RhAPPcast

In this RhAPP journal club video module, Danielle Gatti Palumbo, PharmD, reviews the Phase 3 POETYK PsA-2 clinical trial evaluating deucravacitinib in adults with active psoriatic arthritis. Deucravacitinib is an oral, selective tyrosine kinase 2, or TYK2, inhibitor that targets signaling pathways involved in psoriatic arthritis, including interleukin-23 and type I interferons. This randomized, double-blind, placebo-controlled study assessed the efficacy and safety of deucravacitinib through 52 weeks in patients who were biologic-naive or had previously received conventional disease-modifying antirheumatic drugs or TNF inhibitors. This episode reviews the POETYK PsA-2 trial design, patient population, primary and secondary endpoints, and key clinical findings. It examines improvements in ACR20, ACR50, and ACR70 responses, as well as skin symptoms, physical function, minimal disease activity, dactylitis, and enthesitis. Danielle also discusses the sustained response observed through week 52, outcomes among patients who crossed over from placebo to deucravacitinib, and the treatment’s safety profile, including common adverse events and findings related to serious infections, malignancy, major cardiovascular events, and venous thromboembolism. Designed for rheumatology advanced practice providers, pharmacists, nurse practitioners, physician assistants, and other clinicians caring for patients with psoriatic arthritis, this journal club highlights the potential role of selective TYK2 inhibition as an oral treatment option across multiple psoriatic arthritis disease domains. For more rheumatology education and clinical resources, visit RhAPP's website, the RhAPP content rheum, or the RhAPP ACE app.

In this episode of RhAPPcast, the official podcast of Rheumatology Advanced Practice Providers, host Amanda Mixon leads a multidisciplinary, case-based discussion titled “Cracking the Code: A Rheum-Derm-Neuro Multispecialty Case Approach to Myositis.” Joined by dermatology clinician Laura Bush and neuromuscular medicine PA Maggie Naclerio, this episode explores the complex and often subtle presentations of myositis, idiopathic inflammatory myopathies, dermatomyositis, immune-mediated necrotizing myopathy, and inclusion body myositis. Through real-world clinical cases, the conversation highlights how patients may first present with skin findings, proximal muscle weakness, falls, elevated CK levels, hoarseness, interstitial lung disease concerns, or atypical symptoms that can delay diagnosis. Listeners will gain practical insight into recognizing key myositis signs such as Gottron’s papules, heliotrope rash, shawl sign, holster sign, nailfold capillary changes, limb-girdle weakness, and functional decline, while also learning how dermatology, rheumatology, neurology, primary care, and pulmonology can collaborate to improve outcomes. The episode also covers important diagnostic tools and clinical pearls, including myositis antibody panels, CK trending, aldolase, ESR, CRP, thyroid testing, EMG, MRI, muscle biopsy, HMGCR antibodies, MDA5-associated disease, malignancy risk, false-positive antibody testing, and the importance of a high-quality physical exam. Designed for rheumatology APPs, physician assistants, nurse practitioners, dermatology clinicians, neurology providers, and all healthcare professionals caring for patients with autoimmune muscle disease, this episode emphasizes earlier recognition, better specialty coordination, and individualized treatment strategies for patients living with myositis. Subscribe to RhAPPcast for more rheumatology education, clinical insights, and practical updates from the RhAPP community.

In this episode of RhAPPcast, the official podcast of Rheumatology Advanced Practice Providers, host Amanda Mixon is joined by RhAPP board member Wendy Simmons to explore uncontrolled gout as a systemic inflammatory disease with effects that extend far beyond acute joint pain. The discussion examines how persistent hyperuricemia can lead to monosodium urate crystal deposition, ongoing inflammation, tophi, bone erosion, cartilage damage, tendon complications, and progressive musculoskeletal impairment. Amanda and Wendy also review the connection between uncontrolled gout and common comorbidities, including cardiovascular disease, chronic kidney disease, hypertension, diabetes, obesity, atrial fibrillation, and heart failure. Listeners will gain practical insights into recognizing silent gout progression, assessing uric acid levels and organ function, identifying patients at risk for long-term systemic complications, and coordinating care across rheumatology, primary care, cardiology, and nephrology. The episode also highlights the importance of regular follow-up, patient education, treat-to-target strategies, and individualized gout management. For more rheumatology podcasts, clinical updates, and educational resources designed for advanced practice providers, visit the RhAPP Content Rheum or access education through the RhAPP ACE mobile app.

