Date: Thursday, April 8, 2010
Time: 12:30 pm — 2:00 pm
Location: Fairmont the Queen Elizabeth Hotel
Room: Marquette & Jolliet Room

TARGET AUDIENCE
This activity has been designed to meet the educational needs of hematologists, hemophilia specialists, hemophilia treatment center clinicians, and other healthcare providers interested in managing patients with hemophilia and/or attending the 2010 ASPHO meeting, as well as those enrolled in the Blood CME Center.

STATEMENT OF NEED/PROGRAM OVERVIEW
People with severe hemophilia infuse themselves with clotting factor therapy—factor VIII or factor IX—but as many as 30% of hemophilia A patients can develop inhibitors (which are relatively uncommon in hemophilia B, occurring in 2% to 3% of severely affected individuals). The development of inhibitors represents a major complication in the treatment of patients with severe hemophilia.

The short-term treatment objective is to control bleeding episodes; the long-term objective is to eradicate the inhibitor. Clinicians need to be more aware of and prepared to address the following clinical challenges and patient management issues should they arise:

• Inhibitor development, which has emerged as the most challenging remaining problem associated with hemophilia because it compromises effective hemostasis management in affected individuals and results in higher morbidity and costs of care compared with hemophilic individuals without inhibitors
• Prophylaxis with bypassing agents in hemophilia patients with inhibitors, which is a clinical challenge because bleeding associated with high-titer, high-responding inhibitors is often more difficult to control due to the unpredictable hemostatic effect of the bypassing therapy
• The presence of stable and long-lasting venous access (via central venous devices or arteriovenous fistulae) is essential for the feasibility of prophylaxis and immune tolerance induction in hemophilic children
• Frequent infusion of factor concentrates may be challenging in young boys with hemophilia, especially if their disease is complicated by inhibitors

EDUCATIONAL OBJECTIVES
After completing this activity, the participant should be better able to:

• Review the pathogenicity of inhibitory antibodies to factor VIII in patients with hemophilia A
• Review treatment-related risk factors and evidence of different hemostatic responses to bypassing agents in the treatment of patients with hemophilia with inhibitors
• Compare dosing and administration of the available bypassing agents
• Discuss the clinical and radiologic characteristics and disability associated with hemophilic arthropathy
• Evaluate data regarding the economic impact of prophylaxis versus on-demand therapy in patients with hemophilia and inhibitors
• Assess evidence and expert commentary regarding episodic treatment and prophylaxis to reduce acute bleeds and improve health-related quality of life
• Integrate patient-reported outcomes into management strategies that promote adherence and continue to prevent bleeds as boys age and grow physically

CHAIRPERSON
Victor S. Blanchette, MD, FRCP
Head, Division of Hematology/Oncology
Hospital for Sick Children
Professor of Pediatrics
University of Toronto
Toronto, Ontario, Canada

DISTINGUISHED FACULTY
Michael Recht, MD, PhD
Associate Professor of Pediatrics and Medicine
Director, The Hemophilia Center
Oregon Health & Science University
Portland, Oregon

Amy D. Shapiro, MD
Medical Director
Indiana Hemophilia and Thrombosis Center
Indianapolis, Indiana
Adjunct Professor of Pediatrics
Michigan State University
East Lansing, Michigan


PROGRAM AGENDA

12:30 pm - 1:00 pm	Registration and Lunch
1:00 pm - 1:15 pm	Introduction and Background to Inhibitor Development Victor S. Blanchette, MD, FRCP
1:15 pm - 1:30 pm	Management of High-Titer FVIII Inhibitors Michael Recht, MD, PhD
1:30 pm - 1:45 pm	ITI and Management of Inhibitors in Patients With Mild/Moderate Hemophilia A or B Amy D. Shapiro, MD
1:45 pm - 1:50 pm	Summary and Future Directions Victor S. Blanchette, MD, FRCP
1:50 pm - 2:00 pm	Q&A/Closing Remarks

PHYSICIAN CONTINUING MEDICAL EDUCATION
Accreditation Statement
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 Postgraduate Institute for Medicine (PIM), the Cardiovascular & Metabolic Health Foundation, and Educational Concepts in Medicine. PIM is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation
Postgraduate Institute for Medicine designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.


FEE INFORMATION
There is no fee for this educational activity.

A statement of credit will be issued only upon receipt of a completed activity evaluation form and will be mailed to you within 3 weeks (if applicable).

DISCLOSURE OF CONFLICTS OF INTEREST
Postgraduate Institute for Medicine (PIM) requires instructors, planners, managers, and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest they may have as related to the content of this activity. All identified conflicts of interest are thoroughly vetted by PIM for fair balance, scientific objectivity of studies mentioned in the materials or used as the basis for content, and appropriateness of patient care recommendations.

AMERICANS WITH DISABILITIES ACT
Event staff will be glad to assist you with any special needs (eg, physical, dietary). Please contact Client Services prior to the live event at (800) 732-2161.