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CMEFirst Presents State-of-the-Art Arthritis CME Symposium

MORRISTOWN, N.J., March 18 /PRNewswire/ -- Concerns still persist within the general clinical community regarding the cardiovascular and gastrointestinal risk that is associated with the use of analgesics such as the nonsteroidal anti-inflammatory drugs (NSAIDs). In particular, the use of COX-2 selective inhibitor NSAIDs continues to raise the concern of cardio-renal complications not only in the decision making process of physicians but also in the perception of many patients who still recall the media blitz of reports surrounding the cardiovascular complications associated with the long term use of Vioxx and other "COX-2" analgesics. This is remarkable since simple analgesics such as acetaminophen (Tylenol(R)) and the NSAIDs are the single most commonly used and prescribed category of drug on a world wide basis. Hence, to address these important clinical day-to-day patient management concerns, CMEFirst, LLC, developed and convened a CME symposium on February 7, 2009, at the Omni Hotel in central Los Angeles.

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The location was chosen to ensure the availability of a large number of primary care physicians, internists, orthopedic surgeons, and pain specialists. The faculty recruited for the symposium represented a national and international group of renowned clinicians and investigators who have had extensive experience in the clinical development of analgesics and NSAID compounds from the perspective of clinical trial investigation as well as FDA advisory roles in the decision making processes that lead to the approval and regulation of the use of these drugs.

The initial speaker at the symposium, Allan Gibofsky, MD, JD, is an acclaimed Rheumatologist and is past Chairman of the FDA Arthritis Advisory Committee. In addition, Dr. Gibofsky is the former President of The American College of Rheumatology. He presented a review of the current landscape of arthritis disorders and identified for the participating physicians a differential diagnostic approach to the complex span of arthritis disease states that may be encountered in clinical practice.

This presenter was followed by the program Chairman, Andrew Whelton, MD, DSc, who is a Clinical Pharmacologist and Nephrologist. Dr. Whelton is known internationally for his extensive studies on the cardio-renal safety of analgesics. He characterized the cardiorenal syndromes that emerge in clinical practice in patients using analgesics and NSAIDs. He identified that perhaps the single-most common drug-drug interaction in clinical practice occurs during the concurrent use of antihypertensive drugs and NSAIDs. The explanation for this interaction is that NSAIDs interfere with the antihypertensive effect of many of the most popular antihypertensive drugs. Dr. Whelton cautioned that the resulting destabilization of blood pressure control during this drug-drug interaction may contribute to the development of thrombotic cardiovascular complications during the long-term use of NSAIDs in patients who are being treated for hypertension.

The next presenter, William B. White, MD, Chief of Hypertension and Clinical Pharmacology at the Calhoun Cardiology Center, University of Connecticut School of Medicine, is a world authority in the diagnosis and management of hypertension and is one of the original developers of the technique of Ambulatory Blood Pressure Monitoring (ABPM) which has remarkably improved the characterization of high and low risk hypertensive states. He reviewed for the audience the current steps to be used in the detection, management, and prevention of the complications that may develop in hypertensive patients. He particularly brought to the physician-audience's attention that very small elevations in blood pressure, over the long-term, can and do increase the development of cardiovascular complications such as stroke, myocardial infarction, and kidney disease.

Loren Laine, MD, Professor of Medicine at the Keck School of Medicine, University of Southern California, who is a renowned gastroenterologist, then reviewed the current body of clinical information that characterizes the risk of severe gastrointestinal complications (eg, life-threatening bleeds and/or intestinal perforation) seen during the use of NSAID therapy. He identified for the audience the high-risk patients and clinical strategies that are available to reduce the risk of gastrointestinal complications.

After a lunch break, the audience then heard again from Dr. White, who discussed NSAID-related thrombovascular complications, and Dr. Whelton, who shared arthritis management guidelines as well as FDA product labels for NSAIDs, prescription analgesics, and over-the-counter analgesics. The faculty then discussed 3 illustrative patient case histories with the audience, during which the audience played a lively interactive role.

At the end of the symposium, attendees were awarded 6.0 AMA PRA Category 1 Credits(TM). Four hours of the symposium also accrued toward the 12 hours of CME credit on pain management and/or appropriate care and treatment of the terminally ill that most California-licensed physicians are required to take per state law.

Participants evaluated the scientific and educational content of the symposium and the results of the latter evaluation were that, without question, the symposium was exceedingly beneficial from an educational standpoint and that the faculty presenters were outstanding. In fact, the physician-audience members were highly vocal in requesting additional CME activities that would fulfill their clinical needs as effectively as the arthritis symposium that CMEFirst developed.

Finally, the symposium was enhanced with AV services that were flawlessly provided by The OM Group, a New York-based company available by calling 917-627-1840 or e-mailing

For further information on future CMEFirst programs, contact Erin Flanagan at or (973) 387-5539, ext. 708.

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