In this RhAPP journal club video module, Bharati Bhardwaja, PharmD, BCPS, LSSBB, reviews the Phase 3 TOGETHER-PsA clinical trial and its implications for adults with active psoriatic arthritis who are overweight or have obesity. This study is the first randomized trial to evaluate whether adding the dual GIP/GLP-1 receptor agonist tirzepatide to ixekizumab can improve both rheumatologic and metabolic outcomes. This episode reviews how the TOGETHER-PsA trial was conducted, who participated, and the main findings after 36 weeks. It explains how combining ixekizumab with tirzepatide helped more patients achieve meaningful improvement in psoriatic arthritis symptoms while also losing weight, compared with ixekizumab alone. The video also examines improvements in skin symptoms and metabolic health, as well as the most common side effects and overall safety findings. Designed for rheumatology advanced practice providers, pharmacists, nurse practitioners, physician assistants, and clinicians caring for patients with psoriatic arthritis, this journal club highlights the potential benefits of addressing both immune-mediated inflammation and metabolic factors that may contribute to disease activity. For more rheumatology education and clinical resources, visit RhAPP's website, the RhAPP content rheum, or the RhAPP ACE app.

In this rheumatology FAQ, Audrey Gibson, PA-C, reviews how clinical manifestations and histopathologic features vary across idiopathic inflammatory myopathy subtypes, including dermatomyositis, polymyositis, antisynthetase syndrome, immune-mediated necrotizing myopathy, and inclusion body myositis. This clinically focused discussion highlights the key differences in muscle weakness patterns, skin findings, interstitial lung disease, malignancy risk, autoantibody associations, and muscle biopsy findings that help guide diagnosis, prognosis, monitoring, and treatment decisions. Audrey also explores hallmark histopathologic features such as perifascicular atrophy, endomysial inflammation, perimysial pathology, muscle fiber necrosis, rimmed vacuoles, and inclusion bodies. Designed for rheumatology advanced practice providers and clinicians, this FAQ offers practical insights to support earlier recognition, subtype-specific evaluation, multidisciplinary care, and more personalized management of patients with inflammatory myopathies.

In this rheumatology FAQ, host Audrey Gibson, PA-C from the Arthritis Center of North Georgia in Gainesville, Georgia, discusses the key unmet needs in the treatment of idiopathic inflammatory myopathies, including myositis, dermatomyositis, immune-mediated necrotizing myopathy, and other rare inflammatory muscle diseases. These complex, heterogeneous autoimmune conditions can be difficult to diagnose and manage, often leading to delayed diagnosis, ongoing muscle weakness, disability, treatment toxicity, and gaps in long-term disease control. This episode explores why earlier recognition, better biomarkers, improved risk stratification, standardized treatment algorithms, steroid-sparing therapies, and more targeted treatment options are urgently needed in myositis care. Audrey also reviews how antibody profiles, such as anti-Mi-2, anti-SRP, and anti-MDA5, can influence prognosis and treatment decisions, while highlighting emerging therapeutic approaches including IVIG, rituximab, mycophenolate, JAK inhibitors, FcRn inhibitors, interferon pathway inhibition, and complement-targeted therapies.Designed for rheumatology advanced practice providers and clinicians caring for patients with autoimmune muscle disease, this discussion emphasizes the important role APPs play in identifying subtle disease progression, coordinating multidisciplinary care, monitoring medication toxicity, educating patients, and translating evolving myositis research into practical patient care. For more rheumatology education and clinical resources, visit the RhAPP content rheum, RhAPP ACE app, or RhAPP website.

