AB1268 ONLINE EDUCATION YIELDS SIGNIFICANT GAINS IN RHEUMATOLOGISTS’ KNOWLEDGE OF THE ROLE OF JAK INHIBITORS IN THE MANAGEMENT OF RA

Background:The treatment armamentarium for rheumatoid arthritis (RA) has expanded rapidly in recent years, making it challenging for rheumatologists to stay up to date with key advances. The most recently available treatment options for RA are the JAK inhibitors.Objectives:Our goal with this activity was to assess whether online CME can improve rheumatologists’ knowledge of the role of JAK inhibitors in the management of RA.Methods:Rheumatologists participated in an online CME activity entitled ‘Advancing patient care in rheumatoid arthritis: role of JAK inhibitors’. This was a 30-minute video roundtable discussion between 3 experts, with accompanying slides. This CME activity launched on April 30 2019 with data collection through September 13 2019. The educational effect was assessed using a repeated-pair design, pre-/post-assessment. A Chi-square test of independence determined if a statistically significant improvement (5% significance level,P<.05) existed in the number of correct responses between the pretest and posttest scores. Cramer’s V estimated the effect size of the education.Results:•Significant improvement in average percentage of correct responses, rising from a relatively high baseline of 67% to 81% post-activity (P= .0006)•Increase in percentage of rheumatologists (n=68) answering all 3 questions correctly (37% at baseline rising to 66% post assessment)•Significant improvement in knowledge of clinical trial safety data for JAK inhibitors (43% improvement,P= .0079)•Numerical improvement from relatively high baseline for understanding of unmet needs in RA patients (74% at baseline, 87% post-activity) and the advantages of JAK inhibitors versus TNF inhibitors for a specific patient case (75% at baseline, 84% post-activity)•Considerable educational impact (Cramer’s V = 0.167) with 35% of rheumatologists reporting greater confidence in describing the mechanism of action of current and emerging JAK inhibitors (noteable average confidence shift of 15%)Conclusion:A positive and significant effect on physician knowledge and confidence regarding JAK inhibitors for RA was achieved following this online CME activity. The extent of this educational impact is likely to lead to better patient outcomes since physicians are better equipped to consider JAK inhibitors for appropriate patients. The results also revealed that physicians would benefit from additional education to reinforce their knowledge of key clinical data for JAK inhibitors and on the use of JAK inhibitors in clinical practice.Disclosure of Interests: :Elaine Bell: None declared, Marinella Calle: None declared, Ronald van Vollenhoven Grant/research support from: AbbVie, Arthrogen, Bristol-Myers Squibb, GlaxoSmithKline, Lilly, Pfizer, and UCB, Consultant of: AbbVie, AstraZeneca, Biotest, Bristol-Myers Squibb, Celgene, GSK, Janssen, Lilly, Medac, Merck, Novartis, Pfizer, Roche, and UCB

Download Full-text

AB1267 ONLINE CASE-BASED EDUCATION SIGNIFICANTLY IMPROVED RHEUMATOLOGISTS’ KNOWLEDGE AND CONFIDENCE IN MANAGING PATIENTS WITH RA

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.2297 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1925.2-1925

Author(s):

E. Bell ◽

A. Sendaydiego ◽

P. C. Taylor

Keyword(s):

