Advanced TB Training for Clinicians

August 5, 2010

CNE/CME Certified ACTIVITY

Course Location

Buena Vista Conference Center

661 So. DuPont Hwy.

New Castle, DE19720

Jointly Sponsored by:

New Jersey Medical School Global Tuberculosis Institute, Baltimore City Department of Health, Delaware Division of Public Health, District of Columbia Department of Health, Maryland Department of Health and Mental Hygiene, and UMDNJ-Center for Continuing and Outreach Education

This activity is supported by an educational grant from the Centers for Disease Control and Prevention, Division of Tuberculosis Elimination

The New Jersey Medical School Global Tuberculosis Institute is the Tuberculosis Regional Training and Medical Consultation Center for the Northeastern United States

COURSE DESCRIPTION & OVERALL GOAL

To provide clinicians with the most current approaches to patient management, this course will cover advanced topics in TB using a lecture and interactive case-based approach. Topics includeanti-TB medication regimens, the use of interferon gamma release assays, management of TB patients who are pregnant, have co-morbidities, or are on TNF-alpha inhibitors.

WHO SHOULD ATTEND

This workshop is by invitation of TB Programs and is designed for experienced physicians and nurses/nurse practitioners, and physician assistantswho are involved in the management of patients with TB and/or are at risk for TB infection. Participants are required to have completed a comprehensive course in TB prior to attendance.

WHY COURSE IS NEEDED

As the incidence of tuberculosiscontinues to decline, maintaining clinical and public health expertise in TB is particularly challenging. Therefore, ongoing training and education are important for clinicians so they candevelop and enhance skills in the diagnosis of TB, follow recommended treatment guidelines, and interact effectively with public health agencies.

OBJECTIVES

At the end of this training, participants will be able to:

  • Compare the applications of tuberculin skin testing and interferon gamma release assays to appropriately apply their use in the diagnosis of latent tuberculosis infection
  • Integrate the treatment of TB disease and HIV-infection to provide accurate diagnosis and effective treatment in co-infected patients
  • Apply current standards of practice in the medical management of tuberculosis in pregnant women to provide cure and prevention of adverse effects
  • Select appropriate anti-tuberculosis treatment regimens to improve patient outcomes
  • Utilize current recommendations for screening, diagnosis, and treatment of latent TB infection in patients taking TNF-alpha inhibitors in order to avoid progression to TB disease

COURSE REQUIREMENTS

In order to meet the learning objectives and receive continuing education credits, participants are required to attend the entire course,and complete an evaluation form and a post-course follow-up evaluation within 3 months of the course.

AGENDA

8:30 amRegistration & Continental Breakfast

9:00 amOverview of Course Objectives and Topics – Rajita Bhavaraju

9:30 amAnti-TB Regimens: How Good are they and What Does the Future Hold? ―Dr. Debra Benator

10:15 amBreak

10:30 amManagement of Tuberculosis in Patients Co-Infected with HIV

―Dr. Amanuel Rosario

11:30amCase presentations and discussion - Participants

12:00 pmLunch

1:00 pmManagement of TB in the Pregnant Patient – Dr. Mark Granada

1:45 pmUse of Interferon Gamma Release Assays in the Detection of M. tuberculosis ―Dr. Alfred Lardizabal

2:30 pmBreak

2:45 pmManagement of Patients on TNF-Alpha Inhibitors ―Dr. Henry Fraimow

3:30 pmCase presentation(s) and discussion - Participants

4:15 pmEvaluation

4:30 pmAdjourn

CONTINUING EDUCATION INFORMATION

The University of Medicine and Dentistry of New Jersey – Center for Continuing and Outreach Education is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

University of Medicine and Dentistry of New Jersey–Center for Continuing and Outreach Education designates this educational activity for a maximum of 6.0AMA PRACategory 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

University of Medicine and Dentistry of New Jersey-Center for Continuing and Outreach Education is an approved provider of continuing nursing education by NJSNA, an accredited approver by the AmericanNursesCredentialingCenter's Commission on Accreditation. Provider Number P173-11/09-12. Provider Approval is valid through November 30, 2012.

This activity is awarded 6.0 contact hours. (60 minute CH)

Provider approved by the California Board of Registered Nursing, Provider Number CEP 13780.

Disclosure Disclaimer

In accordance with the disclosure policies of UMDNJ and to conform with ACCME and FDA guidelines, individuals in a position to control the content of this education activity are required to disclose to the activity participants: 1) the existence of any relevant financial relationship with any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients, with the exemption of non-profit or government organizations and non-health care related companies, within the past 12 months; and 2) the identification of a commercial product/device that is unlabeled for use or an investigational use of a product/device not yet approved.

The following individualshave no relevant financial relationships to disclose:

Nisha Ahamed, MPH – Program Director, NJMS Global TB Institute

Rajita Bhavaraju, MPH – Training & Consultation Specialist, NJMS Global TB Institute

DJ McCabe. RN, MSN -Trainer and Consultant, Clinical Programs

Debra Benator, MDhas disclosed the following relevant financial relationships:

TB Trials Consortium Research Support from Sanofi

Safety Monitoring Committee for Linezolid for XDR-TB

Henry Fraimow, MDhas disclosed the following relevant financial relationships:

Clinical Trials at the Division of Infectious Diseases, CooperUniversityHospital: GlaxoSmithKline, Merck

Research Laboratory Support: Pfizer

Jacqueline French, MD (spouse of Henry Fraimow) has disclosed the following relevant financial relationships:

Consultant – Spherics, Johnson & Johnson, AstraZeneca

Grant/research support – Eisai, UCB Pharma, Jazz Pharmaceuticals, SK Pharmaceuticals, & Intranasal Therapeutics

Off-Label/Investigational Use Disclosure

Dr. Fraimow’s presentation mentioned that several TNF-alpha inhibitors are prescribed “off label.” However, this statement is general with no reference to specific TNF-alpha inhibitors or their uses.

Dr. Benator mentions experimental names of investigational drugs and also discusses the use of fluoroquinolones to treat TB (recommended treatment by CDC, ATS, IDSA for drug resistant disease but not approved by FDA for use in TB treatment).

Content Disclaimer

The views expressed in this activity are those of the faculty. It should not be inferred or assumed that they are expressing the views of any manufacturer of pharmaceuticals, or UMDNJ-Center for Continuing and Outreach Education, NJMS Global TB Institute, Maryland Department of Health and Mental Hygiene, Delaware Division of Public Health, Baltimore City Department of Health, or the DC Department of health. It should be noted that the recommendations made herein with regard to the use of therapeutic agents, varying disease states, and assessments of risk, are based upon a combination of clinical trials, current guidelines, and the clinical practice experience of the participating presenters. The drug selection and dosage information presented in this activity are believed to be accurate. However, participants are urged to consult the full prescribing information on any agent(s) presented in this activity for recommended dosage, indications, contraindications, warnings, precautions, and adverse effects before prescribing any medication.

Copyright

Copyright ©2010 UMDNJ-Center for Continuing and Outreach Education and NJMS Global Tuberculosis Institute, and NY City Bureau of TB Control. All rights reserved including translation into other languages. No part of this activity may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval systems, without permission in writing from UMDNJ-Center for Continuing and Outreach Education.