Course Title

HHT Epistaxis: Evaluation & Management

Register to view course>>

Course Author

Jeb Justice, MD, FARS
Associate Professor, Chief, Division of Rhinology and Skull Base Surgery
Associate Residency Program Director
APP Director
Co-Director, University of Florida HHT Center of Excellence
University of Florida
Gainesville, FL

Learning Objectives

The intended result of this activity is increased knowledge/competence, and upon completion of this course, participants should be able to:

1. Describe the pathophysiology, manifestations, and diagnostic criteria of HHT.
2. Recognize the varied clinical presentation of nasal telangiectasia and epistaxis in HHT.
3. Perform an evaluation of epistaxis in HHT patients.
4. Describe the Second HHT International Guidelines recommendations for management of HHT epistaxis including topical and systemic medical therapies, as well as surgical therapies and their limitations.

Target Audience

This activity is designed for physicians and nurses who treat patients with Hereditary Hemorrhagic Telangiectasia (HHT). This activity may also be of interest to physician assistants and pharmacists or anyone who specializes in interventional radiology, radiology, interventional neuroradiology, neurology, pulmonology, gastroenterology, genetics, primary care, pediatrics, hematology, hepatology, otolaryngology, critical care, dentistry, dermatology, or cardiology.

Publication Date

November 10, 2023

Expiration Date

November 10, 2026

Accreditation Information

In support of improving patient care, this activity has been planned and implemented by Cure HHT and Washington University School of Medicine in St. Louis. Washington University School of Medicine in St Louis is jointly accredited 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.

Credits Available for this Activity:

American Medical Association (AMA Credit)

Washington University School of Medicine in St. Louis designates this enduring material for a maximum of 0.75 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

American Nurses Credentialing Center (ANCC Credit)

Washington University School of Medicine in St. Louis designates this enduring material for a maximum of 0.75 ANCC contact hour.

Interprofessional Continuing Education (IPCE)

This activity was planned by and for the healthcare team, and learners will receive a maximum of 0.75 Interprofessional Continuing Education (IPCE) credit for learning and change.

Planning Committee and Content Reviewers

Murali Chakinala, MD, FCCP (Committee Chair)
Professor of Medicine
Division of Pulmonary and Critical Care Medicine
Washington University School of Medicine in St. Louis
St. Louis, MO

Miles Conrad, MD, MPH 
Clinical Professor 
Department of Radiology and Biomedical Imaging 
Interventional Radiology Section 
University of California, San Francisco 
San Francisco, CA 

Adrienne Hammill, MD, PhD
Associate Professor
Department of Pediatrics, Cancer and Blood Diseases Institute, Division of Hematology
Cincinnati Children’s Hospital Medical Center and the University of Cincinnati College of Medicine
Cincinnati, OH

Raj Kasthuri, MD, MBBS
Professor of Medicine
Division of Hematology, UNC Blood Research Center
UNC School of Medicine
Chapel Hill, NC

Marianne Clancy, MPA
Executive Director & Senior Director, Strategic Partnerships
Cure HHT (HHT Foundation International, Inc.)
Monkton, MD

Melissa Dickey, MSN, FNP
Director, National HHT Coordinating Center
Cure HHT (HHT Foundation International, Inc.)
Monkton, MD

Nolie Krock, MSc
Cure HHT (HHT Foundation International, Inc.)
Monkton, MD

Disclosure Information

It is the policy of Washington University School of Medicine in St. Louis, Continuing Medical Education, to ensure balance, independence, objectivity, and scientific rigor in all its educational activities. All planners, faculty and other persons who may influence content of this CME activity have disclosed all relevant financial relationships with commercial interests. All disclosures have been reported and are indicated with their presentations. Any potential conflicts were addressed and mitigated.

All members of the CME department have nothing to disclose.

Speakers are also expected to openly disclose inclusion of discussion of any off-label, experimental, or investigational use of drugs or devices in their presentations.

Presentations are expected to be based on evidence that is accepted within the profession of medicine as adequate justification for their indication in the care of patients. All scientific research should conform to the generally accepted standards of experimental design, data collection and analysis.

These presentations are not an endorsement of any commercial interests.

These presentations are the views and experiences of the presenters. The presenters' views do not represent the policy or position of Washington University School of Medicine in St. Louis. Washington University School of Medicine in St. Louis, Continuing Medical Education, is the sponsor for CME credits.

Disclosures:

• Jeb Justice, MD, FARS
  • Consultant and/or on advisory committees for Medtronic.
  • Consultant and/or on advisory committees for 3D Matrix.
• Claire Kaufman, MD
  • Research support/grants from BSCI.
  • Consultant and/or on advisory committees for Medtronic.
• Murali Chakinala, MD, FCCP
  • Research support/grants from Janssen, Bayer, Medtronic, United Therapeutics, Altavant Sciences, Trio Health Analytics, Acceleron / Merck, Gossamer, Respira Therapeutics, Vaderis Therapeutics, and Cure HHT / DOD.
  • Consultant and/or advisory committees for Insmed Incorporated, United Therapeutics, Vaderis Therapeutics, Aerovate, Merck, Liquidia Technologies, Inc., and Janssen.
  • Compensation for activities performed from Pulmonary Hypertension Association, Cure HHT Foundation, and Janssen.
• Miles Conrad, MD, MPH
  • Consultant and/or advisory committees for Medtronic.
• Adrienne Hammill, MD, PhD
  • Consultant and/or advisory committees for Novartis AG, Aytu BioPharma, Inc., Diagonal Therapeutics, and IDEAYA Biosciences.
• Raj Kasthuri, MD, MBBS
  • Research support/grants from Sobi.
  • Consultant and/or advisory committees for Pharmacosmos Therapeutics.
• Marianne Clancy, MPA
  • No financial relationships to disclose.
• Melissa Dickey, MSN, FNP
  • No financial relationships to disclose.
• Nolie Krock, MSc
  • No financial relationships to disclose.

All disclosures have been mitigated.

Transparency to Learners:
Cure HHT is the sponsor of a Phase II/III clinical trial for pazopanib. Review by the ACCME has determined Cure HHT is not an ineligible company. This disclosure has been mitigated.

Register to view course>>