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FORMAT: Monograph

RELEASE DATE: March 1, 2020
EXPIRATION: March 31, 2021

MAXIMUM CREDITS: 1.5 AMA PRA Category 1 Credits

PROCEED TO CME ACTIVITY

LEARNING METHOD AND MEDIUM
This educational activity consists of a supplement and ten (10) study questions. The participant should, in order, read the learning objectives contained at the beginning of this supplement, read the supplement, answer all questions in the post test, and complete the Activity Evaluation/Credit Request form. To receive credit for this activity, please follow the instructions provided on the post test and Activity Evaluation/Credit Request form. This educational activity should take a maximum of 1.5 hours to complete.

ACTIVITY DESCRIPTION
It is estimated that by 2030, 3.7 million people in the United States will have advanced age-related macular degeneration (AMD), including neovascular AMD (nAMD). The standard of care for nAMD is monthly anti–vascular endothelial growth factor (VEGF) injections, but a growing body of real-world studies indicates that patients do not receive the same number of injections or achieve comparable visual acuity outcomes as do subjects in hallmark clinical trials, likely because of the significant treatment burden associated with monthly injections. To address this unmet need, several clinical trials are ongoing to investigate new treatment strategies and agents for nAMD that reduce treatment burden. Earlier detection of nAMD is one strategy to reduce the functional burden of nAMD through preservation of visual acuity. For active disease, several novel approaches designed to increase treatment response and longevity are under investigation. These include a small molecular weight anti-VEGF, a bispecific VEGF/angiotensin 2–antagonizing antibody, a VEGF-antagonizing DARPin (designed ankyrin repeat protein) molecule, and an implantable device that continuously releases an approved anti-VEGF therapy. Prior to US Food and Drug Administration approval of these innovative treatments, clinicians can harness the latest data on the consequences of persistent fluid to tailor retreatment strategies using approved anti-VEGF treatments, thereby reducing treatment burden while maximizing visual outcomes. The desired results of this educational activity are for retina specialists and other ophthalmologists to use evidence-based preventive, diagnostic, and treatment strategies for nAMD that minimize treatment burden while maximizing vision and quality-of-life outcomes for patients now and as new treatments emerge.

TARGET AUDIENCE

This educational activity is intended for retina specialists and other ophthalmologists who treat patients with nAMD.

LEARNING OBJECTIVES
Upon completion of this activity, participants will be better able to:
  • Design strategies to identify nAMD as soon as possible after symptom onset
  • Discuss the molecular basis for differentiating current and emerging treatments for nAMD
  • Examine clinical trial data for approved and emerging treatments for nAMD
  • Develop individualized disease activity assessment and retreatment plans for patients with nAMD

ACCREDITATION STATEMENT
 This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of New York Eye and Ear Infirmary of Mount Sinai and MedEdicus LLC. The New York Eye and Ear Infirmary of Mount Sinai is accredited by the ACCME to provide continuing medical education for physicians.

AMA CREDIT DESIGNATION STATEMENT
The New York Eye and Ear Infirmary of Mount Sinai designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

GRANTOR STATEMENT
This continuing medical education activity is supported through an unrestricted educational grant from Novartis Pharmaceuticals Corporation.

DISCLOSURE POLICY STATEMENT
It is the policy of New York Eye and Ear Infirmary of Mount Sinai that the faculty and anyone in a position to control activity content disclose any real or apparent conflicts of interest relating to the topics of the educational activity in which they are participating. They are also required to disclose discussions of unlabeled/unapproved uses of drugs or devices during their presentations. New York Eye and Ear Infirmary of Mount Sinai is committed to providing its learners with quality CME activities and related materials that promote improvements in healthcare and not the proprietary interests of a commercial interest and, thus, has established policies and procedures in place that identify and resolve all conflicts of interest prior to the execution or release of its educational activities. Full disclosure of faculty/planners and their commercial relationships, if any, follows.

DISCLOSURES
Pravin U. Dugel, MD, had a financial agreement or affiliation during the past year with the following commercial interests in the form of Consultant/Advisory Board: Abbott Medical Optics; Abfero Pharmaceuticals Inc; Acucela Inc; Aerie Pharmaceuticals, Inc; Aerpio Therapeutics; Alcon; Alimera Sciences; Allergan; Amgen Inc; Annidis Corporation; Arctic Vision Ltd; ArcticDX Inc; AsclepiX; Avalanche Biotechnologies, Inc; Bausch & Lomb Incorporated; Beyeonics Surgical Ltd; BioBridge Global; Boehringer Ingelheim International GmbH; CDR-Life Inc; Chengdu Kanghong Biotechnology Co Ltd; Clearside Biomedical, Inc; Daiichi Sankyo Company, Limited; EyePoint Pharmaceuticals; F. Hoffmann-La Roche Ltd; Gemini Therapeutics; Genentech, Inc; Glaukos Corporation; GrayBug, Inc; Ionis Pharmaceuticals, Inc; Irenix Medical, Inc; IVERIC bio; jCyte; Kodiak Sciences Inc; Lutronic; Lux Biosciences Inc; MacuSight, Inc; Merck & Co., Inc; Nan Fung Group; NeoVista Inc; Neurotech Pharmaceuticals; Novartis Pharmaceuticals Corporation; Oculis; Omeros Corporation; Opthea; Optovue, Incorporated; Ora, Inc; Oxurion NV; PanOptica; Pieris; QLT Inc; Regeneron Pharmaceuticals, Inc; Regenxbio Inc; ReNeuron Group PLC; Retinagenix; Santen Inc; SciFluor Life Sciences, Inc; Shire; Spark Therapeutics, Inc; Stealth BioTherapeutics Inc; Topcon Medical Systems, Inc; TrueVision; and Zeiss; Ownership Interest (Stock options, or other holdings, excluding diversified mutual funds): Aerpio Therapeutics; Allegro Ophthalmics, LLC; Arctic Vision Ltd; ArcticDX Inc; Clearside Biomedical, Inc; GrayBug, Inc; Irenix Medical, Inc; IVERIC bio; Nan Fung Group; Oculis; PanOptica; SciFluor Life Sciences, Inc; and TrueVision.

