Connective Tissue Disease and Pulmonary Arterial Hypertension: Multidisciplinary Coordination of Care to Optimize Outcomes




Connective tissue disease-pulmonary arterial hypertension (CTD-PAH) accounts for ~25% of all PAH cases, yet rheumatologists may fail to recognize the increased risk of PAH secondary to CTD conditions. The survival of patients with CTD-PAH is greatly impacted by delays in diagnosis. Therefore, rheumatologists should maintain a high index of suspicion for PAH in patients with systemic sclerosis (SSc) and other mixed connective tissue disease (CTD). Participants will benefit from a review of current screening and diagnostic recommendations for timely interventions, including routine screening of patients for PAH in a rheumatology practice. Faculty will discuss up-to-date clinical data of PAH therapies, while providing an analysis of management strategies to achieve optimal outcomes for patients with CTD-PAH. Participants will also gain an understanding of the epidemiology and pathophysiology of PAH and associated risks for patients with CTD, as well as the importance of a multidisciplinary team approach to disease management.


Flavia Castelino, MD
Assistant Professor of Medicine
Harvard Medical School
Director, Scleroderma Program
Department of Rheumatology
Massachusetts General Hospital
Boston, Massachusetts


Nicholas S. Hill, MD
Professor of Medicine
Tufts University School of Medicine
Chief of the Division of Pulmonary
Critical Care and Sleep Medicine
Tufts Medical Center
Boston, Massachusetts


Release date: July 23, 2021
Expiration date: July 23, 2022
Estimated time to complete activity: 1 hour



This educational activity has been designed to meet the needs of physicians, physician assistants, nurses, fellows, and medical residents, as well as allied healthcare providers (HCPs) with a rheumatology specialty.


Upon completion of this educational activity, participants should be able to:

  • Review the epidemiology and pathophysiology of CTD, and how it places patients at high risk for secondary PAH
  • Discuss how to use appropriate screening and diagnostic criteria to identify patients with CTDs who may have PAH
  • Describe how to determine if patients should be referred for cardiac catheterization and definitively diagnose PAH
  • Outline how to integrate guideline recommendations and efficacy and safety data of PAH pharmacotherapies for treatment of patients with CTD-PAH
  • Describe how to apply a collaborative approach across multidisciplinary experts to optimize outcomes for patients with CTD-PAH

There are no fees for participating and receiving CME credit for this activity. During the period of July 23, 2021 through July 23, 2022, participants must:

  • Read the learning objectives and faculty disclosures
  • Complete the pretest
  • Study the educational activity
  • Complete the posttest and the evaluation form

A statement of credit will be issued only upon receipt of a completed activity evaluation form and a completed posttest with a score of 70% or better.

For Pharmacist/ACPE learners, please check CPE monitor for your credit within 60 days of completing the activity.




Physician Continuing Education


Accreditation Statement
Integrity Continuing Education is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.


Integrity Continuing Education designates this enduring activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nursing Continuing Education
Global Education Group is accredited with distinction as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.

This educational activity for 1.0 contact hour is provided by Global Education Group. Nurses should claim only the credit commensurate with the extent of their participation in the activity.

Pharmacist Accreditation Statement

Global Education Group is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

Credit Designation
Global Education Group designates this continuing education activity for 1.0 contact hour (0.10 CEU) of the Accreditation Council for Pharmacy Education. (Universal Activity Number – 0530-9999-21-034-H01-P)

This is a knowledge-based activity.


For information about ACCME accreditation of this activity, please contact Integrity Continuing Education at (855) 835-4004 or

For information about ACPE or ANCC accreditation of this activity, please contact Global at (303) 395-1782 or


Integrity Continuing Education and Global Education Group require instructors, planners, managers, and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest they may have as related to the content of this activity. All identified conflicts of interest are thoroughly vetted by Integrity Continuing Education for fair balance, scientific objectivity of studies mentioned in the materials or used as the basis for content, and appropriateness of patient care recommendations.

The following faculty reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of these CME activities:

Nicholas S. Hill, MD
Research Grants –  Acceleron, Actelion, Aerovate, Altavant, Bellarophon, Bayer, Gossamer, Liquidia, Pfizer, Phase Bio, Reata, and United Therapeutics
Consulting/Advisory Board – Aerovate, Altavant, and Liquidia
Data Safety Monitoring Board – Pfizer, and United Therapeutics

Flavia Castelino, MD, has reported no real or apparent conflict of interests.

The following project managers/planners: Lindsay Borvansky, Ashley Cann, Donna Fausak, Andrea Funk,  Liddy Knight, Rhys Williams, RN, MSN, FNP, and Maria Rovere, MTSC,  reported that they or their spouses/life partners, have no financial relationships or relationships to products or devices with commercial interests related to the content of this CE activity.


This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. Integrity Continuing Education, Inc and Global Education Group do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of any organization associated with this activity. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.


When you participate in an online educational activity sponsored by Integrity Continuing Education, Inc, you will be asked for your name, degree(s), affiliation(s), street address, telephone number and…(continued)


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Operating Systems: Windows XP, Windows 2000, Windows Vista, Windows 7, Windows 10, and Mac OS
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For a full listing of recommended operating systems, browsers, and system configurations, please click on the link below:
Click here for more information on minimum system requirements


The information provided at this activity is for continuing education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient’s medical condition.


This CME activity for ACCME credit is provided by Integrity Continuing Education.
This CE activity for ANCC and ACPE credit is jointly provided by Global Education Group and Integrity Continuing Education.


This activity is supported by an educational grant from Actelion Pharmaceuticals US, Inc., a Janssen Pharmaceutical Company of Johnson & Johnson.


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