Rapid Evolution ◽

Safety Data ◽

Treatment Strategies ◽

Further Education ◽

Learning Activity ◽

Tnf Inhibitor ◽

Jak Inhibitors ◽

Significance Level ◽

Average Percentage ◽

Post Assessment

Background:With the rapid evolution in treatment strategies and the increasing range of available therapeutics for rheumatoid arthritis (RA), keeping pace with advances can be a challenge for busy physicians.Objectives:We assessed whether online CME can improve rheumatologists’ knowledge of RA management focusing on the assessment and monitoring of RA, the selection of appropriate treatments and the clinical efficacy and safety data for JAK inhibitors.Methods:Rheumatologists participated in a text-based activity featuring two patient cases with questions that “tested” knowledge and discussion of the main “teaching” points. Educational effect was assessed using a repeated-pair design, pre-/post-assessment. A Chi-square test of independence determined if a statistically significant improvement (5% significance level,P<.05) existed in the number of correct responses between the pretest and posttest scores. Cramer’s V estimated the effect size of the education. The activity launched on 15 December 2018 with data collection through 27 February 2019.Results:•Significant improvement in average percentage of correct responses, rising from 47% at baseline to 92% post-activity (P<.001) and extensive educational impact (Cramer’s V=0.496)•Significant increase in percentage of rheumatologists (n=111) answering all 3 questions correctly (9% at baseline rising to 78% post assessment)•Significant improvements in knowledge of EULAR/ACR assessment criteria (86% improvement,P<.001), EULAR treatment recommendations for a patient failing on MTX and a TNF inhibitor (100% improvement,P<.001), and the VTE risk associated with having RA or receiving RA treatments (108% improvement,P<.001)•46% of rheumatologists reported greater confidence in their ability to appropriately incorporate JAK inhibitors into the treatment of patients with RA (average confidence shift 20%)Conclusion:Overall, this learning activity was highly successful in improving rheumatologists’knowledge and confidence in managing patients with RA, particularly with regard to the appropriate use of JAK inhibitors in patients for whom such treatment is suitable. The extensive impact of this interactive ‘test then teach’ activity is likely to directly translate into patient benefit. Further education on this topic would be useful to enhance and reinforce this knowledge and to support physician confidence in the use of JAK inhibitors in clinical practice.References:[1]https://www.medscape.org/viewarticle/906202Disclosure of Interests:Elaine Bell: None declared, Anne Sendaydiego: None declared, Peter C. Taylor Grant/research support from: Celgene, Eli Lilly and Company, Galapagos, and Gilead, Consultant of: AbbVie, Biogen, Eli Lilly and Company, Fresenius, Galapagos, Gilead, GlaxoSmithKline, Janssen, Nordic Pharma, Pfizer Roche, and UCB

Download Full-text

POS0677 THE ROLE OF MUSCULOSKELETAL ULTRASOUND IN PREDICTING THE RESPONSE TO JAK INHIBITORS: RESULTS FROM A LARGE MONOCENTRIC COHORT

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.3850 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 583-583

Author(s):

C. Garufi ◽

F. Ceccarelli ◽

F. R. Spinelli ◽

S. Mancuso ◽

C. Pirone ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Disease Activity ◽

Structural Damage ◽

Power Doppler ◽

Response To Treatment ◽

Jak Inhibitors ◽

Inflammatory Score ◽

Inflammatory Status

Background:In the management of chronic arthritis, such as Rheumatoid Arthritis (RA), Ultrasound (US) assessment can provide relevant information about the joint inflammatory status in the diagnostic phase and even more in the monitoring of disease activity and structural damage1,2.Objectives:In this longitudinal study, we aimed to assesse the role of US in predicting the efficacy of JAK-inhibitors (JAKi) in RA patients.Methods:We enrolled RA patients starting baricitinib or tofacitinib. All patients were evaluated at baseline and after 4, 12, 24, 48 weeks. Disease activity was calculated by DAS28CRP. US examination in 22 joints (I–V MCPs and PIPs, wrists) aimed at evaluating inflammatory features (synovial effusion and hypertrophy, power Doppler-PD), through a semi-quantitative scale (0-3). The total US (0-198) and PD (0-66) scores were calculated. We scanned bilateral flexor (I–V fingers of hands) and extensor compartments (1-6) tendons: tenosynovitis was scored as absent/present (0/1), resulting in a total score (0-22).Results:We studied 102 patients (M/F 15/87; median age 59.2 years, IQR 17.75; median disease duration 144 months, IQR 126), 61 treated with baricitinib and 41 with tofacitinib. At baseline, the median total US score was 18 (IQR 19) and the median PD score 2 (4). We observed a significant reduction in both total and PD US scores at all time-points (p<0.0001) (Figure 1). At baseline, 75.4% of patients showed tenosynovitis involving at least one tendon, with a median score of 2 (IQR 3.5) significantly decreasing after 24 weeks (p=0.02). Multivariate analysis, adjusted for baseline DAS28CRP and other concomitant treatments (including glucocorticoids and methotrexate treatment), confirmed the independent association between baseline US (PD and tenosynovitis) scores and the reduction of disease activity at follow-up evaluations.Conclusion:The present study confirmed the early efficacy of JAKi in RA patients by using US evaluation. Furthermore, power doppler and tenosynovitis scores could play a predictive role in response to treatment.References:[1]MUELLER RB, HASLER C, POPP F, et al. Effectiveness, Tolerability, and Safety of Tofacitinib in Rheumatoid Arthritis: A Retrospective Analysis of Real-World Data from the St. Gallen and Aarau Cohorts. J Clin Med. 2019;8(10):1548.[2]COLEBATCH AN, EDWARDS CJ, ØSTERGAARD M, et al. EULAR recommendations for the use of imaging of the joints in the clinical management of rheumatoid arthritis. Ann Rheum Dis. 2013;72(6):804-14.Figure 1.Ultrasound inflammatory score (a) and Ultrasound Power Doppler (PD) score (b) at baseline and follow-up.Table 1.Baseline characteristics of 414 RA patients.WEEKS04122448US inflammatory score18 (19)11 (15.5)9.5 (11.7)7.5 (8)6 (11)US PD score2 (4)0 (2)0 (1)0 (1)0 (0.7)Disclosure of Interests:Cristina Garufi: None declared, Fulvia Ceccarelli: None declared, Francesca Romana Spinelli Speakers bureau: Abbvie, Eli Lilly, Consultant of: Gilead/Galapagos, Eli Lilly, Grant/research support from: Pfizer, Silvia Mancuso: None declared, Carmelo Pirone: None declared, Fabrizio Conti Speakers bureau: Abbvie, Eli Lilly, Sanofi, Pfizer, Consultant of: Gilead/Galapagos

