The RA Patient With Multiple Treatment Failures

Managing a Non-Responder to Methotrexate
0.75 ANCC Contact Hours 1 CA-BRN Credit(s) 0.75 AMA PRA Category 1 Credit(s)
Launch Date:
September 24, 2013
Expiration Date:
The accreditation for this activity has expired.

Primary Audience:

Rheumatologists, Rheumatology Nurses

Relevant Terms:

Rheumatoid Arthritis

Neal Birnbaum, MD, FACP, MACR

Neal Birnbaum, MD, FACP, MACR
Director, Division of Rheumatology
California Pacific Medical Center
San Francisco, CA

Neal Birnbaum, MD, FACP, MACR, is Director of the Division of Rheumatology at California Medical Center and Clinical Professor of Medicine at the University of California San Francisco. He also has a private rheumatology practice in San Francisco. He has served as Chief of Staff of the San Francisco Medical Society, and been Chief of Staff at California Pacific Medical Center. He completed medical school at Ohio State University, graduating Cum Laude. He completed a fellowship in Rheumatology and residency in Internal Medicine at the University of Pittsburgh School of Medicine. His clinical skills have been recognized by his inclusion in every edition of The Best Doctors in America. In addition, he has been active in the American College of Rheumatology (ACR) for many years, serving as past ACR president. He is also past president of the California Society of Internal Medicine and a Fellow of the American College of Physicians. He has been Vice-chairman for Medical Affairs of the northern California chapter of the Arthritis Foundation and was a founding board member of the Scleroderma Research Foundation. He also assumed an additional role as board chairperson of Brown and Toland Medical Group. He recently co-authored a book for patients, The Complete Idiot's Guide to Arthritis. He was named an ACR Master in 2011. His work has been published in peer-reviewed journals including Arthritis & Rheumatism and Drug Benefit Trends.

Vivian Bykerk, MD

Vivian Bykerk, MD
Assistant Attending Rheumatologist
Hospital for Special Surgery
New York, NY

Dr. Bykerk has an active clinical practice and works with patients with a variety of musculoskeletal and autoimmune diseases including rheumatoid arthritis, psoriatic arthritis, spondyloarthropathies, and autoimmune ophthalmic illnesses. Her work emphasizes the Hospital for Special Surgery Inflammatory Arthritis Center's aim to ensure that patients have access to the care they need.
With a patient care focus on the importance of proper diagnosis, particularly in the early stages of inflammatory arthritis, which may prevent serious, lifelong arthritic complications. Dr. Bykerk notes that if detected and treated in its early stages, the effects of inflammatory arthritis can be greatly diminished.
"As rheumatologists, we want to see patients with new onset rheumatoid arthritis ideally as soon as possible." said Dr. Bykerk. "Patients often don't get to us for four to six months after their symptoms have been identified. The longer they wait, the higher the chance damage will occur."
Dr. Vivian Bykerk is a member of a team of specialists at the Inflammatory Arthritis Center at Hospital for Special Surgery. The Center includes a dedicated inflammatory arthritis clinic, extensive arthritis registries, scientific studies focused on musculoskeletal and autoimmune diseases, a physician education program, and most importantly, an emphasis on providing quality health care to patients.
Dr. Bykerk brings an extensive knowledge base and experience in rheumatology. She completed a residency in Internal Medicine at Mount Sinai Hospital in Toronto, Ontario, Canada, and spent two years as a Rheumatology Fellow at McGill University, in Montreal, Quebec. Dr. Bykerk received the Senior Rheumatology Scholar Award in 1989 presented by the American College of Rheumatology for her research in lupus. She served as the Director of the Early Arthritis Program at Mount Sinai Hospital, Toronto, Ontario, Canada and comes to Hospital for Special Surgery from Brigham & Women's Hospital, Boston, where she was in the Division of Rheumatology. She has been in rheumatology practice for over 20 years.

Jacqueline Fritz, RN, MSN, CNS

Jacqueline Fritz, RN, MSN, CNS
Medical Advancement Center
Critical Care and Rheumatology Specialist
Cypress, California

