Module

Join Stephane Chevaliez, PharmD, PhD; Paul J. Pockros, MD; and Stefan Zeuzem, MD, as they review and discuss key principles of HCV resistance with currently approved direct-acting antiviral agents, the latest resistance data on agents in development, and important considerations for potential future anti-HCV regimens. These expert faculty members also provide practical strategies for clinical challenges with the newly approved direct-acting agents through a case-based analysis.

Learning Objectives

Upon completion of this activity, participants should be able to:

  • Apply strategies to reduce the development/expansion of resistance to direct-acting antiviral agents when managing patients receiving treatment with approved direct-acting antiviral agents in combination with peginterferon/ribavirin
  • Integrate key principles regarding antiviral resistance when evaluating data on the direct-acting antiviral agents currently in development
  • Evaluate potential future strategies for HCV treatment based on resistance considerations, including the barrier to resistance and patterns of cross-resistance among classes of direct-acting antiviral agents

Topics covered include:

  • Introduction to Drug Resistance in Hepatitis C Virus
  • Key Resistance Principles for Currently Approved Direct-Acting Antiviral Agents
  • Considerations for Retreatment of Previous Peginterferon/Ribavirin Null Responders and Potential Consequences of Protease Inhibitor Resistance
  • Genotype and Resistance Testing
  • Case 1: Previous Null Responder
  • Case 2: Stopping Rules
  • Case 3: Boceprevir Resistance–Associated Variant
  • Future Regimens
  • Future Protease Inhibitors
  • Nucleos(t)ide Polymerase Inhibitors
  • Nonnucleos(t)ide Polymerase Inhibitors
  • NS5A Inhibitors
  • Cyclophilin Inhibitors
  • Summary: Important Considerations to Avoid Resistance-Associated Variants
  • Appendix: Principles of HCV Resistance
 

Program Directors

  • Stefan Zeuzem
    MD

Faculty

  • Stéphane Chevaliez
    PharmD, PhD
    Paul J. Pockros
    MD

Credit Information

  • Release Date:
    October 25, 2011
  • Expiration Date:
    October 24, 2012
  • Physicians:
    maximum of 1.25 AMA PRA Category 1 Credits

Information on this Educational Activity

Disclosure of Conflicts of Interest

The Annenberg Center assesses conflict of interest with its instructors, planners, managers, and other individuals who are in a position to control the content of CME activities. All relevant conflicts of interest that are identified are thoroughly vetted by the Annenberg Center for fair balance, scientific objectivity of studies utilized in this activity, and patient care recommendations. The Annenberg Center is committed to providing its learners with high-quality CME activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest.

The faculty reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:

 

Program Directors

Stefan Zeuzem, MD

Professor of Medicine
Chief, Department of Medicine I
JW Goethe University Hospital
Frankfurt, Germany

Stefan Zeuzem, MD, has disclosed that he has received fees for non-CME services from Bristol-Myers Squibb, Gilead Sciences, Janssen, Merck, Novartis, and Roche; and consulting fees from Abbott, Achillion, Anadys, Boehringer Ingelheim, Bristol-Myers Squibb, Gilead Sciences, Janssen, iTherX, Merck, Novartis, Pfizer, Pharmasset, Roche, Santaris, Tibotec, and Vertex.

 

Faculty

Stéphane Chevaliez, PharmD, PhD


French National Reference Center
for Hepatitis B, C and delta
Department of Virology & INSERM U955
Henri Mondor Hospital
University of Paris 12
Créteil, France

Stephane Chevaliez, PharmD, PhD, has disclosed that he has received grants for research support from Gilead Sciences, and consulting fees from Gilead Sciences, Merck, and Roche.
 