Download Full-text

AB0849 ONLINE EDUCATION YIELDS SIGNIFICANT GAINS IN RHEUMATOLOGISTS’ KNOWLEDGE OF PSORIATIC DISEASE

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.1569 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 1448.2-1449

Author(s):

A. Stan ◽

M. Calle ◽

P. Schoonheim ◽

A. B. Gottlieb

Keyword(s):

Online Education ◽

Correct Answer ◽

P Value ◽

Chi Square ◽

Significance Level ◽

Aggregated Data ◽

Average Percentage ◽

Psoriatic Disease ◽

First Line Therapy ◽

Post Assessment

Background:Physicians face challenges staying up-to-date with the latest research and accessing the ever-growing field of knowledge is time-consuming. Online education can make these clinician’s tasks more efficient and less time-consuming.Objectives:As part of a larger curriculum, we developed an online CME activity titled: “Optimizing Treatment in Patients With Moderate to Severe Psoriasis”. The goal of this study was to assess whether this online CME accredited video discussion improves physicians’ understanding of the prevalence and impact of the various manifestations of psoriatic disease, and how these might impact the choice of treatment in patients with psoriasis and/or psoriatic arthritis.Methods:Rheumatologists participated in an online CME activity (https://www.medscape.org/viewarticle/931595) consisting of a 30-minute video discussion between 2 experts with synchronized slides. Educational effect was assessed using a 4-question repeated pairs, pre-/post-assessment. A chi-square test determined if a statistically significant improvement (P <.05 significance level) existed in the number of correct responses from the pretest and posttest scores. Cramer’s V was used to estimate the level of impact of the education (Modest [.0]; Extensive [>.26]). The CME activity launched on Jul 6, 2020, and the data were collected through Aug 31, 2020.Results:A total of 54 rheumatologists completed the pre- and post activity assessments during the study period. Overall the activity had a signficiant impact (P =.0002) on rheumatologists’ knowledge and competence related to optimisation of treatment in psoriatic disease, with a Cramer’s V value of 0.210 indicating a considerable educational impact. The average percentage of correct responses rose from 67% pre-activity to 85% post-activity. A repeated pairs analysis showed that 21% of rheumatologists improved their knowledge and 64% reinforced their knowledge, respectively. The changes in percentage of correct responses from pre- to post-assessment for all questions are shown in Table 1. More than 60% of rheumatologists had a measurable improvement in confidence in their ability to identify patients with psoriatic disease who are candidates for first-line therapy with biologics.Table 1.Impact of education on rheumatologists’ knowledge of psoriatic diseaseQuestion #Question topicAggregated dataLinked Learner ResultsaAverage % of correct responses Pre- vs. Post-educationP-value% ImprovedblearnersPre- vs. Post-education% Reinforcedc learnersPre- vs. Post-education1.Prevalence of the various manifestations of psoriatic disease46% vs 80%.000235%44%2.Clinical data with biologic therapies in psoriatic disease69% vs 78%NS17%61%3.Competence related to identification of patients who may benefit from biologic therapy87% vs 98%.02711%87%aEach individual learner tracked pre and post-educationbIncorrect answer pre-education, Correct answer post-educationcCorrect answer pre-education, Correct answer post-educationConclusion:This online CME activity significantly improved rheumatologists’ knowledge and competence related to the optimization of treatment in psoriatic disease. However, there is room for further improving physicians’ knowledge of clinical trial outcomes with biologics in patients with PsA, since 22% of rheumatologists provided incorrect answers to question 3 post-education. This topic can be addressed in future educational programs.Disclosure of Interests:None declared

