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An Individualized Approach to PAH Therapy Based on Clinical Data, Goal-Directed Therapy, and Risk Stratification
Program Introduction
Pulmonary arterial hypertension requires risk stratification to develop goal-directed treatment plans, including combination therapy targeting multiple pathways.
Learning Objectives
After completing this educational activity, you should be able to:
- Review the four main classes of therapies for PAH and the emerging therapies
- Discuss the results of major clinical trials that support the use of combination therapy to treat PAH.
- Define goal-directed therapy and describe the targets for PAH using goal-directed therapy.
- Stratify patient risk using evidence-based guidelines and adjust treatment to patient level of risk.
Target Audience
Cardiologists, pulmonologists, internal medicine physicians, and radiologists
Program Description
Pulmonary arterial hypertension is a chronic and progressive disease, and when left untreated results in death. Patients with pulmonary hypertension are assigned to one of five groups established by the European Society of Cardiology/European Respiratory Society (ESC/ERS) based on the etiology of their disease determined by the clinical presentation, pathology, hemodynamic characteristics, and the treatment strategy. Combination therapy can improve or extend life and avoid or defer surgery by reducing some risk factors. Guidelines now incorporate an emphasis on aggressive combination treatment to reduce risk factors. This severe disease has an acute impact on patient quality of life, and patient-reported outcomes and shared decision-making involving a multidisciplinary team are recommended when considering treatment. In this 4-part video, Drs Darlene Kim, MD, and Mohammad Dalabih, MBBS, MHA, of National Jewish Health, discuss guideline-directed risk stratification in patients with PAH and established and novel drugs that address the three traditional pathways involved in the disease, as well as implementing data-driven combination therapy as part of individualized goal-directed therapy.
Support Statement
This activity is supported by educational grants from Bayer HealthCare Pharmaceuticals, Inc. and Janssen Pulmonary Hypertension.
Learning Objective
After completing this educational activity, you should be able to:
- Review the four main classes of therapies for PAH and the emerging therapies
- Discuss the results of major clinical trials that support the use of combination therapy to treat PAH.
- Define goal-directed therapy and describe the targets for PAH using goal-directed therapy.
- Stratify patient risk using evidence-based guidelines and adjust treatment to patient level of risk.
Release, Review, and Expiration Dates
This CME activity was published in December 2022 and is eligible for AMA PRA Category 1 Credit™ through December 31, 2023.
Statement of Need and Purpose
An improved understanding of the updated treatment guidelines for PAH is an educational gap among physicians. There is also a significant need to be able to prescribe pharmacotherapy based on the patient’s disease stage and risk profile. Ongoing clinical trials support the use of specific medications and combinations to help patients with PAH control and improve their status. Clinicians must properly understand risk stratification and mitigation strategies using goal-directed therapy when implementing a medication regimen for PAH.
Unlabeled and Investigational Usage
The faculty of this educational activity may include discussions of products or devices that are not currently labeled for use by the FDA. Faculty members have been advised to disclose to the audience any reference to an unlabeled or investigational use.
No endorsement of unapproved products or uses is made or implied by coverage of these products or uses.
Please refer to the official prescribing information for each product for discussion of approved indicators, contraindications and warnings.
Review Process
The faculty members agreed to provide a balanced and evidence-based presentation and discussed the topics and CME objectives during the planning sessions. The faculty’s submitted content was validated by CME Institute staff, and the activity was evaluated for accuracy, use of evidence, and fair balance by the Chair and a peer reviewer.
The opinions expressed herein are those of the faculty and do not necessarily reflect the opinions of the CME provider and publisher or the commercial supporter
© Copyright 2022 Physicians Postgraduate Press, Inc.
Faculty Affiliation
Mohammad Dalabih, MBBS, MHA
Assistant Professor
Division of Pulmonary, Critical Care & Sleep Medicine
Department of Medicine
National Jewish Health
Denver, CO
Darlene Kim, MD, FACC
Associate Professor of Medicine
Section of Pulmonary Hypertension
Division of Cardiology
National Jewish Health
Denver, CO
Financial Disclosure
The CME Institute adheres to the Standards for Integrity and Independence in Accredited Continuing Education of the Accreditation Council for Continuing Medical Education (ACCME). Any individuals in a position to control the content of a continuing education activity, including faculty, content developers, reviewers, staff, and others, are required to disclose to learners the presence or absence of any relevant financial relationships with an ACCME-defined ineligible company within the preceding 24 months of the activity. The ACCME defines an “ineligible company” as one whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
The CME Institute has mitigated all relevant conflicts of interest prior to the commencement of the activity. None of the individuals involved in the content have relevant financial relationships with ineligible companies except the following:
Dr Dalabih has received consulting fees from Respira Therapeutics; received grant/research support from Actelion/Janssen Pharmaceuticals; and received honoraria for speaking/teaching from United Therapeutics.
Dr Kim has no financial disclosures.
Michael R. Page, PharmD, RPh
Independent Medical Director/Medical Writer
Plainsboro, New Jersey
Dr. Page is a consultant for BioCentric, Inc. and American Medical Communications, Inc.
Terese C. Hammond, MD
Peer Reviewer
Santa Monica, CA
Dr Hammond has received consulting fees from MiNK Therapeutics and Pfizer; has received grant/research support from Agenus and MiNK Therapeutics; and has served on the advisory board for MiNK Therapeutics.
None of the other planners, reviewers, and CME Institute staff for this educational activity have relevant financial relationships with ineligible companies to disclose. All relevant financial relationships have been mitigated
Accreditation Statement
The CME Institute of Physicians Postgraduate Press, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
Credit Designation
The CME Institute of Physicians Postgraduate Press, Inc., designates this enduring material for a maximum of 1.00 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Note: The American Nurses Credentialing Center (ANCC) and the American Academy of Physician Assistants (AAPA) accept certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by the ACCME.
To obtain credit for this activity, study the material and complete the CME Posttest and Evaluation.
Available Credit
- 1.00 AMA PRA Category 1 Credit™
- 1.00 Participation