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CME: Contemporary management strategies in the diagnosis and treatment of immune thrombocytopenia (ITP)

ACCREDITATION EXPIRED: April 09, 2024

Activity Description / Statement of Need:

In this online, self-learning activity:

Immune thrombocytopenia (ITP) is a phenomenon characterized by a peripheral platelet count of less than 100 x 109/L in the absence of any discernable cause, with an increased risk of bleeding. Also known as thrombocytopenic purpura, it occurs in around two to four cases per 100,000 adults, with incidence peaking bimodally: Once between 20-30 years with female predominance and also at 60 years with even distribution between the sexes.

The diagnosis of ITP is one of exclusion and includes platelet autoantibody testing. However, it is complicated and associated with documented gaps in care, with preventable delays in diagnosis and misdiagnosis not uncommon. One study found that one in seven patients diagnosed with ITP were misdiagnosed and reclassified as they received additional clinical evaluation. Another study found that over 22% of patients with ITP did not receive guideline-recommended peripheral blood film examination. These diagnostic challenges have real-world consequences on patient lives, creating anxiety in 73% of patients who experience a delayed diagnosis.

Treatment goals include prevention of severe bleeding episodes, maintaining platelet counts for symptomatic patients, minimizing treatment toxicity, and maximizing health-related quality of life. Conventional therapy includes corticosteroids, intravenous immunoglobulin (IVIg), and anti-D IVIg. However, treatment challenges remain, including variability in practice between providers and high rates of relapse between following standard first-line therapies together with considerable patient frustration. Moreover, some patient subpopulations are more challenging to treat and are less likely to achieve therapeutic success.

Target Audience:

HCPs specializing in: hematology; physician assistants, nurse practitioners, nurses, pharmacists; and any other healthcare professionals with an interest in or who clinically encounter patients with ITP.


Commercial Support Disclosure: This program is supported by an educational grant from Dova.

This activity is free of charge.

 


Release Date: April 09, 2022 -- Expiration Date: April 09, 2024

Faculty: Carlos Lopez, MD, MPH

Agenda

Faculty introduction, disclosures

Review of ITP and ITP diagnosis

·       Epidemiology: Statistics and survival

·       Pathophysiology and clinical features

·       Burden of disease

  • Diagnosis and related challenges

·       Symptoms, bleeding severity, and prognosis

Pharmacotherapy for ITP

  • Goals of therapy
  • First-line therapy for newly diagnosed ITP: Platelet transfusion, corticosteroids, intravenous immunoglobulin (IVIg), and anti-D IVIg

·       Second line, later line, and investigational therapies

    • Thrombopoietin receptor agonists
    • Rituximab
    • Tyrosine kinase inhibition (Bruton’s, spleen)
    • Danazol
    • Other immunosuppressive approaches
    • Other hemostatic agents
    • Role of splenectomy
  • Role of combination therapy
  • Special patient populations
  • Challenges in care related to: Disease course, remission, and relapse
  • Patient case(s)

Summary, conclusions, and best practice recap

Learning Objectives

By the end of the session the participant will be able to:

  • List challenges associated with the burden of disease, diagnosis, and treatment of patients with ITP
  • Recall guideline-recommended diagnostic practices and pharmacotherapy (first- and later-line) for ITP
  • Discuss investigational therapies for ITP, their mechanisms of action, and their anticipated place in therapy
  • Formulate a treatment plan for a patient with ITP

Accreditation

ACCME Activity #202281703

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through ScientiaCME. ScientiaCME is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation: ScientiaCME designates this educational activity for a maximum of 1.5 AMA PRA Category 1 Credit(s)™ toward the AMA Physician's Recognition Award. Physicians should only claim credit commensurate with the extent of their participation in the activity.

