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Activity Release Date:
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April 1, 2010
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Activity Termination Date:
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Physician: March 31, 2011
Nurse: January 30, 2011
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Overview/Statement of Need
In 2008, after reports of an association between erythropoietic stimulating agent (ESA) therapy and the potential for either thrombotic cardiovascular events or more rapid tumor progression in some cancers, the Food and Drug Administration changed the product labeling for ESAs, adding a black box warning as well as more restrictive indications, especially in oncology patients. In addition the Centers for Medicare and Medicaid Services has placed significant restrictions on payments for ESA therapy. These new limitations on ESA have led to increased use of transfusions in anemic cancer patients. This increase in allogeneic transfusions potentially will place an additional burden on the US blood supply. Although allogeneic blood transfusion is one answer to ESA restrictions, the use of intravenous iron therapy (IV iron) is another possible alternative. We will discuss the use of IV iron as primary therapy for anemia, the use of combination IV iron and ESA therapy to improve efficiency and decrease costs, and evidence that IV iron with and without ESA therapy can reduce allogeneic blood transfusions in surgical patients. We will also review the available IV iron agents and their comparative safety profiles.
Educational Objectives
After completing this activity, the participant should be better able to:
- Explain the new ESA restrictions and their effect on clinical practice; especially the use of blood transfusions.
- Describe the role of IV Iron in decreasing the use of blood transfusion.
- Compare IV Iron products in order to make the most appropriate choices for patients.
Target Audience
This activity has been designed to meet the educational needs of physicians and nurses who care for anemic patients.
Accreditation Statements
Physician
This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of The Institute for the Advancement of Human Behavior (IAHB) and the Society for the Advancement of Blood Management (SABM). The IAHB is accredited by the ACCME to provide continuing medical education for physicians.
AMA PRA Statement
The IAHB designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit.TM Physicians should only claim credit commensurate with the extent of their participation in the activity.
Nurse
Amedco is an approved provider of continuing nursing education by the Wisconsin Nurses Association Continuing Education Approval Program Committee, an accredited approver by the American Nurses Credentialing Center's Commission on Accreditation.
Approved status as a provider refers only to its continuing education activities and does not imply ANCC Commission on Accreditation endorsement of any commercial products. This course is co-provided by Amedco and SABM for 1 contact hour.
Provider Contact Information
IAHB, PO Box 17009,. St Paul, MN 55117, phone 651-789-3716, jay@cmehelp.com
Faculty
Aryeh Shander, MD, FCCM, FCCP
Chief, Dept. of Anesthesiology, Critical Care and Hyperbaric Medicine
Englewood Hospital and Medical Center, Englewood, NJ
Clinical Professor of Anesthesiology, Medicine and Surgery
Mount Sinai School of Medicine, New York, NY
Michael Auerbach, MD, FACP
Auerbach Hematology and Oncology Associates, Rosedale, MD
Clinical Professor of Medicine
Georgetown University School of Medicine, Baltimore, MD
Richard Spence, MD, MHA, FACS
Medical Officer
Haemonetics Corporation, Braintree, MA
Disclosure of Conflict of Interests
All faculty and planners participating in the continuing medical/nursing education programs offered by IAHB/Amedco are expected to disclose to the program audience any/all relevant financial relationships related to the content of their presentation. Those with a relationship to disclose are listed below. All others have indicated they have nothing to disclose.
Key: C-Consultant/Advisor, G-Grant/Research, S-Speaker's Bureau, R1-Restricted to Best Available Evidence & ACCME content validation statement, R4-Peer Review with 2nd method of resolution
Aryeh Shander, MD, FCCM, FCCP – Bayer: G,C,S; Centocor Ortho Biotech: C,G,S; Luitpold Pharmaceuticals: C; Masimo: C,S; Novartis: G,C,S; Novo Nordisk: G;C; Pfizer: G; ZymoGenetics: G,S. R1/R4
Maria Esposito Ashton, MS, RPh, MBA – Luitpold Pharmaceuticals: C. R1/R4
The following have indicated they have nothing to disclose: Michael Auerbach, MD; Richard Spence, MD, MHA, FACS; Sharon Sledge, MA, MS, RN, C; Richard Melseth, BA; Helen Hermus, MS; Jay Parker, BS; Margaret Allee, RN.
Disclosure of Off-label/Unapproved Uses
This educational activity includes off-label, investigational, or unapproved recommendations for the uses of drugs or devices that are not indicated by the US Food and Drug Administration. Please refer to the official prescribing information for each product for approved indications, contraindications and warnings.
Disclaimer
The information presented in this activity should not be used by clinicians until completing an evaluation of their patients' condition, and considering possible contraindications based on the manufacturer's product information. This material is presented for informational purposes and is not meant to serve as a guideline for treatment.
Policy on Privacy and Confidentiality
To verify your participation in online educational activities, you may be asked to provide your name, contact information and/or other descriptors. SABM will not sell, rent, lease or trade your personally identifiable information to any third party, except as required by law. We may use this information to inform you of other SABM educational activities. If you wish to have your information excluded from this process, please contact us at info@sabm.org.
Acknowledgement of Commercial Support
We gratefully acknowledge Watson Pharmaceuticals for support of this activity.
Completion of this Acitivity
For physicians, this journal CME activity involves the review of a manuscript and completion of an online evaluation. For nurses, this journal CNE activity involves the review of a manuscript and completion of an online post-test with a passing score of 70% or greater and completion of an evaluation. You will need internet access to complete the activity and obtain your CME/CNE certificate.
If you are unable to access this site, please contact The Society for the Advancement of Blood Management, 602-343-7458 or info@sabm.org.
