OVERVIEW
This free activity, entitled “A Closer Look at Hereditary Angioedema: Expert Perspectives on Optimal Management,” consists of a program overview, three presentations, panel Q&A, a Learning Assessment, and an Evaluation form. The content of this virtual lecture is derived from a symposium presented on November 10, 2009, during the ACAAI Annual Scientific Meeting in Miami Beach, Florida.

MEDIA: Virtual Lecture or Podcast
INTERNET RELEASE DATE: December 30, 2009
(Continuing education credit is no longer available for this activity.)

Estimated time to complete this activity: 2 hours

TARGET AUDIENCE
This activity has been designed to meet the educational needs of physicians involved in the care of patients with hereditary angioedema.

STATEMENT OF NEED
There are many obstacles to timely diagnosis and effective management of hereditary angioedema (HAE). Because the symptoms of HAE can resemble other conditions (such as allergic reactions and gastrointestinal tract obstructions), and diagnosis is dependent on a vast array of laboratory findings and patient and family history, a definitive diagnosis is often delayed by 10 years or more from first onset of symptoms.1,2

Long-term prophylaxis using 17a-alkylated anabolic androgens and antifibrinolytic agents can be moderately successful, but these agents are associated with significant side effects.1,3 Newer therapeutic strategies, such as C1 inhibitor replacement, kallikrein inhibition, and bradykinin antagonism, show promise for improving patient outcomes. To overcome the many obstacles faced by patients with HAE, allergists and other healthcare professionals must be aware of the most up-to-date clinical data regarding diagnosis and treatment.

1Zuraw BL. N Engl J Med. 2008;359:1027-1036.
2Roche O, et al. Ann Allergy Asthma Immunol. 2005;94:498-503.
3Gompels MM, et al. Clin Exp Immunol. 2005;139:379-394.

EDUCATIONAL OBJECTIVES
After completing this activity, the participant should be better able to:

• Describe the pathophysiology and immunologic features of hereditary angioedema (HAE)
• Explain the roles of C1 inhibitor replacement, kallikrein inhibition, and bradykinin receptor antagonism in the treatment of HAE
• Summarize existing and emerging clinical trial data for the therapeutic agents used for the prophylaxis and treatment of HAE
• Identify important medication and patient factors that influence the individualization of therapy

METHOD OF PARTICIPATION
There are no fees for participating and receiving CME credit for this activity. During the period December 30, 2009, through December 30, 2010, participants must 1) read the learning objectives and faculty disclosures; 2) study the educational activity; 3) complete the Learning Assessment by recording the best answer to each question in the "Learning Assessment Answers" box on the Evaluation form; 4) complete the Evaluation form; and 5) mail or fax the Evaluation form with the Learning Assessment answers to Postgraduate Institute for Medicine. You may also complete the Learning Assessment online at www.cmeuniversity.com. Click on “Find Post-Test/Evaluation by Course” on the navigation menu, and search by Project ID 6733.

Participants must receive a score of at least 70% on the Learning Assessment and must complete and submit the Evaluation form to successfully complete this activity. Participants who successfully complete the Learning Assessment and Evaluation form via www.cmeuniversity.com will have a statement of credit made available immediately. Participants who successfully complete this activity and submit the Learning Assessment and Evaluation form via fax or mail will be issued a statement of credit via US mail in 4 to 6 weeks.

PHYSICIAN CONTINUING EDUCATION
ACCREDITATION 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 Postgraduate Institute for Medicine (PIM) and Robert Michael Educational Institute LLC (RMEI). PIM is accredited by the ACCME to provide continuing medical education for physicians.

CREDIT DESIGNATION
Postgraduate Institute for Medicine designates this educational activity for a maximum of 2.0 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

FACULTY
Bryan L. Martin, DO (Moderator)
Professor of Clinical Medicine and Pediatrics
Director, Allergy and Immunology Fellowship Program
Division of Pulmonary, Allergy, Critical Care and Sleep Medicine
Director, Allergy and Immunology Section
The Ohio State University
Columbus, Ohio

Bruce L. Zuraw, MD
Professor of Medicine
Chief, Section of Allergy & Immunology
Allergy & Immunology Training Program Director
University of California School of Medicine, San Diego
San Diego, California
Research Scientist, Veterans Medical Research Foundation
Director, Section of Allergy & Immunology
San Diego Veterans Affairs Medical Center
La Jolla, California