Download Full-text

THU0585 ONLINE EDUCATION YIELDS SIGNIFICANT GAINS IN RHEUMATOLOGISTS’ KNOWLEDGE OF THE JAK INHIBITORS MODE OF ACTION AND CLINICAL TRIAL DATA

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.2722 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 534.2-534

Author(s):

A. Stan ◽

M. Calle ◽

C. Scot-Smith ◽

R. Van Vollenhoven

Keyword(s):

Clinical Trial ◽

Online Education ◽

Clinical Trial Data ◽

Trial Data ◽

Janus Kinase ◽

Jak Inhibitors ◽

Research Support ◽

Educational Grant ◽

Trial Outcomes ◽

Post Assessment

Background:Physicians face challenges staying up-to-date with the latest research and accessing the ever-growing field of knowledge is time-consuming. Online education can make these clinician’s tasks more efficient and less time-consuming.Objectives:This study assessed whether the online CME accredited round-table-discussion with title “Meet the JAKs: Understanding the Role of Janus Kinase Inhibition in RA” improves physicians’ understanding mechanism of action (MOA) of current and emerging Janus kinase (JAK) inhibitors and rationale for their development in rheumatoid arthritis (RA).Methods:Rheumatologists participated in an online CME activity (https://www.medscape.org/viewarticle/913625) consisting of a 30-minute video discussion between 2 experts with accompanying slides. Educational effect was assessed using a 4-question repeated pairs, pre-/post-assessment. A chi-square test was used to determine if a statistically significant improvement (P<.05 significance level) existed in the number of correct responses from the pretest and posttest scores. Cramer’s V was used to estimate the level of impact of the education. The CME activity launched on June 4, 2019, and the data were collected through September 3, 2019.Results:A total of 107 rheumatologists completed the pre- and post activity assessments. Overall the activity had a signficiant impact (P<.001) on rheumatologists’ knowledge of JAK inhibitors and relatedclinical trial data with a Cramer’s V value of 0.319 indicating an extensive educational impact. The average percentage of correct responses rose from 47% pre-activity to 78% post-activity. The repeated pairs analysis (each individual learner tracked pre- and post-education) showed that 34% of learners improved their knowledge and 44% reinforced their knowledge. The change in percentage of correct responses from pre- to post-assessment achieved statistical significance for all 3 questions presented: (1) understanding the MOA of JAK inhibitors vs biologics (64% at baseline rising to 82% post acivity;P<0.01), (2) understanding the specificity of different JAK inhibitors (49% at baseline rising to 85% post acivity;P<.001), (3) knowledge of clinical trial outcomes with JAK inhibitors (29% at baseline rising to 67% post acivity;P<.001) and (4) 60% of rheumatologists gained confidence in their ability to describe the MOA of current and emerging JAK inhibitors.Conclusion:This online CME activity significantly improved rheumatologists’ understanding of JAK inhibitors mode of action. However, there is clearly room for further improving physicians’ knowledge of clinical trial outcomes with these agents, since one third of rheumatologists provided incorrect answers to question 3 post-activity) and this topic can be further addressed in future education.Acknowledgments:This CME-certified activity was supported by anindependent educational grant from AbbVie.Disclosure of Interests:Adriana Stan Grant/research support from: The CME-certified activity was supported by anindependent educational grant from Sandoz., Marinella Calle Grant/research support from: This CME-certified activity was supported by anindependent educational grant from Novartis AG, Camille Scot-Smith Grant/research support from: This CME-certified activity was supported by anindependent educational grant from AbbVie, Ronald van Vollenhoven Grant/research support from: BMS, GSK, Lilly, UCB, Pfizer, Roche, Consultant of: AbbVie, AstraZeneca, Biogen, Biotest, Celgene, Gilead, Janssen, Pfizer, Servier, UCB, Speakers bureau: AbbVie, Pfizer, UCB