Jacqueline M. Fritz RN, MSN CNS is the Director of Education at the Medical Advancement Center. Jackie has been developing course material and teaching for the Medical Advancement Center since 1991. She reviews and approves all course material, hand picks all of their instructors and audits the classes that she does not personally teach.
In addition to her duties with Medical Advancement Center, she currently works as a NP in a rheumatology practice and is the director of their infusion center. She also lectures for Abbott, Centocor, Genentech, Novartis and UCB about the biologics that are currently being used to treat rheumatologic and autoimmune diseases. She is also a frequent lecturer for Bard Statlock and LCMH.
Jackie's background includes working in the intensive care and cardiac care units of major medical centers, as well as training under Dr. John Messenger a well know and highly respected cardiologist. Her list of qualifications and accomplishments are too numerous to list.
1. Implement evidence-based guidelines into practice as warranted for the treatment of specific subsets of patients with rheumatoid arthritis (RA)
2. Implement and/or optimize the utilization of target-based patient management within the next 3 months to standardize patient care and optimize overall outcomes

Instructions on How to Receive Credit
  • Participants must review the materials on accreditation information, target audience, learning objectives, and disclosure information.
  • Complete the entire activity, pre/post-test and evaluation.
  • After passing the post-test, print out your electronic CE certificate.
  • In order to successfully complete this activity learners must achieve a minimum of 65% on the post-test.
This activity is supported by an unrestricted educational grant from AbbVie, Bristol-Myers Squibb, and UCB, Inc.

This activity is sponsored by the Institute for Continuing Healthcare Education

Release Date: September 24, 2013
Expiration Date: September 24, 2014

Accreditation Statements
The Institute for Continuing Healthcare Education is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The Institute for Continuing Healthcare Education designates this enduring material for a maximum of 0.75 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

The Institute for Continuing Healthcare Education is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.

This activity offers 0.75 contact hours to participating nurses. This credit may be applied toward licensure requirements in those states that recognize American Nurses Credentialing Center's Commission on Accreditation (ANCC-COA) accredited providers.

Accreditation applies solely to educational activities and does not imply approval or endorsement of any commercial product by the ANCC-COA.

California Nurses
The Institute for Continuing Healthcare Education is approved by the California Board of Registered Nursing, Provider Number 13313. The Institute for Continuing Healthcare Education approves this activity for 1.0 contact hours.
Relationships are abbreviated as follows: E, Educational Planning Committee; G, Grant/research support recipient; A, Advisor/review panel member/educational planning committee; C, Consultant/Independent Contractor; SS, Stock shareholder; SB, Speaker bureau; PE, Promotional Event Talks; H, Honoraria; O, Other.

Neil Birnbaum, MD 
California Pacific Medical Center
San Francisco, CA

Dr. Birnbaum has disclosed the following relevant financial relationships in the past 12 months: Janssen, Amgen, Pfizer,& Abbott/PE.

Vivian Bykerk, MD
Hospital for Special Surgery
New York, NY

Dr. Bykerk has disclosed the following relevant financial relationships that have occurred within the past 12 months: Amgen, Antares, Astellas, BMS, Genentech, Merck, and UCB/A, Novartis,/SS.

Jacqueline M. Fritz, RN, MSN, CSN 
Medical Advancement Center
Cypress, CA

Ms. Fritz has disclosed the following relevant financial relationships that has occurred within the past 12 months: Institute for Continuing Healthcare Education and UCB/A; Amgen, UCB, Genentech, Johnson & Johnson, Savient/SB; Amgen, UCB, Genentech, Johnson & Johnson, Savient/PE.

Medical Writer
Eve Wilson, PhD, CCMEP, ELS
Morphos Medical Education, LLC
Bowie, MD

Dr. Wilson has disclosed that she does not have any relevant financial relationships specific to the subject matter of the content of the activity.

Peer Reviewer
Stanford Peng, MD
Virginia Mason Medical Center
Seattle, WA

Dr. Peng has disclosed that he does not have any relevant financial relationships specific to the subject matter of the content of this activity.

Activity Development and Management Team
Cathy Pagano, CCMEPAllison A. Muller, Pharm.D, D.ABATScott Kober, MBA, CCMEPApril Reynolds, MS, ELSSandra Davidson; and Megan Small are employees of the Institute and have no relationships to disclose.

Off-label Product Disclosure
This educational activity includes discussion of published and/or investigational uses of agents that are not indicated by the U.S. Food and Drug Administration. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

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General Disclosure and Copyright Statement
The opinions expressed in this publication are those of the participating faculty and not those of the Institute for Continuing Healthcare Education (the Institute), AbbVie, Bristol-Myers Squibb, or UCB, Inc., or any manufacturers of products mentioned herein.

This information is provided for general medical education purposes only and is not meant to substitute for the independent medical judgment of a healthcare professional regarding diagnostic and treatment options of a specific patient's medical condition. In no event will the Institute be responsible for any decision made or action taken based upon the information provided in this activity.

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The Institute reserves the right to cancel or modify the activity content, faculty, and activities if necessary.