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About This Activity

Activity Description and Learning Objectives

In this activity, world-leading experts in ILD discuss current challenges in the clinical management of ILDs other than IPF (non-IPF ILDs), and appraise how recent clinical trial data is shifting existing treatment paradigms.

This activity has been jointly provided by Oakstone and touchIME RESPIRATORY. Oakstone Publishing is accredited by the ACCME to provide continuing medical education to physicians.

After watching this activity, participants should be better able to:

Target Audience

This activity has been designed to meet the educational needs of physicians involved in the multi-disciplinary management of non-IPF ILDs, including respiratory specialists, rheumatologists, radiologists and pathologists.

Disclosures

Oakstone Publishing has assessed conflict of interest with its faculty, authors, editors, and any individuals who were in a position to control the content of this CME activity. Any identified relevant conflicts of interest were resolved for fair balance and scientific objectivity of studies utilized in this activity. Oakstone Publishing’s planners, content reviewers, and editorial staff disclose no relevant commercial interests.

Faculty

Prof. Maher disclosures
Academic funding from GlaxoSmithKline. Consultancy or speaker fees from Apellis, AstraZeneca, Bayer, Blade Therapeutics, Boehringer Ingelheim, Bristol-Myers Squibb, Galapagos NV, GlaxoSmithKline, Indalo, Novartis, Pliant, Respivant, Roche and Samumed.

Prof. Kolb disclosures
Consulting services for Algernon, AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb, Covance, GlaxoSmithKline, Gilead, Indalo, Galapagos NV, Janssen, Mitolmmune, Pieris Pharmaceuticals, Prometic, Third Pole, twoXAR and Roche.

Prof. Kreuter disclosures
Speaker fees from AstraZeneca, Bayer, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Novartis and Roche. Consultancy fees from Boehringer Ingelheim, Galapagos, GlaxoSmithKline, InterMune and Roche.

Content Reviewer

Walter Murray Yarbrough, MD, has no financial interests/relationships or affiliations in relation to this activity.

Touch Medical Director

Paul Taylor, PhD, has no financial interests/relationships or affiliations in relation to this activity.

Requirements for Successful Completion

Oakstone Publishing designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

In order to receive credit for this activity, participants must review and complete the post-test and evaluation form. A score of 70% or higher is needed to obtain CME credit. Statements of credit are awarded upon successful completion of the post-test and evaluation form.

Date of original release: July 29, 2020. Date credits expire: July 29, 2021.

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CME Post-test

To obtain the CME credit(s), please complete this post-test. To help us assess the impact of the activity and to create further education, please also take a few minutes to complete the evaluation form.

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Q1. Of the statements below which is correct regarding patients with non-IPF ILDs?

  1. A. Up to one third of patients develop a progressive fibrosing ILD irrespective of underlying aetiology
  2. B. Nearly all patients develop a progressive fibrosing ILD
  3. C. The aetiology of non-IPF ILD determines whether patients develop a progressive fibrosing ILD
  4. D. Progressive fibrosing ILD is rarely a consequence of non-IPF ILD

Please try again

An international survey of physicians and analysis of US insurance claims reported that 18–32% of patients with a non-IPF ILD develop a progressive fibrosing ILD. This was reported across all types of ILD.

ILD, interstitial lung disease; IPF, idiopathic pulmonary fibrosis.

Reference:
Wijsenbeek M, et al. Curr Med Res Opin. 2019;35:2015–24.

Q2. Of the statements below describing the results of a Phase II study (NCT03099187) of pirfenidone vs placebo in progressive unclassifiable ILD, which is correct?

  1. A. Significantly increased DLCO in the placebo arm
  2. B. Significant increase in six-minute walking distance in the pirfenidone arm
  3. C. Significantly reduced rate of FVC decline in the pirfenidone arm
  4. D. Significantly reduced rate of FVC decline in the placebo arm

Please try again

A Phase II study reported that, at week 24, the mean decline in FVC was lower in patients randomized to pirfenidone as compared with placebo (between-group difference, 95.3 mL; 95% CI 35.9–154.6, p=0.002).

DLCO, diffusion capacity of the lung for carbon monoxide; FVC, forced vital capacity; ILD, interstitial lung disease; IPF, idiopathic pulmonary fibrosis.

