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    Faculty & Disclosures
    Dr Leonard Bacharier

    Vanderbilt University Medical Center, Nashville, TN, USA

    Leonard Bacharier is the Janie Robinson and John Moore Lee chair of pediatrics and professor of pediatrics at Vanderbilt University Medical Center (VUMC), Nashville, TN, USA. He is also the section chief of pediatric allergy and immunology in the Department of Pediatrics, scientific director of the Center for Clinical and Translational Research and director of the Center for Pediatric Asthma Research at VUMC. read more

    Dr Bacharier is a paediatric allergist/immunologist with extensive experience in paediatric asthma research, particularly clinical trials. He has led and participated in multiple federally-funded multicenter clinical trials in childhood asthma. He has over 200 peer-reviewed manuscripts derived from these projects. He is the sole American paediatrician on the Global Initiative for Asthma Science Committee. Dr Bacharier serves as an associate editor for the Journal of Allergy and Clinical Immunology and is also the editor of two leading textbooks in the field of allergy and immunology.

    Dr Leonard Bacharier discloses: Advisory board/Panel fees from AstraZeneca (relationship terminated), GlaxoSmithKline (relationship terminated), Regeneron Pharmaceuticals, Sanofi and Vertex Pharmaceuticals. Consultancy fees from OMPharma. Speaker’s bureau Fees from Regeneron Pharmaceuticals.
    Dr Dermot Ryan

    University of Edinburgh, Scotland, UK

    Dermot Ryan is an honorary research fellow at the Usher Institute, University of Edinburgh, Scotland, UK. He is also vice president of the Respiratory Effectiveness Group and a director of the International Primary Care Respiratory Group. read more

    Dr Ryan was a principal in general practice for 30 years in Loughborough, UK. He has long been interested in asthma, having twice been chairman of Primary Care Respiratory Society. He was responsible for the establishment of the chair of primary care respiratory medicine at the University of Aberdeen. He contributed to two previous iterations of the British Asthma Guidelines produced by SIGN and the British Thoracic Society.

    He has authored or co-authored over 200 papers on asthma, chronic obstructive pulmonary disorder, allergic rhinitis, allergy, immunotherapy and electronic/mobile health in peer-reviewed journals.

    Dr Dermot Ryan discloses: Consultant fees from Regeneron Pharmaceuticals (relationship terminated) and Thermo Fisher Scientific. Speaker’s bureau fees from Glenmark Pharmaceuticals and Viatris (relationship terminated).
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    Diagnosing severe paediatric asthma
    Biologics for severe paediatric asthma
    Optimal management of severe paediatric asthma
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    Respiratory Disorders, Allergic Conditions CE/CME accredited

    touchIN CONVERSATION
    A relaxed discussion between two faculty focussed on real world clinical issues. Useful tips below will show how to navigate the activity. Join the conversation. Close

    Improving outcomes in severe paediatric asthma: New treatments, new possibilities

    Faculty Podcast Featured
    Useful tips
    • Downloads including slides are available for this activity in the Toolkit
    Learning Objectives

    After watching this activity, participants should be better able to:

    • Recall the symptoms associated with severe asthma in children
    • Summarize the clinical evidence supporting the use of biologics in children with severe asthma
    • Describe the optimal long-term management of children with severe asthma
    Overview

    In this activity, an asthma specialist and a primary care respiratory specialist respond to questions from healthcare professionals involved in the care of paediatric patients with severe asthma. They discuss the symptoms and diagnosis of childhood asthma, the latest data and rationale for the use of biologics in children, and the long-term management of these patients.

    This activity is jointly provided by USF Health and touchIME. read more

    Target Audience

    This activity has been designed to meet the educational needs of allergists, immunologists, paediatricians, pulmonologists and general practice physicians involved in the management of paediatric patients with severe paediatric asthma.

    Disclosures

    USF Health adheres to the Standards for Integrity and Independence in Accredited Continuing Education. All individuals in a position to influence content have disclosed to USF Health any financial relationship with an ineligible organization. USF Health has reviewed and mitigated all relevant financial relationships related to the content of the activity. The relevant relationships are listed below. All individuals not listed have no relevant financial relationships.

    Faculty

    Dr Leonard Bacharier discloses: Advisory board/Panel fees from AstraZeneca (relationship terminated), GlaxoSmithKline (relationship terminated), Regeneron Pharmaceuticals, Sanofi and Vertex Pharmaceuticals. Consultancy fees from OMPharma. Speaker’s bureau Fees from Regeneron Pharmaceuticals.

    Dr Dermot Ryan discloses: Consultant fees from Regeneron Pharmaceuticals (relationship terminated) and Thermo Fisher Scientific. Speaker’s bureau fees from Glenmark Pharmaceuticals and Viatris (relationship terminated).