Stay up to date with the latest advances in rheumatoid arthritis management in this RhAPPcast Fireside Chat episode focused on the SELECT-SWITCH trial and its implications for clinical practice. Hosted by Amanda Mixon, PA-C, this discussion features expert perspectives from Jeannette Hart, PA-C, and James Levine, DO, as they explore treatment decision-making after TNF inhibitor failure and what the latest evidence means for patients with rheumatoid arthritis.Learn why the SELECT-SWITCH trial was designed, how it compares switching to a different mechanism of action versus cycling within the TNF inhibitor class, and what the study revealed about efficacy, remission rates, and low disease activity outcomes. The panel discusses real-world considerations when selecting next-line therapies, including the role of JAK inhibitors such as upadacitinib, patient characteristics that may influence treatment choices, and how current guidelines support switching mechanisms after inadequate TNF inhibitor response.Whether you're a rheumatology provider, advanced practice provider (APP), or healthcare professional managing patients with rheumatoid arthritis, this episode provides practical insights into interpreting clinical trial data, discussing treatment changes with patients, and balancing efficacy and safety when making therapeutic decisions. For more expert-led education, visit the Content Rheum and stay up to date with the latest clinical insights in rheumatologic care.

In this episode of RhAPPcast, the official podcast of Rheumatology Advanced Practice Providers, host Amanda Mixon, PA-C, is joined by Heather Finlayson, PA-C, to discuss treat-to-target strategies in lupus management and how DORIS remission can be applied in real-world clinical practice. This conversation explores what successful lupus care looks like beyond flare management, including steroid minimization, low disease activity, shared decision-making, and the use of objective tools such as SLEDAI-2K to monitor disease activity. Listeners will gain practical insights on setting realistic remission goals, reducing long-term prednisone burden, recognizing when to escalate therapy, and helping patients understand that remission in systemic lupus erythematosus means stable disease control on therapy. Designed for rheumatology APPs and clinicians, this episode offers actionable strategies to improve lupus outcomes, support patient-centered care, and bring treat-to-target goals into everyday practice.

In this episode of RhAPPcast, the official podcast of the Rheumatology Advanced Practice Providers, host Amanda Mixon, PA-C, is joined by rheumatology pharmacist expert Danielle Gatti Palumbo, PharmD, to explore the expanding role of clinical pharmacists in rheumatology care. This conversation highlights how pharmacists are integrated into multidisciplinary teams to support the management of complex rheumatic diseases through medication optimization, side effect management, patient counseling, and improving access to therapies.Listeners will gain practical insights into key areas where pharmacists add value, including navigating complex dosing regimens, managing biologics and biosimilars, monitoring labs and safety parameters, and overcoming insurance and prior authorization barriers. The discussion also emphasizes real-world challenges such as patient adherence, therapy switching, and coordination between providers, pharmacies, and patients. Additionally, this episode underscores the importance of pharmacist-led patient education, shared decision-making, and proactive follow-up to enhance outcomes and reduce gaps in care.Ideal for rheumatology providers, pharmacists, and advanced practice providers, this episode delivers actionable strategies to improve efficiency, safety, and collaboration in clinical practice.For more expert-led rheumatology education, visit the RhAPP Content Rheum and RhAPP ACE app, and subscribe to RhAPPcast for future episodes.

In this episode of RhAPPcast, the official podcast of Rheumatology Advanced Practice Providers, host Amanda Mixon, PA-C, is joined by Wendy Simmons, PA-C, for Part 3 of the EULAR 2026 Osteoporosis RhAPP Up Series.Together, they review key osteoporosis abstracts from the 2026 EULAR Congress, including new insights on the longitudinal impact of menopause on bone health and osteoporosis risk in women with spondyloarthritis, as well as the importance of monitoring bone mineral density, fracture risk, and individualized osteoporosis management.This episode also explores long-term data on romosozumab followed by denosumab compared with denosumab alone in glucocorticoid-induced osteoporosis, highlighting the value of treatment sequencing, anabolic-first strategies, trabecular bone score, and early intervention for patients at very high risk of fracture.Watch Part 3 now and revisit the full EULAR 2026 Osteoporosis RhAPP Up Series. For more rheumatology education, visit the RhAPP Content Rheum and RhAPP ACE Mobile App.

In this episode of RhAPPcast, the official podcast of Rheumatology Advanced Practice Providers, host Amanda Mixon, PA-C, is joined by Wendy Simmons, PA-C, for Part 2 of the EULAR 2026 Osteoporosis RhAPP Up Series.Together, they review key osteoporosis abstracts from the 2026 EULAR Congress, including new insights on the use of GLP-1 based therapies in patients taking oral bisphosphonates for osteoporosis and the potential impact on adverse events, medication tolerability, calcium absorption, and long-term bone health.This episode also explores bone mineral density in patients with rheumatoid arthritis under different biologic and targeted synthetic treatment strategies, highlighting the importance of ongoing bone health monitoring, individualized therapy decisions, and the need for additional research before applying these findings broadly in clinical practice.Stay tuned for the next episode in the EULAR 2026 Osteoporosis RhAPP Up Series. For more rheumatology education, visit the RhAPP Content Rheum and RhAPP ACE Mobile App.

In this episode of RhAPPcast, the official podcast of Rheumatology Advanced Practice Providers, host Amanda Mixon, PA-C, is joined by Wendy Simmons, PA-C, for Part 1 of the EULAR 2026 Osteoporosis RhAPP Up Series. Together, they review key osteoporosis abstracts from the 2026 EULAR Congress, including new insights on glucocorticoid-induced osteoporosis, adherence to the 2022 ACR guidelines, fracture risk reduction, and the role of rheumatology bone specialist clinics in improving patient outcomes. This episode also explores the treat-to-target approach in osteoporosis management, comparing real-world outcomes with teriparatide and denosumab, while highlighting the importance of individualized therapy, sequencing, bone mineral density goals, and early intervention for patients at high risk of fragility fractures. Watch Part 1 now and stay tuned for the next episodes in the EULAR 2026 Osteoporosis RhAPP Up Series. For more rheumatology education, visit the RhAPP Content Rheum and RhAPP ACE Mobile App.

In this episode of RhAPPcast, the official podcast of Rheumatology Advanced Practice Providers, host Amanda Mixon, PA-C, is joined by Audrey Gibson, PA-C, for part three of their special RhAPP Up series covering key psoriatic arthritis updates from the 2026 EULAR Congress.They begin by discussing real-world evidence on long-term treatment persistence with advanced therapies in psoriatic arthritis, highlighting how different mechanisms of action compare over time. The conversation focuses on what persistence and discontinuation rates may reflect in clinical practice and how real-world data can help inform treatment decisions.The episode also reviews a phase 2B study of a selective TYK2 inhibitor, exploring its effects on inflammatory biomarkers and clinical response in patients with active psoriatic arthritis. The discussion highlights how emerging biomarker research may one day help guide more personalized treatment selection and improve outcomes.Whether you're a rheumatology provider, advanced practice provider (APP), or other healthcare professional, this episode offers practical insights into real-world treatment patterns, emerging targeted therapies, and the future potential of biomarker-driven precision medicine in psoriatic arthritis care.Thank you for watching, be sure to explore the three-part ILD RhAPP Up Series, and stay tuned for our upcoming Osteoporosis Abstract Reviews.

In this episode of RhAPPcast, the official podcast of Rheumatology Advanced Practice Providers, host Amanda Mixon, PA-C, is joined by Audrey Gibson, PA-C, for part two of their special RhAPP Up series covering key psoriatic arthritis updates from the 2026 EULAR Congress.They discuss new long-term data highlighting the durability of response with emerging therapies in psoriatic arthritis, including how patients who respond early may be able to maintain disease control over several years. The conversation focuses on what sustained efficacy means for real-world treatment decisions and long-term disease management.The episode also reviews subgroup data from a phase 3 study of an IL-23–targeting therapy, showing consistent improvements in joint symptoms and inhibition of structural damage progression across a range of patient types. The discussion highlights the importance of early inflammation control and its role in reducing long-term joint damage.Whether you're a rheumatology provider, advanced practice provider (APP), or other healthcare professional, this episode offers practical insights into long-term treatment outcomes, emerging biologic therapies, and key factors that may influence therapy selection in psoriatic arthritis care.Stay tuned for part three of the RhAPP Up series and visit the Content Rheum to stay up to date with the latest clinical insights in rheumatologic care.

