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All relevant financial relationships for anyone with the ability to control the content of this educational activity are listed below and have been mitigated. Others involved in the planning of this activity have no relevant financial relationships.

Disclosures for additional planners can be found here.

Faculty

Ulrich Baumann, MD

Professor of Pediatric Gastroenterology and Hepatology
Hanover Medical School
Hanover, Germany
Institute of Immunology and Immunotherapy
University of Birmingham
Birmingham, United Kingdom

Disclosures

Ulrich Baumann, MD, has the following relevant financial relationships:
Consultant or advisor for: Albireo; Mirum; Nestle; Vivet
Speaker or member of speakers bureau for: Alexion; AstraZeneca
Research funding from: Albireo; Alexion; Mirum

Editors

Gillian Griffith, BA (Mod), MA

Medical Education Director, Medscape, LLC

Disclosures

Gillian Griffith, BA (Mod), MA, has no relevant financial relationships.

Gina Montanero, PharmD

Associate Medical Writer, Medscape, LLC

Disclosures

Gina Montanero, PharmD, has no relevant financial relationships.

Compliance Reviewer

Yaisanet Oyola, MD

Associate Director, Accreditation and Compliance, Medscape, LLC

Disclosures

Yaisanet Oyola, MD, has no relevant financial relationships.

Peer Reviewer

This activity has been peer reviewed and the reviewer has no relevant financial relationships.

CME

Recognizing Pediatric Cholestasis and Its Causes: Test Your Knowledge and Improve Your Skills

Authors: Ulrich Baumann, MD
CME Released: 1/3/2023
Valid for credit through: 1/3/2024

Start Activity

Credits Available

Physicians - maximum of 0.25 AMA PRA Category 1 Credit(s)™

You Are Eligible For
- Letter of Completion

Target Audience and Goal Statement

This educational activity is intended for an audience of hepatologists, general pediatricians, primary care physicians, gastroenterologists/hepatologists, and other physicians in Europe involved in the diagnosis and management of patients with CLD.

The goal of this activity is for learners to be better able to differentially diagnose Alagille syndrome (ALGS) and describe emerging therapeutic approaches.

Upon completion of this activity, participants will:

Have self-assessed their learning needs related to clinical features of pediatric CLD
Have increased knowledge regarding
- Current or emerging treatments for CLD

Disclosures

Disclosures for additional planners can be found here.

Faculty

Ulrich Baumann, MD

Professor of Pediatric Gastroenterology and Hepatology
Hanover Medical School
Hanover, Germany
Institute of Immunology and Immunotherapy
University of Birmingham
Birmingham, United Kingdom

Disclosures

Ulrich Baumann, MD, has the following relevant financial relationships:
Consultant or advisor for: Albireo; Mirum; Nestle; Vivet
Speaker or member of speakers bureau for: Alexion; AstraZeneca
Research funding from: Albireo; Alexion; Mirum

Editors

Gillian Griffith, BA (Mod), MA

Medical Education Director, Medscape, LLC

Disclosures

Gillian Griffith, BA (Mod), MA, has no relevant financial relationships.

Gina Montanero, PharmD

Associate Medical Writer, Medscape, LLC

Disclosures

Gina Montanero, PharmD, has no relevant financial relationships.

Compliance Reviewer

Yaisanet Oyola, MD

Associate Director, Accreditation and Compliance, Medscape, LLC

Disclosures

Yaisanet Oyola, MD, has no relevant financial relationships.

Peer Reviewer

This activity has been peer reviewed and the reviewer has no relevant financial relationships.

Accreditation Statements

In support of improving patient care, Medscape, LLC is jointly accredited with commendation by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

For Physicians

Medscape, LLC designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credit(s)™ . Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Contact This Provider

For questions regarding the content of this activity, contact the accredited provider for this CME/CE activity noted above. For technical assistance, contact [email protected]

Instructions for Participation and Credit

There are no fees for participating in or receiving credit for this online educational activity. For information on applicability and acceptance of continuing education credit for this activity, please consult your professional licensing board.

This activity is designed to be completed within the time designated on the title page; physicians should claim only those credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the activity online during the valid credit period that is noted on the title page. To receive AMA PRA Category 1 Credit™, you must receive a minimum score of 70% on the post-test.

Follow these steps to earn CME/CE credit*:

Read about the target audience, learning objectives, and author disclosures.
Study the educational content online or print it out.
Online, choose the best answer to each test question. To receive a certificate, you must receive a passing score as designated at the top of the test. We encourage you to complete the Activity Evaluation to provide feedback for future programming.

You may now view or print the certificate from your CME/CE Tracker. You may print the certificate, but you cannot alter it. Credits will be tallied in your CME/CE Tracker and archived for 6 years; at any point within this time period, you can print out the tally as well as the certificates from the CME/CE Tracker.

*The credit that you receive is based on your user profile.

