Hemophilia & Other Bleeding Disorders

Welcome to the Blood CME Center’s Hemophilia and Other Bleeding Disorders Education Center. This educational channel has been developed by experts in congenital and acquired factor deficiencies to deliver high–quality, clinically practical education to clinicians dedicated to treating patients with hemophilia and other bleeding and clotting disorders. Exclusive CME programs include interactive learning activities and personalized modular learning forums.

 
 
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“Clinical Challenges in Your Hemophilia Treatment Center”
Credits: 0.75 CME / 0.8 CNE Expires: 12/2012
This interactive learning activity, part of the “CME/CE NetWorkShopstm” Webinar series, brings together two hemophilia experts to discuss current issues and practices in hemophilia care. Noted Blood CME Center faculty Mark Reding, MD, and Leonard Valentino, MD, address such topics as burden of illness, including demographics and indirect costs of hemophilia care, current prophylactic practices at US hemophilia treatment centers, use of bypassing agents, and the impact of persistent pain on patient quality of life.


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“Hemophilia Today: What Clinicians Really Want to Know”
Credits: 1.5 CME / 1.5 CNE Expires: 11/2012
Although standards and criteria for the care of persons with congenital bleeding disorders published by the National Hemophilia Foundation provide guidance to member clinicians and those practicing in hemophilia treatment centers (HTCs), other healthcare providers who treat patients with these disorders may not have as much personal experience and/or ready access to these resources. This educational activity features three renowned experts in the field of bleeding disorders, Victor S. Blanchette, MD; Meera B. Chitlur, MD; and Steven W. Pipe, MD, who address some common gaps in knowledge by providing professional opinion on current and emerging therapies and clinical challenges associated with managing patients with hemophilia.


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“The Aging Hemophilia Patient: Comorbidities and Management Issues”
Credits: 0.5 CME / 0.5 CNE Expires: 8/2012
For clinicians treating aging hemophilia patients, there is little evidence-based data to guide the management of chronic and acute medical conditions. In this learning activity, bleeding disorder expert Louis M. Aledort, MD, assesses the prevalence of diseases of aging in older hemophilia patients and examines potential management plans for age-related comorbidities such as cardiovascular disease and joint disease.


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“Hemophilia Clinical Consults: Epidemiology, Clinical Course, and Management of Acquired Hemophilia A”
Credits: 1.0 CME / 1.0 CNE Expires: 6/2012
The incidence of acquired hemophilia A occurs between approximately 1.34 and 1.48 per 1 million per year and predominantly affects older patients. Due to the subcutaneous, muscle, or gastrointestinal bleeding that presents with the disease, specialty physicians need to be aware of possible clinical presentations and treatment options. In this case-based learning activity, Craig Kessler, MD, and Mariasanta Napolitano, MD, both from the Lombardi Comprehensive Cancer Center at Georgetown University Medical Center in Washington, DC, discuss the pathogenesis and treatment of acquired hemophilia A and engage in a Q&A exchange regarding various clinical presentations and diagnoses.


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“STAT: An Interactive Learning Activity About Bleeding Disorders and Coagulation Deficiencies for EM Residents”
Credits: Not for credit
Patients with coagulation deficiencies, either congenital or acquired, may bleed spontaneously with either trauma or surgical intervention. Additionally, patients with unknown bleeding disorders not treated at hemophilia treatment centers usually seek immediate care from an emergency room. In a symposium held in conjunction with the Society for Academic Emergency Medicine Annual Meeting, Peter Kouides, MD; David Green, MD; Thomas Ortel, MD, PhD; Michael Paidas, MD; and Mark Walsh, MD, discussed several topics pertinent to EM residents who may encounter bleeding disorders. Topics included the epidemiology and clinical characteristics of adult bleeding disorders, coagulation tests and assays, taking a bleeding history, platelet function testing, and the female bleeding patient in the emergency room.