Reference:
Maher et al. Lancet Respir Med. 2020;8:147–57.

Q3. For a patient with ILD receiving nintedanib, careful monitoring should be performed for which potential adverse event?

  1. A. Atrial fibrillation
  2. B. Thrombocytopenia
  3. C. Bleeding
  4. D. Headache

Please try again

Adverse events in patients treated with nintedanib that should be carefully monitored include diarrhoea, bleeding, elevated hepatic enzymes and major adverse cardiovascular events.

Reference:
Lancaster L, et al. BMJ Open Resp Res. 2019;6:e000397.

Q4. Of the statements below describing the results of the Phase III FOCUSSED trial of tocilizumab versus placebo in patients with systemic sclerosis, which is correct?

  1. A. Significantly improved cumulative distribution of change of FVC from baseline in the tocilizumab arm
  2. B. Significant increase in six-minute walking distance in the tocilizumab arm
  3. C. Significant increase in six-minute walking distance in the placebo arm
  4. D. Significantly improved cumulative distribution of change of FVC from baseline in the placebo arm

Please try again

The FOCUSSED trials reported that the cumulative distribution of change from baseline to week 48 in percent predicted FVC was significantly improved in the tocilizumab compared the placebo arm (median interquartile range -3.9 [-7.2, 0.6] and -0.6 [-5.3, 3.9], respectively, van Elteren p=0.0015).

FVC, forced vital capacity.

Reference:
Khanna, D et al. Arthritis Rheumatol. 2018;70(Suppl 10).

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Credit Back to Education Zone

touchPANEL DISCUSSION

What progress is being made in the
clinical management of non-IPF ILDs?

Introduction

Watch a panel of world-leading ILD experts discuss current challenges in the clinical management of ILDs other than IPF (non-IPF ILDs).

Prof. Toby Maher chairs a discussion with Prof. Martin Kolb and Prof. Michael Kreuter exploring challenges surrounding the diagnosis and treatment of non-IPF ILDs, and appraise how recent clinical trial data is shifting existing treatment paradigms and approaches to clinical management to improve outcomes for patients living with non-IPF ILDs.

This activity is intended for global respiratory specialists and other physicians involved in the multi-disciplinary clinical management ILDs, including rheumatologists, radiologists and pathologists.

This touchPANEL DISCUSSION was recorded in July 2020.

Learning Objectives

After watching this touchPANEL DISCUSSION, you should be able to:

  • Discuss how to improve the accurate and early diagnosis of non-IPF ILDs
  • Evaluate the current unmet needs in the management of patients with non-IPF ILDs
  • Analyse the emerging treatment options for non-IPF ILDs

Clinical Spotlight

  • What are the current barriers to accurate and timely diagnosis of ILDs other than IPF?
  • How can advances in our understanding of IPF inform more effective and timely approaches to the clinical management of non-IPF ILDs?
  • What would best practice in the management of non-IPF ILDs look like?
  • How are recent clinical trial data driving changes in clinical practice and shifting existing treatment paradigms?

Clinical Spotlight

  • What are the current barriers to accurate and timely diagnosis of ILDs other than IPF?
  • How can advances in our understanding of IPF inform more effective and timely approaches to the clinical management of non-IPF ILDs?
  • What would best practice in the management of non-IPF ILDs look like?
  • How are recent clinical trial data driving changes in clinical practice and shifting existing treatment paradigms?

The Expert Panel

PROF. TOBY MAHER

PROF. MARTIN KOLB

PROF. MICHAEL KREUTER

PROF. TOBY MAHER

Toby Maher, Professor of Clinical Medicine at Keck School of Medicine, University of Southern California, USA, is a world-renowned practicing pulmonologist specializing in ILD.

His research interests include clinical trials, biomarker discovery, the lung microbiome and host immune response in the pathogenesis of fibrotic lung disease. He has authored over 240 papers and book chapters on IPF and is an associate editor for American Journal of Respiratory and Critical Care Medicine.

Disclosures: Academic funding from GlaxoSmithKline. Consultancy or speaker fees from Apellis, AstraZeneca, Bayer, Blade Therapeutics, Boehringer Ingelheim, Bristol-Myers Squibb, Galapagos NV, GlaxoSmithKline, Indalo, Novartis, Pliant, Respivant, Roche and Samumed.

