event`.`activity_id`=:ypl0)
0.000271
28
SELECT * FROM `activities` `t` WHERE `t`.`id`=59 LIMIT 1
0.000282
29
SELECT * FROM `activities` `t` WHERE `t`.`id`=59 LIMIT 1
0.000283
30
SHOW COLUMNS FROM `questionnaires`
0.001020
31
SHOW CREATE TABLE `questionnaires`
0.000305
32
SELECT * FROM `questionnaires` `t` WHERE t.activity_id=:id AND t.type=:type LIMIT 1
0.000543
33
SHOW COLUMNS FROM `resources`
0.001125
34
SHOW CREATE TABLE `resources`
0.000305
35
SELECT `resource`.`id` AS `t1_c0`, `resource`.`shortAddress` AS `t1_c1`, `resource`.`status` AS `t1_c2`, `resource`.`title` AS `t1_c3`, `resource`.`type` AS `t1_c4`, `resource`.`image` AS `t1_c5`, `resource`.`slides` AS `t1_c6`, `resource`.`linkedResources` AS `t1_c7`, `resource`.`reading` AS `t1_c8`, `resource`.`shortDescription` AS `t1_c9`, `resource`.`fullDescription` AS `t1_c10`, `resource`.`link` AS `t1_c11`, `resource`.`createDate` AS `t1_c12`, `resource`.`archived` AS `t1_c13` FROM `resources` `resource` WHERE (`resource`.`id`=:ypl0)
0.000296
Log Messages
Message (details) Level Category Time