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“Clinical Decisions in the Emergency Department: Pros and Cons of Managing Oral Anticoagulant-Associated Hemorrhages and Acute Traumatic Coagulopathy”
Credits: Not for credit
Widespread use of anticoagulants has led to an increase in bleeding episodes seen in emergency departments. The best strategy for reversal of coaguloathy associated with warfarin-related bleeding is still under debate. In a dinner symposium held in conjunction with the Annual Meeting of the Society for Academic Emergency Medicine, W. Frank Peacock, MD; Bryan A. Cotton, MD, MPH; and David A. Garcia, MD, discussed the interpretation of current coagulation assays and their impact on clinical decisions; best practices for the rapid reversal of anticoagulant-associated intracerebral hemorrhage; and the reversal of acute traumatic coagulopathy in patients presenting to the emergency department.


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“Hemophilia Clinical Consults: Hemophilic Arthropathy, Reduced Bone Density, and Preventive Strategies”
Credits: 1.0 CME / 1.0 CNE Expires: 6/2012
Hemophilic arthropathy is the signature characteristic of hemarthroses, and has a negative impact on patient quality of life, often resulting in pain and disability. In this case-based learning activity, Leonard A. Valentino, MD, and Audrey C. Taylor, RN, MSN, FNP-BC, examine clinical cases in which patients experiencing hemophilic arthrophathy are evaluated, and provide clinical discussion on the prevention and management of hemophilic arthropathy and other musculoskeletal disorders.


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“Transitioning From Pediatric to Adult Hemophilia Care: Managing Lifestyle and QoL Challenges”
Credits: 0.5 CME / 0.5 CNE Expires: 6/2012
Due to advances in hemophilia treatment, patients with the disease are experiencing increased survival and reduced morbidity. In this learning activity, bleeding disorder expert Roshni Kulkarni, MD, assesses the importance of transitional care services for adolescent hemophilia patients going into adult-centered care and explores the various issues that comprehensive care teams may encounter during the transition of treatment.


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“Hemophilia Clinical Consults: Inhibitor Formation, Management, and Therapeutic Options”
Credits: 1.0 CME / 1.0 CNE Expires: 5/2012
Hemophilia patients with inhibitors carry both a higher economic burden and higher burden of physical disability when compared to non-inhibitor patients. Hemophilia expert Guy Young, MD, and Karen Gee, RN, BSN, CPHON, outline 3 clinical cases in which hemophilia patients present with inhibitors and provide clinical discussion on emerging treatment strategies, dosing of the bypassing agents, and prophylactic bypassing therapy.


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“Hemophilia Clinical Consults: Therapeutic Decisions in the Perioperative Management of Patients With Hemophilia A Undergoing Surgery”
Credits: 1.0 CME / 1.0 CNE Expires: 5/2012
Few guidelines exist for the management of surgery in hemophilia patients. In this case-based learning activity, Louis M. Aledort, MD, MACP, and Johanna McCarthy, RN, examine 3 clinical cases in which hemophilia patients undergo surgical procedures, and provide clinical discussion on the perioperative management of hemophilia A patients with no inhibitors, perioperative management of patients with inhibitors, and dosing strategies for bypassing agents.


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“Current Strategies for the Surgical Management of Patients With Congenital Bleeding Disorders”
Credits: Not for credit
Patients with congenital bleeding disorders are at risk for poor outcomes due to the clinical challenges present during surgical procedures. In a dinner symposium held in conjunction with the 2011 ASPHO (American Society of Pediatric Hematology/Oncology) Annual Meeting, Victor S. Blanchette, MD, FRCP, Head of the Division of Hematology/Oncology at the Hospital for Sick Children; Steven W. Pipe, MD, Associate Professor of Pediatrics and Pathology at C.S. Mott Children’s Hospital, University of Michigan; and Meera B. Chitlur, MD, Assistant Professor, Division of Pediatric Hematology/Oncology at Children’s Hospital of Michigan, present on issues pertaining to the perioperative management of patients with congenital bleeding disorders. As part of their discussion, these noted experts address hemophilic and non-hemophilic inhibitors of coagulation, standard and emerging coagulation tests, and novel and experimental clotting factors.


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“Practical Strategies for Managing Hemophilia and Preventing Inhibitor Development”
Credits: Not for credit
The goal of hemophilia therapy is to treat and prevent bleeding episodes and related complications, such as inhibitor development, by replacing the deficient clotting factor. In this learning activity, bleeding disorder expert Leonard A. Valentino, MD, assesses the benefits and risks of plasma-derived and recombinant factor replacement therapies and examines effective inhibitor prevention strategies, including prophylaxis and the avoidance of immunological danger signals.