Nancy M. Holekamp, MD, had a financial agreement or affiliation during the past year with the following commercial interests in the form of Consultant/Advisory Board: Allergan; Clearside Biomedical, Inc; Gemini Therapeutics; Genentech, Inc; Lineage Cell Therapeutics, Inc; Novartis Pharmaceuticals Corporation; Regeneron Pharmaceuticals, Inc; and Viewpoint Therapeutics; Contracted Research: Gemini Therapeutics; Genentech, Inc; Gyroscope; and Notal Vision, Inc; Honoraria from promotional, advertising or non-CME services received directly from commercial interests or their Agents (eg, Speakers Bureaus): Allergan; Genentech, Inc; Novartis Pharmaceuticals Corporation; Regeneron Pharmaceuticals, Inc; and Spark Therapeutics, Inc; Ownership Interest (Stock options, or other holdings, excluding diversified mutual funds): Katalyst Healthcares & Life Sciences.

Baruch D. Kuppermann, MD, PhD, had a financial agreement or affiliation during the past year with the following commercial interests in the form of Consultant/Advisory Board: Alcon; Alimera Sciences; Allegro Ophthalmics, LLC; Allergan; Apellis Pharmaceuticals; Cell Care Therapeutics; Eyedaptic Inc; Galimedix Therapeutics, Inc; Genentech, Inc; Glaukos Corporation; Interface Biologics, Inc; IVERIC bio; jCyte; Novartis Pharmaceuticals Corporation; Regeneron Pharmaceuticals, Inc; and Re-Vana Therapeutics; Contracted Research: Alcon; Alimera Sciences; Allegro Ophthalmics, LLC; Allergan; Apellis Pharmaceuticals; Genentech, Inc; Ionis Pharmaceuticals, Inc; jCyte; Novartis Pharmaceuticals Corporation; Oxurion NV; and Regeneron Pharmaceuticals, Inc; Honoraria from promotional, advertising or non-CME services received directly from commercial interests or their Agents (eg, Speakers Bureaus): Allergan; and Optovue, Incorporated.

Carl D. Regillo, MD, had a financial agreement or affiliation during the past year with the following commercial interests in the form of Consultant/Advisory Board: Allegro Ophthalmics, LLC; Allergan; Genentech, Inc; Ionis Pharmaceuticals, Inc; Kodiak Sciences Inc; Novartis Pharmaceuticals Corporation; and Shire; Contracted Research: Allergan; Apellis Pharmaceuticals; Astellas Pharma US, Inc; Genentech, Inc; IVERIC bio; Kodiak Sciences Inc; Novartis Pharmaceuticals Corporation; and Regeneron Pharmaceuticals, Inc.

NEW YORK EYE AND EAR INFIRMARY OF MOUNT SINAI PEER REVIEW DISCLOSURE
Gennady Landa, MD, has no relevant commercial relationships to disclose.

EDITORIAL SUPPORT DISCLOSURES
Erika Langsfeld, PhD; Cynthia Tornallyay, RD, MBA, CHCP; Kimberly Corbin, CHCP; Barbara Aubel; and Michelle Ong have no relevant commercial relationships to disclose.

DISCLOSURE ATTESTATION
The contributing physicians listed above have attested to the following:
  1. that the relationships/affiliations noted will not bias or otherwise influence their involvement in this activity;
  2. that practice recommendations given relevant to the companies with whom they have relationships/affiliations will be supported by the best available evidence or, absent evidence, will be consistent with generally accepted medical practice; and
  3. that all reasonable clinical alternatives will be discussed when making practice recommendations.

OFF-LABEL DISCUSSION
This CME activity includes discussion of unlabeled and/or investigative uses of drugs. Please refer to the official prescribing information for each drug discussed in this activity for FDA-approved dosing, indications, and warnings.

New York Eye and Ear Infirmary of Mount Sinai Privacy & Confidentiality Policies
https://www.nyee.edu/education/cme

CME Provider Contact Information
For questions about this activity, call 212-870-8127.

TO OBTAIN AMA PRA CATEGORY 1 CREDIT
To obtain AMA PRA Category 1 Credit™ for this activity, read the material in its entirety and consult referenced sources as necessary. Please take this post test and evaluation online. Upon passing, you will receive your certificate immediately. You must score 70% or higher to receive credit for this activity, and may take the test up to 2 times. Upon registering and successfully completing the post test, your certificate will be made available online and you can print it or file it.

DISCLAIMER
The views and opinions expressed in this educational activity are those of the faculty and do not necessarily represent the views of New York Eye and Ear Infirmary of Mount Sinai , MedEdicus LLC, Novartis Pharmaceuticals Corporation, EyeNet, or the American Academy of Ophthalmology.

This CME activity is copyrighted to MedEdicus LLC ©2020. All rights reserved. 199

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