Description

Target Audience

Objectives

At the conclusion of this activity, the participant will be able to:

1. Define immunocompetence and review the impact of biologic therapies on infections.
2. Summarize the safety of B-cell–directed therapies with regard to the following clinical scenarios: repeated use, safety of switching to DMARD or TNF inhibitor therapy after RTX failure, and serious and opportunistic infection rates.
3. State clinical considerations for immunizing patients who are candidates for B-cell–directed therapy.
4. Summarize the safety of long-term courses of B-cell–directed therapy and the impact of fixed versus on-demand treatment.
5. Describe the retreatment efficacy of currently available B-cell–directed therapies.
6. Summarize the rationale for targeting CD20 on B cells and list upcoming CD20-targeting therapies.
7. Describe the rationale of B-cell depletion for the management of SLE.
8. Summarize recent clinical trial data on the use of belimumab, rituximab, and epratuzumab in the treatment of SLE.
9. Summarize recent clinical trial data on the use of B-cell targeting in the treatment of other autoimmune diseases.
10. Discuss recent advances in understanding how B-cell biology affects autoimmune rheumatic diseases (ARDs).
11. Review how new biologic agents target B cells and their mechanisms of action.
12. Identify how studies of B-cell–targeted therapy are changing our understanding of integrated immune responses and the pathogenesis of ARDs .

Accreditation

The Cleveland Clinic Foundation Center for Continuing Education is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The Cleveland Clinic Foundation Center for Continuing Education designates this educational activity for a maximum of 1.50 AMA PRA Category 1 Credit(s)™.  Physicians should only claim credit commensurate with the extent of their participation in the activity.

This activity may be submitted for American Osteopathic Association Continuing Medical Education credit in Category 2.

Activity Director

Leonard H. Calabrese, DO
Professor of Medicine
Cleveland Clinic Lerner College of Medicine
R.J. Fasenmyer Chair of Clinical Immunology
Department of Rheumatic & Immunologic Diseases
Cleveland, Ohio

Editorial Board

Marc D. Cohen, MD
Professor of Medicine
Chief of Rheumatology
National Jewish Medical
  and Research Center
Denver, Colorado

Jonathan Kay, MD
Associate Clinical
  Professor of Medicine
Harvard Medical School
Director of Clinical Trials
Rheumatology Unit
Massachusetts General
  Hospital
Boston, Massachusetts

Gregg J. Silverman, MD
Professor of Medicine
Director, Laboratory of
  B-Cell Immunology
Division of Rheumatology,
  Allergy, and Immunology
University of California
  San Diego School of
  Medicine
La Jolla, California

Faculty

Leonard H. Calabrese, DO; Marc D. Cohen, MD; Jonathan Kay, MD; Gregg J. Silverman, MD

Faculty Disclosure

In accordance with the Standards for Commercial Support issued by the Accreditation Council for Continuing Medical Education (ACCME), The Cleveland Clinic Foundation Center for Continuing Education requires resolution of all faculty conflicts of interest to ensure CME activities are free of commercial bias.

The following faculty have indicated that they may have a relationship, which in the context of their presentation(s), could be perceived as a potential conflict of interest: