Clearing the Confusion: Diagnosis and Treatment of Fibromyalgia and Associated Comorbidities (if: I found what I read about this course reassuring that good science is starting to prevail for FM. Hopefully I inferred correctly, and hopefully we're next.) Jointly Sponsored by the University of California, Irvine School of Medicine and CME Enterprise. Release Date: June 29, 2009 Expiration Date: June 28, 2010 Supported by an educational grant from Eli Lilly and Company Eli Lilly and Company Overview This activity will be taught and facilitated by recognized experts in fibromyalgia. Utilizing slides and audio from didactic lectures and a question-and-answer session, epidemiologic data, ethnic disparities, and current clinical practice guidelines for the diagnosis and treatment of patients with fibromyalgia will be presented. Emphasis will be placed on current evidence suggesting a common pathophysiology between fibromyalgia and its common comorbid conditions. The accurate diagnosis of common comorbidities associated with fibromyalgia and their impact on evidence-based pharmacological and nonpharmacological treatment recommendations for patients with fibromyalgia will also be discussed. Statement of Need Fibromyalgia is a relatively common chronic pain condition which causes substantial morbidity and disability affecting roughly 2% of the population, or 5 million Americans, especially women ages 45 to 75. The numerous comorbid disorders and symptoms present in patients with fibromyalgia, including affective spectrum disorders, fatigue, sleep disturbance, and cognitive disturbances, appear to result from common underlying pathophysiological abnormalities. Research into pharmacological and nonpharmacological therapies is evolving rapidly, with the recent publication of evidence-based clinical practice recommendations, and the first FDA-approved pharmacological treatments. Despite these developments and the recognition of fibromyalgiaas a disease entity by the American College of Rheumatology, the American Pain Society, the European League Against Rheumatism, the American Medical Association, the World Health Organization, and the National Institutes of Health, some confusion still surrounds the validity, identification, and treatment of fibromyalgia, among both physicians and patients. Healthcare professionals caring for patients with fibromyalgia would benefit from an in-depth discussion of the current state of the science regarding this condition. Who Should Participate This activity is intended for internal medicine physicians and other healthcare professionals interested in the diagnosis and treatment of fibromyalgia. Learning Objectives At the conclusion of this activity, the participant should be able to 1. Apply American Pain Society guidelines and American College of Rheumatology criteria for the accurate diagnosis of fibromyalgia in the primary care setting. 2. Summarize the role of central pain augmentation in the pathophysiology of fibromyalgia and associated comorbidities and its impact on treatment. 3. Identify common comorbidities and define their influence on fibromyalgia diagnosis and treatment. 4. Integrate evidence-based clinical practice guidelines into pharmacological and nonpharmacological treatment plans tailored to the patients primary presentation and comorbidities. 5. Assimilate into practice cultural awareness of ethnic disparities in the diagnosis and treatment of fibromyalgia. FACULTY AND AFFILIATIONS Chairperson Don L. Goldenberg, MD Chief of Rheumatology, Newton-Wellesley Hospital Newton, Massachusetts Professor of Medicine, Tufts University School of Medicine Boston, Massachusetts Stuart L. Silverman, MD, FACP, FACR Attending Physician, Cedars-Sinai Medical Center Clinical Professor of Medicine and Rheumatology, David Geffen School of Medicine at University of California, Los Angeles Medical Director, Osteoporosis Medical Center Beverly Hills, California To view faculty bios click here This activity was recorded live at a dinner meeting on Thursday, April 23, 2009 in Philadelphia, Pennsylvania at the Loews Philadelphia Hotel ACTIVITY AGENDA 35 minutes Understanding and Diagnosing Fibromyalgia and Common Comorbidities Don Goldenberg, MD Chief of Rheumatology, Newton-Wellesley Hospital Newton, Massachusetts Professor of Medicine, Tufts University School of Medicine Boston, Massachusetts 35 minutes Optimizing Treatment for Fibromyalgia Stuart L. Silverman, MD, FACP, FACR Attending Physician, Cedars-Sinai Medical Center Clinical Professor of Medicine and Rheumatology, David Geffen School of Medicine at University of California, Los Angeles Medical Director, Osteoporosis Medical Center Beverly Hills, California 15 minutes Questions and Answers (recorded from the live activity) 5 minutes Posttest and Evaluation FACULTY DISCLOSURE INFORMATION Faculty Disclosure In accordance with the ACCME Standards for Commercial Support, educational activities sponsored by the University of California, Irvine School of Medicine (UCI) must demonstrate balance, independence, objectivity, and scientific rigor. All faculty, authors, editors, and planning committee members participating in a UCI-sponsored activity are required to disclose any relevant financial interest or other relationship with the manufacturer(s) of any commercial product(s) and/or provider(s) of commercial services that are discussed in an educational activity. Dr. Goldenberg is a consultant for Abbott, Eli Lilly and Company, Forest Pharmaceuticals, Merck, and Pfizer Inc.; on the Speakers Bureau for Abbott, Merck, and Pfizer Inc.; and an advisor for Eli Lilly and Company. Dr. Silverman is a consultant for Merck, Novartis, Procter & Gamble, Roche, and Wyeth; on the Speakers Bureau for Eli Lilly and Company, Merck, Procter & Gamble, and Roche; and receives research support from Eli Lilly and Company, Merck, Novartis, Procter & Gamble, Roche, and Wyeth. In accordance with the ACCME Essential Areas and policies regarding commercial support, the audience is advised that the following faculty will discuss unlabeled or unapproved uses of drugs or devices. Dr. Goldenbergs presentation will include discussion of off-label, experimental, and/or investigational uses of amitriptyline, cyclobenzaprine, and fluoxetine in the management and treatment of patients with fibromyalgia. Dr. Silvermans presentation will include discussion of off-label, experimental, and/or investigational uses of amitriptyline, cyclobenzaprine, doxepin, gabapentin, gamma-hydroxybutyrate (sodium oxybate), imipramine, pramipexole, pregabalin, tramadol, and venlafaxine in the management and treatment of patients with fibromyalgia. The Planning Staff of the UCI School of Medicine and CME Enterprise have nothing to disclose. All presentations have been peer reviewed for evidence base and fair balance. The views and opinions expressed in this activity are those of the faculty and do not necessarily reflect the views of the University of California, Irvine School of Medicine and CME Enterprise. 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 the University of California, Irvine School of Medicine and CME Enterprise. The University of California, Irvine School of Medicine is accredited by the ACCME to provide continuing medical education for physicians. Credit Designation Statement The University of California, Irvine School of Medicine designates this educational activity for a maximum of 1.5 AMA PRA Category 1 Credits . Physicians should only claim credit commensurate with the extent of their participation in the activity.