Michael M. Frank, MD
Samuel L. Katz Professor of Pediatrics, Medicine, and Immunology
Duke University School of Medicine
Durham, North Carolina

Allen P. Kaplan, MD
Clinical Professor of Medicine
Medical University of South Carolina
Charleston, South Carolina
Staff Physician
National Allergy, Asthma and Urticaria Centers of Charleston
Charleston, South Carolina

DISCLOSURE OF CONFLICTS OF INTEREST
Postgraduate Institute for Medicine (PIM) assesses conflict of interest with its instructors, planners, managers and other individuals who are in a position to control the content of CME activities. All relevant conflicts of interest that are identified are thoroughly vetted by PIM for fair balance, scientific objectivity of studies utilized in this activity, and patient care recommendations. PIM is committed to providing its learners with high-quality CME activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest.

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

• Bryan L. Martin, DO, has no affiliations with commercial interests to disclose.
• Bruce L. Zuraw, MD, has affiliations with Dyax Corp.; Lev Pharmaceuticals, Inc.; Jerini AG; CSL Behring; and Pharming Group NV (Honorarium and Consulting/Advisory Board); and Lev Pharmaceuticals, Inc. and Pharming Group NV (Research Grants).
• Michael M. Frank, MD, has affiliations with ViroPharma Incorporated, CSL Behring, Shire Pharmaceuticals, and Dyax Corp. (Honorarium); and CSL Behring, Shire Pharmaceuticals, Dyax Corp., and Pharming Group NV (Consulting/Advisory Board).
• Allen P. Kaplan, MD, has affiliations with Lev Pharmaceuticals Inc. and Novartis Pharmaceuticals (Research Grants); Lev Pharmaceuticals, Inc. and sanofi-aventis (Consulting/Advisory Board); sanofi-aventis and GlaxoSmithKline (Speaker); and Dyax Corp. (Honorarium).

The planners and managers reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:

Postgraduate Institute for Medicine

• Linda Graham, RN, BSN, has no affiliations with commercial interests to disclose.
• Jan Hixon, RN, BSN, MA, has no affiliations with commercial interests to disclose.
• Trace Hutchison, PharmD, has no affiliations with commercial interests to disclose.
• Julia Kirkwood, RN, BSN, has no affiliation with commercial interests to disclose.
• Jan Schultz, RN, MSN, CCMEP, has no affiliations with commercial interests to disclose.
  

Robert Michael Educational Institute LLC

• Sherri Kramer, MD, has no affiliations with commercial interests to disclose.
• Laura Altobelli, MS, has no affiliations with commercial interests to disclose.
• Lillian McVey has no affiliations with commercial interests to disclose.

DISCLOSURE OF UNLABELED USE
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. PIM, Robert Michael Educational Institute LLC (RMEI) and ViroPharma Incorporated do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of PIM, RMEI, or ViroPharma Incorporated. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

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 their 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.

FEE INFORMATION
There is no fee for this educational activity.

QUESTIONS & TECHNICAL ASSISTANCE
For questions regarding the content of this activity, contact the accredited provider for this CME activity: jjones@pimed.com. For technical assistance, contact jungsen@rmcom.net.

SYSTEM REQUIREMENTS
Hardware/Software requirements include:
• Windows 95, 98se, ME, XP, NT 4.0, 2000   
  - Internet Explorer 4.0+
  - Netscape Navigator 6.2+
  - AOL 8
  - Mozilla Firefox 1.0+
• Macintosh 9.2, OS X 10.1+
  - Safari 1.1+
  - Netscape Navigator 6.2+
  - Internet Explorer 5.2+
  - Mozilla Firefox 1.0+
• Additional Requirements
  - Macromedia Flash Player 7
  - Internal/external speakers
  - Broadband connection (DSL/cable) recommended

FOR MORE INFORMATION:

Additional educational activities offered by Robert Michael Educational Institute LLC can be found at www.RMEI.com or by calling toll-free to 866-770-RMEI.

United States Hereditary Angioedema Association (HAEA)
This non-profit patient advocacy organization is dedicated to expediting US approval of safer and more effective HAE therapies. In addition, the HAEA provides a wide range of services that include clinical trial placement, physician referrals, education, and individualized patient case management.
For more information, visit www.haea.org.

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