Download Full-text

THU0651-HPR ONLINE EDUCATION YIELDS SIGNIFICANT GAINS IN RHEUMATOLOGISTS’ KNOWLEDGE OF THE ROLE OF ENTHESITIS IN THE DIAGNOSIS AND MANAGEMENT OF PSA

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.3137 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 570.1-570

Author(s):

A. Stan ◽

M. Calle ◽

P. Schoonheim ◽

P. J. Mease

Keyword(s):

Clinical Trial ◽

Psoriatic Arthritis ◽

Online Education ◽

Correct Answer ◽

Research Support ◽

Diagnosis And Management ◽

Educational Grant ◽

Trial Outcomes ◽

Post Assessment

Background:Physicians face challenges staying up-to-date with the latest research and accessing the ever-growing field of knowledge is time-consuming. Online education can make these clinician’s tasks more efficient and less time-consuming.Objectives:As part of a larger curriculum, we developed an online CME activity titled: “Enthesitis in Psoriatic Arthritis: Disease, Diagnosis and Decisions”. The goal of this study was to assess whether this online CME accredited video discussion improves physicians’ understanding of the role of enthesitis in the diagnosis and management of patients with psoriatic arthritis (PsA) in clinical practice.Methods:Rheumatologists participated in an online CME activity (https://www.medscape.org/viewarticle/910671) consisting of a 30-minute video discussion between 2 experts with accompanying slides. Educational effect was assessed using a 4-question repeated pairs, pre-/post-assessment. A chi-square test was used to determine if a statistically significant improvement (P<.05 significance level) existed in the number of correct responses from the pretest and posttest scores. Cramer’s V was used to estimate the level of impact of the education. The CME activity launched on March 28, 2019, and the data were collected through June 7, 2019.Results:A total of 145 rheumatologists completed the pre- and post activity assessments. Overall the activity had a signficiant impact (P<.0001) on rheumatologists’ knowledge of the role of enthesitis in the diagnosis and management of PsA, with a Cramer’s V value of 0.153 indicating a noticeble educational impact. The average percentage of correct responses rose from 54% pre-activity to 69% post-activity. A repeated pairs analysis showed that 22% of rheumatologists improved their knowledge and 47% reinforced their knowledge, respectively. The change in percentage of correct responses from pre- to post-assessment for all questions are shown in table. Almost 40% of rheumatologists had a measurable improvement in confidence in their ability to evaluate the presence of enthesitis according to a clinical exam or ultrasound.Table.Impact of education on rheumatologists’ knowledge of enthesitisQuestion #Question topicAggregated dataLinked Learner ResultsaAverage % of correct responses Pre- vs. Post-educationP-value% ImprovedblearnersPre- vs. Post-education% ReinforcedclearnersPre- vs. Post-education1.Immunopathology of PsA75% vs 84%.057912%72%2.Prevalence of enthesitis in patients with PsA44% vs 68%<.000133%34%3.Clinical trial outcomes in patients with enthesitis43% vs 56%.034522%34%aEach individual learner tracked pre and post-educationbIncorrect answer pre-education, Correct answer post-educationcCorrect answer pre-education, Correct answer post-educationConclusion:This online CME activity significantly improved rheumatologists’ understanding of role of enthesitis in the diagnosis and management of PsA. However, there is clearly room for further improving physicians’ knowledge of clinical trial outcomes with biologics in patients with enthesitis, since 44% of rheumatologists provided incorrect answers to question 3 post-education. This topic can be addressed in future education.Acknowledgments:This CME-certified activity was supported by independent funding from Novartis AG.Disclosure of Interests:Adriana Stan Grant/research support from: The CME-certified activity was supported by an independent educational grant from Sandoz., Marinella Calle Grant/research support from: This CME-certified activity was supported by an independent educational grant from Novartis AG, Peter Schoonheim Grant/research support from: This CME-certified activity was supported by independent funding from Sandoz., Philip J Mease Grant/research support from: Abbott, Amgen, Biogen Idec, BMS, Celgene Corporation, Eli Lilly, Novartis, Pfizer, Sun Pharmaceutical, UCB – grant/research support, Consultant of: Abbott, Amgen, Biogen Idec, BMS, Celgene Corporation, Eli Lilly, Novartis, Pfizer, Sun Pharmaceutical, UCB – consultant, Speakers bureau: Abbott, Amgen, Biogen Idec, BMS, Eli Lilly, Genentech, Janssen, Pfizer, UCB – speakers bureau

Download Full-text