Testosterone Update

CHAIRPERSON
Culley C. Carson III, MD
Rhodes Distinguished Professor of Urology
University of North Carolina at Chapel Hill
Chapel Hill, North Carolina

FACULTY
Kevin T. McVary, MD
Professor of Urology
Northwestern University
Feinberg School of Medicine
Chicago, Illinois

Martin M. Miner, MD
Co-Director, Men's Health Center
Miriam Hospital
Clinical Associate Professor of Family Medicine and Urology
Warren Alpert Medical School of Brown University
Providence, Rhode Island

INTENDED AUDIENCE
Primary care physicians (family physicians, internists, general practitioners) and other healthcare professionals interested in the diagnosis, management, and treatment of benign prostatic hyperplasia/lower urinary tract symptoms, hypogonadism, and erectile dysfunction attending the 2012 American Academy of Family Physicians Scientific Assembly.

STATEMENT OF NEED
Men presenting with erectile dysfunction (ED) should be screened for benign prostatic hyperplasia–associated lower urinary tract symptoms (BPH/LUTS) and vice versa. Medical treatments for BPH/LUTS appear to be equally effective—producing improvement in 75% to 80% of patients—but their adverse effect (AE) profiles differ. The patient should be informed about the impact of medication and surgery on sexual health, and sexual function should be assessed both when choosing the appropriate management strategy for BPH/LUTS and when evaluating the patient's response to treatment.

Given the close associations between BPH/LUTS, hypogonadism, and ED, treatment algorithms are needed for the concomitant management of LUTS and hypogonadism as well as associated conditions, such as sexual dysfunction and ED. An effective management strategy would incorporate agents that are efficacious and tolerable, cause minimal AEs, and can be used either as monotherapy or in a combination regimen as appropriate. Physicians should take into account individual health factors, efficacy, tolerability, treatment-related AEs (eg, retrograde ejaculation, diminished libido, and ED), cost, and patient preference. As evidence accumulates, considering how daily phosphodiesterase type 5 inhibitor therapy that improves erectile function and BPH/LUTS and how treatment of hypogonadism with testosterone therapy affects LUTS and ED may open new research avenues and shift the current treatment paradigm.

EDUCATIONAL OBJECTIVES
At the conclusion of this activity, participants should be better able to:

Screen all men seeking care for benign prostatic hyperplasia–associated lower urinary tract symptoms (BPH/LUTS), hypogonadism, and erectile dysfunction (ED) for related comorbidities
Examine with patients the adverse effect (AE) profile of each therapy when deciding the appropriate management strategy for BPH/LUTS, hypogonadism, or ED, and carefully monitor the patient's treatment response
Select therapeutic modalities with minimal AEs, including sexual AEs
Monitor the effect of treatment for BPH/LUTS, hypogonadism, or ED on the prostate
Integrate BPH/LUTS, hypogonadism, and ED treatment goals to improve quality of life and optimize health outcomes

ACCREDITATION AND CERTIFICATION
This Enduring Material activity, Case in Point - Shifting Treatment Paradigms: Synergistic Management of BPH/LUTS Hypogonadism and ED, has been reviewed and is acceptable for up to 1.25 Prescribed credit(s) by the American Academy of Family Physicians. AAFP certification begins December 17, 2012. Term of approval is for one year from this date with the option of yearly renewal. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Dannemiller and Cognimed. Dannemiller is accredited by the ACCME to provide continuing medical education for physicians. Dannemiller designates this enduring material for a maximum of 1.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

There is no charge for this activity. Statements of Credit will be provided by e-mail following activity participation and upon completion and return of the evaluation form to CogniMed Inc. via submission at the end of the activity; by mail to CogniMed Inc., 70 South Orange Avenue, Suite 230, Livingston, NJ 07039; or by fax to 973-758-0052. If you have any questions about your certificate, please e-mail cme@dannemiller.com.

CONTENT REVIEW STATEMENT
To resolve identified/potential conflicts of interest, the educational content was fully reviewed by a physician member of the Dannemiller Clinical Content Review Committee who have no financial relationships with commercial interests. The resulting certified activity was found to provide educational content that is current, evidence based and commercially balanced.

DISCLOSURE STATEMENT
It is the policy of Dannemiller to ensure fair balance, independence, objectivity, and scientific rigor in all programming. All faculty and planners participating in sponsored programs are expected to identify and reference off-label product use and disclose any significant relationships with those supporting the activity or any others whose products or services are discussed. The faculty for this activity have disclosed that there will not be discussion about the use of products for non–FDA-approved indications.

In accordance with the Accreditation Council for Continuing Medical Education standards, parallel documents from other accrediting bodies, and Dannemiller policy, the following disclosures have been made:

Dannemiller Staff
Michelle Montgomery, Director of Continuing Education, has nothing to disclose.
Mark Nadeau, MD, Content Reviewer, has nothing to disclose.

CogniMed Inc. Staff
Roseann MacLachlan, Senior Program Manager, has nothing to disclose.
Estelle Perera, Director, Scientific Affairs, and Medical Writer, has nothing to disclose.
Chantel Phipany, Vice President and Director, has nothing to disclose.
Elizabeth Stanton, Editor, has nothing to disclose.

Faculty
Culley C. Carson III, MD, receives research support from, is a consultant for, and serves on the speakers bureaus of American Medical Systems; Auxilium Pharmaceuticals, Inc.; Eli Lilly and Company; and GlaxoSmithKline.

Kevin T. McVary, MD, receives research support from, is a consultant for, and/or serves on the speakers bureaus of Allergan, Inc.; Eli Lilly and Company; GlaxoSmithKline; the National Cancer Institute; the National Institutes of Health; and Watson Pharmaceuticals, Inc.

Martin M. Miner, MD, receives research support from Auxilium Pharmaceuticals, Inc. He is a consultant for Merck & Co., Inc.

The ideas and opinions presented in this educational activity are those of the faculty and do not necessarily reflect the views of Dannemiller and/or its agents. As in all educational activities, we encourage the practitioners to use their own judgment in treating and addressing the needs of each individual patient, taking into account that patient's unique clinical situation. Dannemiller disclaims all liability and cannot be held responsible for any problems that may arise from participating in this activity or following treatment recommendations presented.