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“Prophylaxis in Hemophilia Patients Without Inhibitors and Its Impact on Inhibitor Development”
Credits: 0.5 CME / 0.5 CNE Expires: 3/2012
Prophylaxis is currently considered the optimal treatment for hemophilia management. However, the treatment poses a risk for inhibitor formation, with the highest risk being present during the first 20 exposure days. In this learning activity, Leonard A. Valentino, MD, reviews emerging trends and issues relevant to the treatment of hemophilia patients without inhibitors, and the impact of prophylaxis on inhibitor development.


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“Prophylaxis in Hemophilia: Do Immunologic Danger Signals or Pharmacokinetics Hold Relevance?”
Credits: 0.75 CME / 0.75 CNE Expires: 3/2012
Pediatric hematologist Donald L. Yee, MD, offers his expert opinion on the role of prophylaxis in the management of hemophilia patients, with a focus on inhibitor risk. In explicating data from clinical studies comparing prophylaxis with on-demand treatment, Dr. Yee draws on current danger signal theories that advance the argument that low-dose prophylaxis may reduce the incidence of inhibitors. Dr. Yee also addresses the role of pharmacokinetics and the impact of factor VIII trough levels on prophylaxis efficacy, as well as dose tailoring as a cost-effective treatment strategy when designing a prophylaxis regimen.


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“HTC CME NetWorkShopsTM: Current Issues and Trends in Hemophilia Care”
Credits: 1.0 CME / 1.0 CNE Expires: 3/2012
Clinicians at hemophilia treatment centers (HTCs) need to be aware of the latest developments in hemophilia; however, HTC staff are not always able to attend congresses where current trends in treatment are discussed. In this eMonograph, several noted experts in hemophilia have collaborated to present recent evidence and findings in such areas as inhibitor development, treatment strategies, and hemophilia B.


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“Early Prophylaxis and the Influence of Immunologic “Danger Signals” on Inhibitor Development”
Credits: 0.5 CME / 0.5 CNE Expires: 2/2012
Inhibitor development in hemophilia patients can be a multifactorial process, involving both patient- and treatment-related risk factors. A patient’s immune system also plays a key role in response to exogenous factor exposure. In this learning activity, hemophilia expert Donald L. Yee, MD, examines how the risk for inhibitor development may be decreased through early and regular factor exposure in the absence of immunologic “danger signals.”


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“Management of High-Titer FVIII Inhibitors”
Credits: Not for credit
In this activity, Michael Recht, MD, PhD, explores the efficacy of prophylactic bypassing therapies in hemophilia A patients with inhibitors and examines evidence from comparative trials of FEIBA and rFVIIa as on-demand treatment in this patient cohort.


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“Elective Orthopedic Surgery in Patients With Inhibitors: Preoperative and Postoperative Care”
Credits: Not for credit
What type of care is required of hemophilia A patients with inhibitors who elect to undergo orthopedic surgery? A nurse and a physical therapist discuss the preoperative and postoperative challenges such patients present to the hemophilia treatment center team. Issues addressed in this podcast include the importance of patient education, dosing of bypassing agents, calculation of factor requirements, preoperative and postoperative exercise programs, and the importance of physical therapy in the surgical patient’s rehabilitative process. An actual patient with inhibitors provides his viewpoint on the orthopedic surgery he has had and discusses his concerns, rehabilitation program, and quality-of-life issues.

