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Effectiveness of Recombinant Human Growth Hormone (rhGH) in the Treatment of Patients With Cystic Fibrosis

To Receive a Certificate for This Activity

  1. Read the CME information on this page.
  2. Review information on the contributor biographies.
  3. View the presentations in this enduring material.
  4. Complete the CME posttest (you must answer 7 out of 9 questions correctly).
  5. Complete and submit the CME registration and evaluation forms.

CME Information

Course Overview

Many patients with cystic fibrosis experience growth retardation associated with the metabolic and nutritional challenges posed by their disease, with growth measures resisting improvement even when nutritional deficiencies are aggressively treated as part of standard care. Low weight and short stature have been associated with increased morbidity and mortality, leading some investigators to propose that the growth promoting and anabolic effects of recombinant human growth hormone (rhGH) may reduce disease symptoms and improve health outcomes.

This CME activity covers the systematic review and meta analysis of the current clinical literature, conducted by the University of Connecticut Evidence-based Practice Center, to evaluate the evidence about the effectiveness and safety of using rhGH to improve growth, pulmonary function, and long-term health outcomes in pediatric patients with cystic fibrosis.

Educational Objectives

At the conclusion of this activity, the participant should be able to:

  • Describe the rationale for use of recombinant human growth hormone (rhGH) in patients with cystic fibrosis (CF).
  • Estimate the impact of rhGH treatment on growth and pulmonary function measurements in patients with CF.
  • Estimate the impact of rhGH use on hospitalization rate, IV antibiotic use, bone fractures, health related quality of life, and mortality risk for patients with CF, as understood by the current evidence.
  • Describe the predictive value of intermediate outcomes (pulmonary function and anthropometrics) for mortality risk and health related quality of life, in the general population of patients with CF.
  • Discuss the risks of CF related diabetes and cancer presented by rhGH treatment of patients with CF.

Target Audience

This CME activity is designed to meet the educational needs of primary care and internal medicine physicians, as well as health care professionals who treat patients with cystic fibrosis.

Method of Participation

This activity is in PowerPoint file format and is accompanied by talking points and references linked to PubMed abstracts.

To receive a maximum of 1.0 AMA PRA Category 1 Credit(s)™ you should:

  • View the presentations in this enduring material.
  • Complete the posttest (you must answer 7 out of 9 questions correctly).
  • Complete and submit the CME registration and evaluation forms.

The estimated time to complete this activity, including review of the materials, is 1.0 hour(s).

Hardware/software requirements: Activities should be run with recent versions of common browsers, including Internet Explorer, Firefox, and Google Chrome.

If you have questions about the participation process, please e-mail the Office of Continuing Medical Education, cme@bcm.edu or phone 713.798.8237.

Accreditation/Credit Designation

Baylor College of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Baylor College of Medicine designates this enduring material activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.    

Term of Approval

March 2011 through March 2014. Original release date: March 2011

Peer Review

In October 2010, this continuing medical education online enduring material was reviewed by Rebecca T. Kirkland, MD, Professor Emeritus, Department of Pediatrics, Baylor College of Medicine, Houston, Texas. To ensure the continued scientific relevance of this enduring material, its content will be reviewed again in March 2014.

Disclosures:  Nothing to disclose.

Program Director

John L. Kirkland, MD
Professor Emeritus
Pediatrics
Baylor College of Medicine
Houston, Texas

Disclosures:  Nothing to disclose.

Disclaimer

This CME activity is designed for use by healthcare professionals for educational purposes only. Information and opinion offered by the contributors represent their viewpoints. Conclusions drawn by the participant should be derived from careful consideration of all available scientific information. Prescription information and use of medical devices should be undertaken only after confirmation of information by consulting the FDA-approved uses and information.

Baylor College of Medicine makes every effort to have accurate information presented, no warranty, expressed or implied, is offered. The participant should use his/her clinical judgment, knowledge, experience, and diagnostic decision-making before applying any information, whether provided here or by others, for any professional use.

Links are provided to other Internet sites solely for the convenience of users. Once you link to another site, you are subject to the site's terms and conditions of use including copyright and licensing restrictions.

Disclosure

The Office of Continuing Medical Education (OCME) makes every effort to develop CME activities that are scientifically based, accurate, current, and objectively presented. In accordance with the Accreditation Council for Continuing Medical Education Standards for Commercial Support SM, Baylor College of Medicine (BCM) has implemented a mechanism requiring everyone in a position to control the content of an educational activity (e.g., directors, planning committee members, contributors, peer reviewers) to disclose any relevant financial relationships with commercial interests (drug/device companies) and manage/resolve any conflicts of interest prior to the activity. Individuals must disclose to participants the existence or non-existence of financial relationships: l) at the time of the activity or within 12 months prior; and 2) of their spouses/partners.

Baylor College of Medicine does not view the existence of interests or relationships with commercial entities as implying bias or decreasing the value of a presentation. It is up to the participants to determine whether the interests or relationships influence the presenter with regard to exposition or conclusions.

If at any time during this activity you feel that there has been commercial or promotional bias, please inform us by using the commercial bias comments box in the evaluation form. Please answer the questions about balance in the CME activity evaluation candidly.

The following individual(s) has/have reported no financial or other relationships with commercial entities whose products/services may relate to the educational content of this activity:

John L. Kirkland, MD, Activity Director: nothing to disclose
Rebecca T. Kirkland, MD, Peer Reviewer: nothing to disclose.
Christopher M. Oermann, MD, Contributor: nothing to disclose
C. Michael White, PharmD, PCP, FCCP, Contributor: nothing to disclose.

Some drugs/devices identified during this activity may have United States Food and Drug Administration (FDA) clearance for specific purposes only or for use in restricted research settings. The FDA has stated that it is the responsibility of the individual physician to determine the FDA status of each drug or device that he/she wishes to use in clinical practice and to use the products in compliance with the applicable law.

Baylor College of Medicine requires that all contributors disclose an unlabeled use or investigational use (not yet approved for any purpose) of pharmaceutical and medical device products, and provide adequate scientific and clinical justification for such use. Physicians are urged to fully review all the available data on products or procedures before using them to treat patients.

Acknowledgement of Support

This activity is supported by a contract, HHSA290200810015C, from the Agency for Healthcare Research and Quality (AHRQ).

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