PROF. MARTIN KOLB

Professor Martin Kolb, Director of the Division of Respirology at McMaster University, practices general internal medicine and respirology at the Firestone Institute for Respiratory Health, Hamilton, Canada.

He has published extensively on research interests including: pre-clinical models of lung injury and repair, matrix homeostasis in lung fibrosis and mesenchymal progenitor cell characterisation (circulatory and tissue-resident). He is actively involved in clinical trials investigating pulmonary fibrosis and markers of disease activity.

Disclosures: Consulting services for Algernon, AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb, Covance, GlaxoSmithKline, Gilead, Indalo, Galapagos NV, Janssen, Mitolmmune, Pieris Pharmaceuticals, Prometic, Third Pole, twoXAR and Roche.

PROF. MICHAEL KREUTER

Michael Kreuter is Professor of Internal Medicine at the University of Heidelberg, Germany, where he leads the Centre for Interstitial and Rare Lung Diseases (Thoraxklinik), a European Reference Network (ERN)-certified ILD centre.

As principal investigator of the German Centre for Lung Research, Professor Kreuter’s scientific and clinical research interests focus on ILD and rare lung diseases, encompassing clinical management of ILDs, epidemiology, biomarker discovery and comorbidities. In Spring 2020, he hosted the ERS ILD schools.

Disclosures: Speaker fees from AstraZeneca, Bayer, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Novartis and Roche. Consultancy fees from Boehringer Ingelheim, Galapagos, GlaxoSmithKline, InterMune and Roche.

About This Activity

Activity Description and Learning Objectives

In this activity, world-leading experts in ILD discuss current challenges in the clinical management of ILDs other than IPF (non-IPF ILDs), and appraise how recent clinical trial data is shifting existing treatment paradigms.

This activity has been jointly provided by Oakstone and touchIME RESPIRATORY. Oakstone Publishing is accredited by the ACCME to provide continuing medical education to physicians.

After watching this activity, participants should be better able to:

  • Discuss how to improve the accurate and early diagnosis of non-IPF ILDs
  • Evaluate the current unmet needs in the management of patients with non-IPF ILDs
  • Analyse the emerging treatment options for non-IPF ILDs

Target Audience

This activity has been designed to meet the educational needs of physicians involved in the multi-disciplinary management of non-IPF ILDs, including respiratory specialists, rheumatologists, radiologists and pathologists.

Disclosures

Oakstone Publishing has assessed conflict of interest with its faculty, authors, editors, and any individuals who were in a position to control the content of this CME activity. Any identified relevant conflicts of interest were resolved for fair balance and scientific objectivity of studies utilized in this activity. Oakstone Publishing’s planners, content reviewers, and editorial staff disclose no relevant commercial interests.

Faculty

Prof. Maher disclosures
Academic funding from GlaxoSmithKline. Consultancy or speaker fees from Apellis, AstraZeneca, Bayer, Blade Therapeutics, Boehringer Ingelheim, Bristol-Myers Squibb, Galapagos NV, GlaxoSmithKline, Indalo, Novartis, Pliant, Respivant, Roche and Samumed.

Prof. Kolb disclosures
Consulting services for Algernon, AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb, Covance, GlaxoSmithKline, Gilead, Indalo, Galapagos NV, Janssen, Mitolmmune, Pieris Pharmaceuticals, Prometic, Third Pole, twoXAR and Roche.

Prof. Kreuter disclosures
Speaker fees from AstraZeneca, Bayer, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Novartis and Roche. Consultancy fees from Boehringer Ingelheim, Galapagos, GlaxoSmithKline, InterMune and Roche.

Content Reviewer

Walter Murray Yarbrough, MD, has no financial interests/relationships or affiliations in relation to this activity.

Touch Medical Director

Paul Taylor, PhD, has no financial interests/relationships or affiliations in relation to this activity.

Requirements for Successful Completion

Oakstone Publishing designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

In order to receive credit for this activity, participants must review and complete the post-test and evaluation form. A score of 70% or higher is needed to obtain CME credit. Statements of credit are awarded upon successful completion of the post-test and evaluation form.

Date of original release: July 29, 2020. Date credits expire: July 29, 2021.