Clearing the Confusion: Diagnosis and Treatment of FM and Associated Comorbidities

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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.
 

gracenote

All shall be well . . .
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Supported by an educational grant from Eli Lilly and Company.
I'm skeptical. See this article from the Huffington Post. I've only posted the first part.

http://www.huffingtonpost.com/2009/02/08/eli-lilly-pfizer-spent-mi_n_165045.html

Fibromyalgia, Questionable "Disease," Boosted By Eli Lilly And Pfizer, Reports AP

MATTHEW PERRONE | February 8, 2009 11:41 PM EST |

WASHINGTON Two drugmakers spent hundreds of millions of dollars last year to raise awareness of a murky illness, helping boost sales of pills recently approved as treatments and drowning out unresolved questions _ including whether it's a real disease at all.

Key components of the industry-funded buzz over the pain-and-fatigue ailment fibromyalgia are grants _ more than $6 million donated by drugmakers Eli Lilly and Pfizer in the first three quarters of 2008 _ to nonprofit groups for medical conferences and educational campaigns, an Associated Press analysis found.

That's more than they gave for more accepted ailments such as diabetes and Alzheimer's. Among grants tied to specific diseases, fibromyalgia ranked third for each company, behind only cancer and AIDS for Pfizer and cancer and depression for Lilly.

Fibromyalgia draws skepticism for several reasons. The cause is unknown. There are no tests to confirm a diagnosis. Many patients also fit the criteria for chronic fatigue syndrome and other pain ailments.

Experts don't doubt the patients are in pain. They differ on what to call it and how to treat it.

Many doctors and patients say the drugmakers are educating the medical establishment about a misunderstood illness, much as they did with depression in the 1980s. Those with fibromyalgia have often had to fight perceptions that they are hypochondriacs, or even faking their pain.

But critics say the companies are hyping fibromyalgia along with their treatments, and that the grantmaking is a textbook example of how drugmakers unduly influence doctors and patients.

"I think the purpose of most pharmaceutical company efforts is to do a little disease-mongering and to have people use their drugs," said Dr. Frederick Wolfe, who was lead author of the guidelines defining fibromyalgia in 1990 but has since become one of its leading skeptics.