Ref No Description
     
029 Clinical Challenges in Your Hemophilia Treatment Center Learning activity addresses clinical challenges in hemophilia treatment centers
028 The Aging Hemophilia Patient: Comorbidities and Management Issues Learning activity concerning management issues of the aging hemophilia patient
026 Hemophilia Clinical Consults: Epidemiology, Clinical Course, and Management of Acquired Hemophilia A Interactive, case-based learning activity regarding the epidemiology, clinical presentation, and management of patients with acquired hemophilia A
025 Hemophilia Clinical Consults: Hemophilic Arthropathy, Reduced Bone Density, and Preventive Strategies Case-based learning activity exploring preventive strategies for hemophilic arthropathy, and clinical characteristics
024 Transitioning From Pediatric to Adult Hemophilia Care: Managing Lifestyle and QoL Challenges Learning activity concerning the transition from pediatric to adult hemophilia care
023 Hemophilia Clinical Consults: Inhibitor Formation, Management, and Therapeutic Options Case-based, interactive learning activity exploring the natural history of inhibitors and available management and therapeutic options
022 Hemophilia Clinical Consults: Therapeutic Decisions in the Perioperative Management of Patients With Hemophilia A Undergoing Surgery Case-based learning activity exploring surgical procedures in hemophilia A patients and factors to consider during perioperative management
021 Practical Strategies for Managing Hemophilia and Preventing Inhibitor Development Clinical Insight featuring discussion of inhibitor prevention and treatment strategies in hemophilia
020 Prophylaxis in Hemophilia Patients Without Inhibitors and Its Impact on Inhibitor Development Presentation on the impact of prophylaxis on inhibitor development and its use in hemophilia patients without inhibitors
019 Prophylaxis in Hemophilia: Do Immunologic Danger Signals or Pharmacokinetics Hold Relevance? Presentation on prophylaxis and potential immunologic triggers of inhibitor development
018 HTC CME NetWorkShopsTM: Current Issues and Trends in Hemophilia Care Learning activity concerning issues and trends in hemophilia treatment centers
017 Early Prophylaxis and the Influence of Immunologic ‘Danger Signals’ on Inhibitor Development Learning activity concerning immunologic “danger signals” and the effects of early prophylaxis on inhibitor development
016 Pathophysiology of Joint Bleeding and Synovitis: The Impact on Joint Health Learning activity on the impact of joint bleeding and synovitis on joint health.
015 Safe Use of Radiosynovectomy for Chronic Hemophilic Synovitis Learning activity on the safety issues associated with radiosynovectomy for treating hemophilic synovitis
014 Treatment Decisions and Clinical Outcomes in Hemophilia B Patients With Inhibitors Presentation on treatment decisions and clinical outcomes for inhibitor patients with FIX deficiency
013 FIX Deficiency and Inhibitors: Report From the ISTH-SSC International Registry Learning activity concerning the ISTH-SSC International Registry and hemophilia B with inhibitors
012 Clinical Challenges in Your Hemophilia Treatment Center Learning activity concerning clinical challenges in hemophilia treatment centers
011 Management of High-Titer FVIII Inhibitors Learning activity on managing FVIII inhibitors in hemophilia A patients.
010 Radiosynovectomy in Hemophilia Learning activity concerning the use of radiosynovectomy as a treatment for hemophilic synovitis.
009 The Nurse Coordinator’s Perspective on Managing Hemophilia Patients With Inhibitors Clinical Insight featuring discussion of the nurse coordinator’s role in hemophilia care and managing hemophilia patients with inhibitors
008 Perspectives in Hemophilia: Clinical Challenges and Current Issues in Managing Patients With Inhibitors Learning activity concerning clinical challenges in managing hemophilia patients with inhibitors.
007 Expert Opinion: The Clinical Importance of Adhering to Preventive PT Regimens for Minimizing Joint Damage Presentation on the benefits of PT for hemophilia patients
006 Hemophilia Consults: Should Patients With Inhibitors Receive Prophylaxis With Bypassing Agents? Learning activity concerning use of prophylactic bypassing therapy in hemophilia patients with inhibitors.
005 Perspectives in Hemophilia: Clinical Challenges and Current Issues in Managing Patients With Inhibitors Presentation from the 2010 American Society of Pediatric/Hematology/Oncology Annual Meeting
003 Elective Orthopedic Surgery in Patients With Inhibitors: The Hematologist/Orthopedic Surgeon Consult Expert commentary on orthopedic surgery in hemophilia A patients with inhibitors
002 Elective Orthopedic Surgery in Patients With Inhibitors: Preoperative and Postoperative Care Preoperative and postoperative care of hemophilia A patients with inhibitors
001 Elective Orthopedic Surgery in Patients With Inhibitors: Preoperative and Postoperative Care Preoperative and postoperative care of hemophilia A patients with inhibitors

 

 

 

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