    Content reviewer

    Karim Hanna, MD has no relevant financial relationships to disclose.

    Touch Medical Director

    Adriano Boasso has no financial interests/relationships or affiliations in relation to this activity.

    USF Health Office of Continuing Professional Development and touchIME staff have no financial interests/relationships or affiliations in relation to this activity.

    Requirements for Successful Completion

    In order to receive credit for this activity, participants must review the content and complete the post-test and evaluation form. Statements of credit are awarded upon successful completion of the post-test and evaluation form.

    If you have questions regarding credit please contact cpdsupport@usf.edu 

    Accreditations

    Physicians

    This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through a joint providership of USF Health and touchIME. USF Health is accredited by the ACCME to provide continuing medical education for physicians.

    USF Health designates this enduring material for a maximum of 0.75 AMA PRA Category 1 CreditTM.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    The European Union of Medical Specialists (UEMS) – European Accreditation Council for Continuing Medical Education (EACCME) has an agreement of mutual recognition of continuing medical education (CME) credit with the American Medical Association (AMA). European physicians interested in converting AMA PRA Category 1 CreditTM into European CME credit (ECMEC) should contact the UEMS (www.uems.eu)

    Advanced Practice Providers

    Physician Assistants may claim a maximum of 0.75 Category 1 credits for completing this activity. NCCPA accepts AMA PRA Category 1 CreditTM from organizations accredited by ACCME or a recognized state medical society.

    The AANPCP accepts certificates of participation for educational activities approved for AMA PRA Category 1 CreditTM by ACCME-accredited providers. APRNs who participate will receive a certificate of completion commensurate with the extent of their participation.

    Date of original release: 15 December 2022. Dates credits expire: 15 December 2023.

    If you have any questions regarding credit please contact cpdsupport@usf.edu

     

    This activity is CE/CME accredited

    To obtain the CE/CME credit(s) from this activity, please complete this post-activity test.

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    Topics covered in this activity

    Respiratory Disorders / Allergic Conditions
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    This Activity Is Funded By:

    An independent medical educational grant from Sanofi and Regeneron Pharmaceuticals. This activity is jointly provided by USF Health and touchIME.

    The information provided by this CME activity is for continuing education purposes only and is not meant to substitute for the independent medical/clinical judgment of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition.

    USF is an Equal Opportunity / Affirmative Action / Equal Access Institution.

    USF Health is accredited by the Accreditation Council for Continuing Medical Education, the American Nurses Credentialing Center and the Accreditation Council for Pharmacy Education to provide continuing education to healthcare professionals. As an accredited provider, USF Health is required to disclose personal information to relevant accredited bodies that certify CME to process credits/contact hours, comply with reporting requirements, and for internal recordkeeping and regulatory purposes. USF Health does not share or sell any individual’s contact information or unique identifiers to any commercial supporter, advertiser, or third party without the specific permission of the individual.

    Unapproved products or unapproved uses of approved products may be discussed by the faculty; these situations may reflect the approval status in one or more jurisdictions. The presenting faculty have been advised by touchIME and USF Health to ensure that they disclose any such references made to unlabelled or unapproved use. No endorsement by touchIME or USF Health of any unapproved products or unapproved uses is either made or implied by mention of these products or uses in touchIME or USF Health activities. touchIME and USF Health accept no responsibility for errors or omissions.

    This content is intended for healthcare professionals.

    Date of original release: 15 December 2022. Dates credits expire: 15 December 2023.

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    touchIN CONVERSATION
    Improving outcomes in severe paediatric asthma: New treatments, new possibilities
    0.75 CE/CME credit
    Question 1/5
    A 9-year-old boy, who was diagnosed with asthma based on spirometry and FEV1, has been receiving medium-dose ICS-LABA treatment for 9 months. He has returned to your clinic as his symptoms remain uncontrolled. What should your next step be before making a diagnosis of severe asthma?

    FEV1, forced expiratory volume in 1 second; ICS, inhaled corticosteroids; IgE, immunoglobulin E; LABA, long-acting beta2-agonist; OCS, oral corticosteroids.

    Environmental or behavioural risk factors can worsen asthma symptoms and interfere with disease control.1,2 Managing these risk factors can help reduce the risk of exacerbations.1 Patients should be assessed for management of potentially modifiable risk factors, such as ensuring proper inhaler technique and treatment adherence, and ensuring comorbidities, such as allergic rhinitis, are correctly managed.1

    References

    1. Global Initiative for Asthma. Available at: https://ginasthma.org/wp-content/uploads/2022/07/GINA-Main-Report-2022-FINAL-22-07-01-WMS.pdf (accessed 14 November 2022).
    2. Martin J, et al. BMJ Paediatr Open. 2022;6:e001277.
    Question 2/5
    When should biologics be initiated in children with a confirmed asthma diagnosis?

