Treatment options for a patient who is breastfeeding
Question:
I have a 37-year-old female patient who has moderate psoriasis with scalp and face involvement. She was being treated with UVB two to three times per week and calcipotriene until she became pregnant, at which point she continued with UVB therapy alone. She is now 2 months postpartum and wants to “recover” from pregnancy as quickly as possible, including getting back to her prepregnancy clearance. My patient is breastfeeding and says she plans to continue until her son reaches 1 year. She is having issues with phototherapy since it requires frequent visits. What can I offer her?
Please read the CME information below and click Begin Activity at the bottom of this page to continue to the answer.
Release date: January 2011
Expiration date: January 31, 2012
Estimated time to complete activity: 15 minutes
This educational initiative is provided by Curatio CME Institute, the University of Chicago, and the Society of Dermatology Physician Assistants. This activity was created in collaboration with the National Psoriasis Foundation, the Dermatology Nurses’ Association, and the International Psoriasis Council.
Support for this activity has been provided through an educational grant from Centocor Ortho Biotech.
Activity Overview
Questions submitted to Ask the Expert and the answers provided by the members of our panel will be posted on PsoriasisTx.com along with supporting literature where appropriate.
Target Audience
This activity has been designed to meet the educational needs of dermatologists and other health care professionals involved in the care of patients with psoriasis.
Learning Objectives
Each Ask the Expert activity will have one of the learning objectives listed below associated with it.
Upon completion of this activity, participants should be able to:
- Develop practical strategies to optimize the treatment of patients with moderate to severe psoriasis across a wide range of real-world clinical scenarios
- Develop strategies for managing a diverse set of patients with psoriasis that include consideration of comorbid disease and concomitant conditions
- Distinguish comorbid conditions that can affect the treatment of patients with moderate to severe psoriasis
- Formulate a treatment plan that can be used in a pregnant or breastfeeding patient with psoriasis or psoriatic arthritis
- Describe the mechanisms of action of traditional and biologic systemic agents and how they relate to potential safety issues
- Integrate strategies for managing safety-related issues in patients receiving long-term therapy with biologic agents
Faculty
Listed below is the faculty panel for the Ask the Expert section of PsoriasisTx.com. One faculty member has been selected to answer this Ask the Expert question based on his or her area of expertise.
Alan Menter, MD
Jerry Bagel, MD
Jeffrey J. Crowley, MD
Kenneth B. Gordon, MD
Neil J. Korman, MD, PhD
Kristine Kucera, DHS, MPAS, PA-C
Melodie Young, MSN, RN, A/GNP-C
Accreditation
Physicians and Physician Assistants
The University of Chicago is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
The University of Chicago designates this educational activity for a maximum of 0.25 AMA PRA Category 1 CreditTM. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Method of Participation
There are no fees for participating in this CME/CE activity. To receive credit during the period January 2011 to January 31, 2012, participants must (1) read the learning objectives and disclosure statements, (2) study the educational activity, and (3) complete the postsurvey and activity evaluation, including the certificate information section.
The postsurvey can be accessed at the end of the activity. Please e-mail any questions to cmeinfo@curatiocme.com.
Medium
The Internet was selected as the instructional format to accommodate the learning preferences of a significant portion of the target audience.
Disclosure
In accordance with the ACCME Standards for Commercial Support and the ANCC Standards on Disclosure and Commercial Support, all CME/CE providers are required to disclose to the activity audience the relevant financial relationships of everyone in a position to control content of an educational activity. A relevant financial relationship is a relationship in any amount occurring in the last 12 months with a commercial interest whose products or services are discussed in the CME activity content over which the individual has control. Relationship information appears below:
Jerry Bagel, MD, has disclosed the following relevant financial relationships:
| Consultant | Abbott |
| Speaker | Abbott, Amgen, Centocor Ortho Biotech, Galderma |
Jeffrey Crowley, MD, has disclosed the following relevant financial relationships:
| Consultant | Abbott, Centocor Ortho Biotech |
| Principal Investigator | Abbott, Amgen, Lilly |
| Speaker | Abbott |
Kenneth B. Gordon, MD, has disclosed the following relevant financial relationships:
| Consultant/Investigator | Abbott, Amgen, Centocor Ortho Biotech |
| Consultant | Merck |
Neil Korman, MD, PhD, has disclosed the following relevant financial relationships:
| Speaker/Consultant | Abbott, Amgen, Astellas, Centocor Ortho Biotech, Genentech |
Kristine Kucera, DHS, MPAS, PA-C, has disclosed the following relevant financial relationships:
| Speaker | Abbott, Amgen, Centocor Ortho Biotech, Warner-Chilcott |
Alan Menter, MD, has disclosed the following relevant financial relationships:
| Advisory Board/Speaker | Abbott, Amgen, Astellas, Centocor Ortho Biotech, Galderma, Genentech, Warner Chilcott, Wyeth |
| Consultant | Abbott, Amgen, Astellas, Centocor Ortho Biotech, Eli Lilly, Galderma, Genentech, Stiefel, Warner Chilcott, Wyeth |
| Investigator | Abbott, Allergan, Amgen, Astellas, Asubio, Celgene, Centocor Ortho Biotech, DUSA, Eli Lilly, Genentech, Novartis, Novo Nordisk, Pfizer, Promius, Stiefel, Syntrix Biosystems, Warner Chilcott, Wyeth |
Melodie Young, MSN, RN, A/GNP-C, has disclosed the following relevant financial relationships:
| Consultant | Abbott, Centocor Ortho Biotech, Coria Labs, Ortho |
| Speaker | Abbott, Centocor |
| Subinvestigator | Celgene |
Curatio CME Institute
The employees of Curatio CME Institute have disclosed no relevant financial relationships.
University of Chicago Center for Continuing Medical Education
The employees of the Center for Continuing Medical Education have disclosed no relevant financial relationships.
Dermatology Nurses’ Association
The employees of the Dermatology Nurses’ Association have disclosed no relevant financial relationships.
Society of Dermatology Physician Assistants
The employees of the Society of Dermatology Physician Assistants have disclosed no relevant financial relationships.
National Psoriasis Foundation
The employees of the National Psoriasis Foundation have disclosed no relevant financial relationships.
International Psoriasis Council
Paul Tebbey, PhD, has disclosed the following relevant financial relationships:
| Consultant | Incyte Pharmaceuticals |
| Employee | Baxter Healthcare |
Disclaimer
The information presented in this activity is for continuing medical education purposes only and is not meant to substitute for the independent medical judgment of a physician regarding diagnosis and treatment of a specific patient’s medical condition.
Hardware/Software Requirements
- JavaScript enabled Internet browser
Unapproved Product Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the US Food and Drug Administration. Curatio CME Institute, the University of Chicago, the Dermatology Nurses’ Association, the Society of Dermatology Physician Assistants, the National Psoriasis Foundation, the International Psoriasis Council, and Centocor Ortho Biotech do not recommend the use of any agent outside the labeled indications.
The opinions expressed in this educational activity are those of the faculty and do not represent the views of Curatio CME Institute, the University of Chicago, the Dermatology Nurses’ Association, the Society of Dermatology Physician Assistants, the National Psoriasis Foundation, the International Psoriasis Council, or Centocor Ortho Biotech. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Contact Information
PsoriasisTx.com
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Suite 103
Exton, PA 19341
editor@psoriasistx.com
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