Paul J. Pockros, MD


Head, Division of Gastroenterology/Hepatology
Director, SC Liver Research Consortium
Clinical Director of Research, Scripps Translational Science Institute
The Scripps Clinic
La Jolla, California

Paul J. Pockros, MD, has disclosed that he has received grants for research support from Abbott, Bristol-Myers Squibb, Conatus, Genentech, Gilead Sciences, Janssen, Medpace/Mochida, Merck, Pfizer, and Vertex; fees for non-CME services from Bristol-Myers Squibb, Genentech, and Vertex; and consulting fees from Bristol-Myers Squibb, Gilead Sciences, Kadmon, Janssen, Merck, Roche, and Vertex.
 

Staff

Taryn O’Loughlin Gross, PhD


Senior Managing Editor

Taryn O’Loughlin Gross, PhD, has no significant financial relationships to disclose.
 

Edward King, MA


Vice President, Editorial
Clinical Care Options, LLC

Edward King, MA, has no significant financial relationships to disclose.
 

Jennifer M. Blanchette, PhD


Associate Managing Editor

Jennifer M. Blanchette, PhD, has no significant financial relationships to disclose.
 

Anna Poppa, 


Editorial Contributor

Anna Poppa has disclosed that she has received consulting fees from ViiV Healthcare.
 

The planners and managers reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:

The following planners and managers, Jan Hixon, RN, BSN, MA; Trace Hutchison, PharmD; Julia Kimball, RN, BSN; Samantha Mattiucci, PharmD; Jan Schultz, RN, MSN, CCMEP; Patricia Staples, MSN, NP-C, CCRN; and Gordon West, PhD, CCMEP, hereby state that they or their spouse/life partner do not have any financial relationships or relationships to products or devices with any commercial interest related to the content of this activity of any amount during the past 12 months.

Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The Annenberg Center, Postgraduate Institute for Medicine (PIM), Clinical Care Options, and activity supporters do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the Annenberg Center, PIM, Clinical Care Options, and activity supporters. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

 

Target Audience

This activity is intended for physicians and other healthcare providers involved in the care of patients infected with hepatitis C.


Goal

The goal of this activity is to address the causes and consequences of the emergence of resistance to novel agents for the management of hepatitis C, along with strategies to limit the clinical impact of resistance.


Learning Objectives

Upon completion of this activity, participants should be able to:

  • Apply strategies to reduce the development/expansion of resistance to direct-acting antiviral agents when managing patients receiving treatment with approved direct-acting antiviral agents in combination with peginterferon/ribavirin
  • Integrate key principles regarding antiviral resistance when evaluating data on the direct-acting antiviral agents currently in development
  • Evaluate potential future strategies for HCV treatment based on resistance considerations, including the barrier to resistance and patterns of cross-resistance among classes of direct-acting antiviral agents
 

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 through the joint sponsorship of the Annenberg Center for Health Sciences at Eisenhower and Clinical Care Options. The Annenberg Center for Health Sciences at Eisenhower is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation

The Annenberg Center for Health Sciences at Eisenhower designates this enduring material for a maximum of 1.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

European physicians can earn their ECMEC®s by completing e-learning programs from accredited CME providers from the United States, that have been certified for AMA PRA Category 1 Credits™. A procedure for the conversion of AMA PRA Category 1 Credits™ into ECMEC®s will be installed when appropriate.

 

Commercial Support


This program is supported by an educational grant from Roche.

 

Program Medium


This program has been made available online.

 

Site Requirements


  • Internet Explorer 7+, Firefox 3+, Safari 3+, or Chrome
  • JavaScript enabled
  • 1024x768+ screen resolution
  • Adobe Flash Player
 

Instructions for Credit

Participation in this self-study activity should be completed in approximately 1.25 hours. To successfully complete this activity and receive credit, participants must follow these steps during the period from October 25, 2011, through October 24, 2012:

1. Register online at http://www.clinicaloptions.com.
2. Read the target audience, learning objectives, and faculty disclosures.
3. Study the educational activity online or printed out.
4. Submit answers to the posttest questions and evaluation questions online.

You must receive a test score of at least 70% and respond to all evaluation questions to receive a certificate. After submitting the evaluation, you may access your online certificate by selecting the certificate link on the posttest confirmation page. Records of all CME activities completed can be found on the "CME Manager" page. There are no costs/fees for this activity.

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