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References

Verkade HJ, et al. Biliary atresia and other cholestatic childhood diseases: advances and future challenges. J Hepatol. 2016;65:631-642.
National Organization for Rare Disorders (NORD). Alagille syndrome. 2020. Accessed November 21, 2022. https://rarediseases.org/rare-diseases/alagille-syndrome/
Ghazy RM, et al. Neonatal cholestasis: recent insights. Egypt Pediatric Assoc Gazette. 2019;67:1-14.
Ayoub MD, et al. Alagille syndrome: current understanding of pathogenesis, and challenges in diagnosis and management. Clin Liver Dis. 2022;26:355-370.
National Organization for Rare Disorders (NORD). Biliary atresia. 2019. Accessed November 21, 2022. https://rarediseases.org/rare-diseases/extrahepatic-biliary-atresia/
Hartley, J. The jaundiced baby. In: Kelly DA, ed. Diseases of the Liver and Biliary System in Children. 4th ed. Wiley Blackwell;2017:97-126.
Amer S, et al. A comprehensive review of progressive familial intrahepatic cholestasis (PFIC): genetic disorders of hepatocanalicular transporters. Gastroenterology Res. 2014;7:39-43.
National Organization for Rare Disorders (NORD). Bile acid synthesis disorders. 2020. Accessed November 21, 2022. https://rarediseases.org/rare-diseases/bile-acid-synthesis-disorders/
Ayoub MD, et al. Alagille syndrome: diagnostic challenges and advances in management. Diagnostics. 2020;10:907.
Kamath BM, et al. Systematic review: the epidemiology, natural history, and burden of Alagille syndrome. J Pediatr Gastroenterol Nutr. 2018;67:148-156.
Turnpenny PD, et al. Alagille syndrome: pathogenesis, diagnosis and management. Eur J Hum Genet. 2012;20:251-257.
Kamath BM, et al. Outcomes of childhood cholestasis in Alagille syndrome: results of a multicenter observational study. Hepatology Commun. 2020;4:387-398.
Vandriel SM, et al; Global ALagille Alliance (GALA) Study Group. Natural history of liver disease in a large international cohort of children with Alagille syndrome: results from the GALA study. Hepatology. 2022. doi: 10.1002/hep.32761 [Epub ahead of print]
Elisofon SA, et al. Health status of patients with Alagille syndrome. J Pediatr Gastroenterol Nutr. 2010;51:759-765.
Alagille Syndrome Alliance. The genetics of Alagille syndrome. 2020. Accessed November 22, 2022. https://drive.google.com/file/d/1RanudibAsipyEY9tbmTDt58aiZES8IRp/view
Kamath BM, et al. Potential of ileal bile acid transporter inhibition as a therapeutic target in Alagille syndrome and progressive familial intrahepatic cholestasis. Liver Int. 2020;40:1812-1822.
[prescribing information]. Approved 2021. Revised September 2021.
[prescribing information]. Approved 2021. Revised October 2022.
European Medicines Agency. Livmarli. Accessed December 15, 2022. Updated December 12, 2022. https://www.ema.europa.eu/en/medicines/human/EPAR/livmarli
gov. Efficacy and safety of odevixibat in patients with Alagille syndrome (ASSERT). Accessed November 22, 2022. https://clinicaltrials.gov/ct2/show/NCT04674761?term=Odevixibat&cond=algs&draw=2&rank=1
gov. Long-term safety and efficacy of odevixibat in patients with Alagille syndrome (ASSERT-EXT). Accessed November 22, 2022. https://clinicaltrials.gov/ct2/show/NCT05035030?term=Odevixibat&cond=algs&draw=2&rank=2
Gonzales E, et al. Efficacy and safety of maralixibat treatment in patients with Alagille syndrome and cholestatic pruritus (ICONIC): a randomised phase 2 study. Lancet. 2021;398:1581-1592.
Schneider BL, et al. Impact of long-term administration of maralixibat on children with cholestasis secondary to Alagille syndrome. Hepatology Commun. 2022;6:1922-1933.
Thompson RJ, et al. Odevixibat treatment in progressive familial intrahepatic cholestasis: a randomised, placebo-controlled, phase 3 trial. Lancet Gastroenterol Hepatol. 2022;7:830-842.
gov. A study to evaluate the safety and tolerability of maralixibat in infant participants with cholestatic liver diseases including progressive familial intrahepatic cholestasis (PFIC) and Alagille syndrome (ALGS). (RISE). Accessed November 22, 2022. https://clinicaltrials.gov/ct2/show/NCT04729751
Sanchez P, et al. Therapeutics development for Alagille syndrome. Front Pharmacol. 2021;12:704586.

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CME Information

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Faculty and Disclosures

Faculty

Ulrich Baumann, MD

Editors

Gillian Griffith, BA (Mod), MA

Gina Montanero, PharmD

Compliance Reviewer

Yaisanet Oyola, MD

Peer Reviewer

CME

Recognizing Pediatric Cholestasis and Its Causes: Test Your Knowledge and Improve Your Skills

Credits Available

You Are Eligible For

Target Audience and Goal Statement

Disclosures

Faculty

Ulrich Baumann, MD

Editors

Gillian Griffith, BA (Mod), MA

Gina Montanero, PharmD

Compliance Reviewer

Yaisanet Oyola, MD

Peer Reviewer

Accreditation Statements

For Physicians

Instructions for Participation and Credit

Recognizing Pediatric Cholestasis and Its Causes: Test Your Knowledge and Improve Your Skills

References