    ICS, inhaled corticosteroids; LABA, long-acting beta2-agonist; OCS, oral corticosteroids.

    According to the GINA Global Strategy, patients with asthma that remains uncontrolled despite adherence to medium- or high-dose ICS-LABA and management of other contributing factors, should be referred for phenotypic assessment before initiating treatment with biologic therapy.

    Abbreviations

    GINA, Global Initiative for Asthma; ICS, inhaled corticosteroids; LABA, long-acting beta2-agonist.

    Reference

    Global Initiative for Asthma. Available at: https://ginasthma.org/wp-content/uploads/2022/07/GINA-Main-Report-2022-FINAL-22-07-01-WMS.pdf (accessed 14 November 2022).

    Question 3/5
    How can you support parents or carers to better manage the symptoms of your paediatric patients with severe asthma?

    Patients should be checked for potentially modifiable risk factors as part of their asthma assessment.1 Factors such as environmental exposure to allergens, exposure to smoke, viral respiratory tract infections or comorbidities can trigger symptom onset and should be monitored and managed where possible.1,2

    References

    1. Global Initiative for Asthma. Available at: https://ginasthma.org/wp-content/uploads/2022/07/GINA-Main-Report-2022-FINAL-22-07-01-WMS.pdf (accessed 14 November 2022).
    2. Martin J, et al. BMJ Paediatr Open. 2022;6:e001277.
    Question 4/5
    Which of the following is predictive of response to biologic therapy?

    CT, computed tomography; FeNO, fractional exhaled nitric oxide; IgE, immunoglobulin E.

    Patient assessment can guide biologic selection. Eosinophilic inflammation is driven by type-2 cytokines, and elevated blood eosinophil count is a predictive biomarker of biologic therapy efficacy. Increased FeNO is also predictive of improved response to various biologic agents, although not for anti-IL-5 agents.1 Combined elevated eosinophils and increased FeNO may also further increase the predictive power of these biomarkers.2

    Abbreviations

    FeNO, fractional exhaled nitric oxide; IL-5, interleukin 5.

    References

    1. Runnstrom M, et al. J Inflamm Res. 2022;15:241–9.
    2. Kroes J, et al. Biochem Pharmacol. 2020;179:113978.
    Question 5/5
    Which of the following statements about asthma presentation in children is true?

    Respiratory symptoms are common in children and are often non-specific or appear as respiratory infections.1 These non-specific symptoms should not be used for diagnosis.1 Symptoms in children are usually virally triggered and patients may present few symptoms prior to experiencing an upper airway infection.2 Instead, diagnosis should be based on documented airflow limitation.1,3

    References

    1. Gaillard E, et al. Eur Respir J. 2021;58:2004173.
    2. Trivedi M, Denton E. Front Pediatr. 2019;7:256.
    3. Global Initiative for Asthma. Available at: https://ginasthma.org/wp-content/uploads/2022/07/GINA-Main-Report-2022-FINAL-22-07-01-WMS.pdf (accessed 14 November 2022).
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    Improving outcomes in severe paediatric asthma: New treatments, new possibilities

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    This Activity Is Funded By:

    An independent medical educational grant from Sanofi and Regeneron Pharmaceuticals. This activity is jointly provided by USF Health and touchIME.

    The information provided by this CME activity is for continuing education purposes only and is not meant to substitute for the independent medical/clinical judgment of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition.

    USF is an Equal Opportunity / Affirmative Action / Equal Access Institution.

    USF Health is accredited by the Accreditation Council for Continuing Medical Education, the American Nurses Credentialing Center and the Accreditation Council for Pharmacy Education to provide continuing education to healthcare professionals. As an accredited provider, USF Health is required to disclose personal information to relevant accredited bodies that certify CME to process credits/contact hours, comply with reporting requirements, and for internal recordkeeping and regulatory purposes. USF Health does not share or sell any individual’s contact information or unique identifiers to any commercial supporter, advertiser, or third party without the specific permission of the individual.

    Unapproved products or unapproved uses of approved products may be discussed by the faculty; these situations may reflect the approval status in one or more jurisdictions. The presenting faculty have been advised by touchIME and USF Health to ensure that they disclose any such references made to unlabelled or unapproved use. No endorsement by touchIME or USF Health of any unapproved products or unapproved uses is either made or implied by mention of these products or uses in touchIME or USF Health activities. touchIME and USF Health accept no responsibility for errors or omissions.

    This content is intended for healthcare professionals.

    Date of original release: 15 December 2022. Dates credits expire: 15 December 2023.

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