CME-MOC_badge

ABIM MOC Recognition Statement: Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.5 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

ABIM MOC Credit Type: Medical Knowledge

Physicians: For maintenance of certification (MOC) points, you must enter your board certification ID # and birth date correctly.  It is the learner's responsibility to provide this information completely and accurately at the completion of the activity. Without providing it, the learner will NOT receive MOC points for this activity. By providing this data, you acknowledge that it will be shared with ACCME and the applicable certifying board. Please note: Not all activities on this site provide MOC points. If this activity does not specify that it provides MOC points in this section, then it does NOT provide MOC points. This activity provides MOC points only for ABIM.

Pharmacists

ScientiaCME is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. This activity is approved for 1.5 contact hours (0.15 CEUs) of continuing pharmacy education credit. Proof of participation will be posted to your NABP CPE profile within 4 to 6 weeks to participants who have successfully completed the post-test. Participants must participate in the entire presentation and complete the course evaluation to receive continuing pharmacy education credit. ACPE #0574-0000-22-026-H01-P. This is an Application (A)-type activity. 

PharmacistsYou must enter your NABP # and birth date correctly so that proof of participation can be posted to your NABP CPE profile. It is the learner's responsibility to provide this information completely and accurately at the completion of the activity. Without providing it, the learner will NOT receive CPE credit for this activity.

Nurse Practitioners (NPs): The American Academy of Nurse Practitioners accepts AMA PRA Category 1 Credit(s)™ from organizations accredited by the ACCME. ScientiaCME will provide NPs who successfully complete each activity with a certificate of participation indicating that the activity was designated for AMA PRA Category 1 Credit(s)™.

Physician Assistants: The American Academy of Physician Assistants accepts AMA PRA Category 1 Credit(s)™ from organizations accredited by the ACCME.


Faculty Disclosure and Resolution of COI

As a provider of continuing medical education, it is the policy of ScientiaCME to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. In accordance with this policy, faculty and educational planners must disclose any significant relationships with commercial interests whose products or devices may be mentioned in faculty presentations, and any relationships with the commercial supporter of the activity. The intent of this disclosure is to provide the intended audience with information on which they can make their own judgments. Additionally, in the event a conflict of interest (COI) does exist, it is the policy of ScientiaCME to ensure that the COI is resolved in order to ensure the integrity of the CME activity. For this CME activity, any COI has been resolved thru content review by ScientiaCME.

Faculty Disclosure:

Carlos Lopez, MD, MPH, Hematology/Oncology Chief Fellow, Northwell Health, has no relevant financial disclosures.

Disclosures of Educational Planners: Charles Turck, PharmD, BCPS, BCCCP, President of ScientiaCME, has no relevant financial disclosures.

Faculty will discuss off-label uses.

All relevant financial relationships have been mitigated.

ScientiaCME adheres to the ACCME’s Standards for Integrity and Independence in Accredited Continuing Education. Any individuals in a position to control the content of a CE activity, including faculty, planners, reviewers or others are required to disclose all relevant financial relationships with ineligible entities (commercial interests). All relevant conflicts of interest have been mitigated prior to the commencement of the activity.

Commercial Support Disclosure: This program is supported by an educational grant from Dova.

 

Copyright © 2021 by Scientia Perpetuam, LLC TM

Instructions

  • Read the learning objectives above
  • Take the Pre-Test (optional). Completion of the pre-test will help us evaluate the knowledge gained by participating in this CME activity.
  • View the online activity. You may view this is in more than one session, and may pause or repeat any portion of the presentation if you need to.
  • Minimum participation threshold: Take the post-test. A score of 70% or higher is required to pass and proceed to the activity evaluation.
  • Complete the activity evaluation and CME registration. A CE certificate will be emailed to you immediately.

Cultural/Linguistic Competence & Health Disparities

System Requirements

PC
Windows 7 or above
Internet Explorer 8
*Adobe Acrobat Reader
MAC
Mac OS 10.2.8
Safari or Chrome or Firefox
*Adobe Acrobat Reader
Internet Explorer is not supported on the Macintosh

*Required to view Printable PDF Version


Perform Pre-Test (optional)

Please take a few minutes to participate in the optional pre-test. It will help us measure the knowledge gained by participating in this activity.


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