This CE activity is jointly provided by ProCE, Inc. and Hospital Pharmacy. ProCE, Inc. is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. ACPE Universal Activity Number: 0221-9999-15-208-H01-P has been assigned to this knowledge-based home-study CE activity (initial release date 09-01-2015). This CE activity is approved for 1.5 contact hours (0.15 CEUs) in states that recognize ACPE providers. This CE activity is provided at no cost to participants. Completion of the evaluation and the post-test with a score of 70% or higher are required to receive CE credit. No partial credit will be given.

Faculty: Dennis J. Cada, PharmD, FASHP, FASCP (Editor), Founder and Contributing Editor, The Formulary; Danial E. Baker, PharmD, FASHP, FASCP, Director, Drug Information Center, and Professor of Pharmacy Practice, College of Pharmacy, Washington State University, Shannon G. Panther, PharmD, Clinical Assistant Professor, College of Pharmacy, Washington State University, and Kyle Ingram, PharmD, Drug Information Resident, College of Pharmacy, Washington State University. The authors indicate no relationships that could be perceived as a conflict of interest. This activity is self-funded by Hospital Pharmacy.

Release Date: September 1, 2015

Expiration Date: September 1, 2015

Continuing Education for this activity is processed through the ProCE online CE Center. To receive CE credit, please go to:

www.ProCE.com/HPJFDR

Click to access the activity page to enroll and complete the Post-Test and Evaluation

For questions related to registering for and obtaining CE credit, contact ProCE at 630-540-2848 or Info@ProCE.com.

1. Secukinumab has been approved by the US Food and Drug Administration (FDA) for which of the following conditions in patients who are eligible for systemic therapy or phototherapy?
   1. Moderate to severe psoriatic arthritis
   2. Moderate to severe plaque psoriasis
   3. Stable rheumatoid arthritis
   4. Active ankylosing spondylitis
      
      
2. Secukinumab is a monoclonal antibody that targets which of the following cytokines?
   1. Interleukin-17A
   2. Interleukin-6
   3. Tumor necrosis factor-alpha
   4. Interferon-gamma
      
      
3. Which of the following is a contraindication for secukinumab use?
   1. Hypersensitivity to secukinumab
   2. Renal impairment
   3. Pregnant status
   4. Active Crohn disease
      
      
4. What is the most common adverse reaction associated with secukinumab?
   1. Diarrhea/nausea/vomiting
   2. Hypersensitivity/anaphylaxis
   3. Infection/inflammation
   4. Injection site reaction
      
      
5. Which of the following statements correctly describes the manufacturer’s recommendations regarding vaccinating patients being treated with secukinumab?
   1. Both live vaccinations and non-live vaccinations should be avoided.
   2. Live vaccinations should be avoided but non-live vaccinations may be administered.
   3. Both live vaccinations and non-live vaccinations may be administered.
   4. Live vaccinations may be administered but non-live vaccinations should be avoided.
      
      
6. Secukinumab is classified as a drug in which Pregnancy Category?
   1. A
   2. B
   3. C
   4. X
      
      
7. What is the recommended dosing schedule for initiating subcutaneous secukinumab therapy?
   1. Two 150 mg injections once a week for 5 doses and then one 150 mg injection once a month
   2. One 150 mg injection once a week for 5 doses and then two 150 mg injections once a month
   3. Two 150 mg injections once a week for 5 doses and then two 150 mg injections once a month
   4. One 150 mg injection once a month for 5 doses and then one 150 mg injection once a week
      
      
8. Which formulation of secukinumab must be administered by a health care provider?
   1. Topical cream
   2. Sensoready pen
   3. Prefilled syringe
   4. Lyophilized powder
       

Case History

N.K. is a 44-year-old, 58-kg female with uncontrolled plaque psoriasis and no known medication allergies. In addition to plaque psoriasis, she has diabetes and high blood pressure. Current medications include metformin, glipizide, metoprolol, lisinopril, hydrochlorothiazide, and betamethasone dipropionate. The dermatologist conducted a thorough interview that verified that N.K. had no history of Crohn disease or tuberculosis. Her typical rate of infection is infrequent, consisting of occasional colds and urinary tract infections.

9. N.K. must be tested for what disease or condition prior to initiating secukinumab therapy?
   1. Candidiasis infection
   2. Pregnancy
   3. Tuberculosis
   4. Crohn disease
      
      
10. N.K’s sister, S.K., is treating her plaque psoriasis with etanercept and is wondering how her drug compares with secukinumab. How did etanercept compare to secukinumab in achieving a Psoriasis Area and Severity Index (PASI) score of 75 by week 12 in the FIXTURE trial?
    1. Secukinumab showed improved efficacy over etanercept.
    2. Etanercept showed improved efficacy over secukinumab.
    3. Secukinumab and etanercept showed similar improvements.
    4. Etanercept was numerically, but not statistically, better than secukinumab.
       
       
11. N.K. is planning an extended trip to South America. She is wondering if she can receive the yellow fever live vaccine and an influenza vaccine while taking secukinumab. How should N.K. be advised?
    1. Only an inactivated influenza vaccine may be administered concomitantly with secukinumab, not a live attenuated influenza vaccine or the live yellow fever vaccine.
    2. Only a live attenuated influenza vaccine may be administered concomitantly with secukinumab, not the inactivated influenza vaccine or the live yellow fever vaccine.
    3. Only the live yellow fever vaccine may be administered concomitantly with secukinumab, not either the live attenuate influenza vaccine or the inactivated influenza vaccine.
    4. Both the live yellow fever vaccine and either the live attenuated or inactivated influenza vaccine may be administered concomitantly with secukinumab.
       
       
12. N.K. is packed and ready to explore South America. What instructions should N.K. receive regarding the storage and handling of her Cosentyx Sensoready pens during the trip?
    1. The pens must be refrigerated but can be at room temperature for up to 24 hours.
    2. The pens must be refrigerated and stored in the original cartons to protect from light.
    3. The pens must be kept in the freezer but can be at room temperature for up to 24 hours.
    4. The pens must be kept in the freezer and stored in the original cartons to protect from light.
       
       
13. After 6 months of secukinumab therapy, N.K. started to complain of pain, swelling, and redness after each injection to her left thigh. What is the likely cause of this problem?
    1. Hypersensitivity from repeated exposure
    2. Worsening of plaque psoriasis symptoms
    3. Manifestation of new allergy to latex
    4. Failing to rotate the site of injection
       
       
14. After her trip to South America, N.K. developed pneumonia and was hospitalized. Her next scheduled dose of secukinumab is in 2 days. How should N.K. be counseled?
    1. Decrease secukinumab dose by 50% until the infection is resolved.
    2. Administration of secukinumab during an infection is allowed.
    3. Do not administer secukinumab again until the infection is resolved.
    4. Discontinue secukinumab and do not consider restarting therapy.
       
       
15. N.K. is responding well to secukinumab therapy, but has developed an anaphylactic reaction to latex gloves. Which formulation of secukinumab should be associated with a lower risk of a latex-related anaphylactic reaction in N.K.?
    1. Topical cream
    2. Sensoready pen
    3. Prefilled syringe
    4. Lyophilized powder