In this episode of RhAPPcast, the official podcast of Rheumatology Advanced Practice Providers, host Amanda Mixon, PA-C, is joined by Audrey Gibson, PA-C, as they kick off the first episode of a special three-part RhAPP Up series focused on key psoriatic arthritis updates from the 2026 EULAR Congress.They discuss several key abstracts from the meeting, including a head-to-head trial comparing two different therapeutic approaches in active psoriatic arthritis and what the results may mean for treatment decisions in clinical practice. The conversation highlights how new data may help guide therapy selection and improve patient care.The episode also reviews emerging data on a novel IL-17A inhibitor and its impact on patient-reported outcomes, including pain, fatigue, physical function, and quality of life. The conversation emphasizes the importance of aligning treatment goals with what matters most to patients, not just traditional clinical endpoints.Whether you're a rheumatology provider, advanced practice provider (APP), or other healthcare professional, this episode offers practical insights into evolving psoriatic arthritis treatment strategies, emerging biologic therapies, and the growing emphasis on precision medicine in inflammatory arthritis care.Stay tuned for Part 2 of the RhAPP Up series and visit the Content Rheum to stay up to date with the latest clinical insights in rheumatologic care.

In this episode of RhAPPcast, the official podcast of Rheumatology Advanced Practice Providers, host Amanda Mixon, PA-C, and guest Jessica Glennie, CNP, conclude their 2026 EULAR ILD RhAPP Up Series with a review of important new research on rheumatoid arthritis-associated interstitial lung disease (RA-ILD) and progressive pulmonary fibrosis (PPF).The discussion examines long-term data showing that interstitial lung disease can develop in patients with rheumatoid arthritis despite effective disease control, reinforcing the importance of ongoing screening and pulmonary monitoring. The episode also highlights new findings on an emerging antifibrotic therapy, including its potential to slow lung function decline, reduce respiratory complications, and improve outcomes for patients with autoimmune-related lung disease.Whether you're a rheumatology provider, advanced practice provider (APP), or other healthcare professional, this episode offers practical insights into identifying patients at risk for ILD, the value of early detection, and advances in the treatment of progressive pulmonary fibrosis.Stay tuned for new episodes highlighting the Osteoporosis and PsA Abstracts from EULAR 2026. Visit the Content Rheum and RhAPP ACE app for more rheumatology education.

In this episode of RhAPPcast, the official podcast of Rheumatology Advanced Practice Providers, host Amanda Mixon, PA-C, welcomes Jessica Glennie, CNP, to continue their 2026 EULAR ILD RhAPP Up series by reviewing the latest research on systemic sclerosis-associated interstitial lung disease (SSc-ILD) and progressive pulmonary fibrosis (PPF).The discussion highlights new real-world data showing that many patients with early SSc-ILD maintain stable lung function when closely monitored and treated appropriately. The episode also explores the safety and tolerability of an emerging antifibrotic therapy, reviewing its potential role in slowing disease progression while offering a favorable side effect profile for patients with autoimmune-related lung disease.Whether you're a rheumatology provider, advanced practice provider (APP), or other healthcare professional, this episode delivers practical insights into early disease monitoring, evolving treatment options, and strategies to help improve long-term outcomes for patients with ILD.Stay tuned for Part 3 and visit the Content Rheum to stay up to date with the latest clinical insights in rheumatologic care.

In this episode of RhAPPcast, the official podcast of Rheumatology Advanced Practice Providers, host Amanda Mixon, PA-C, is joined by Jessica Glennie, CNP, as they discuss key interstitial lung disease (ILD) updates from the 2026 EULAR Congress in the first episode of a special three-part RhAPP Up series.They explore the healthcare and financial impact of connective tissue disease-associated ILD (CTD-ILD), highlighting why early diagnosis and treatment are so important for improving patient outcomes and reducing long-term costs. The episode also reviews emerging research on a potential new therapy for systemic sclerosis that may target multiple aspects of the disease and help slow its progression.Whether you're a rheumatology provider, advanced practice provider (APP), or other healthcare professional, this episode provides practical insights into the latest ILD research, evolving treatment strategies, and the value of early, multidisciplinary care.Stay tuned for Part 2 and visit the Content Rheum to stay up to date with the latest clinical insights in rheumatologic care.

Stay ahead of the latest advancements in rheumatology with this in-depth RhAPPcast episode exploring TYK2 inhibition and its expanding role in immune-mediated diseases. Hosted by Amanda Mixon, PA-C, this episode features expert insights from Danielle Gatti-Palumbo, PharmD, and Jennifer Mylod, DNP, as they break down the science behind TYK2 signaling within the JAK-STAT pathway and its clinical relevance in conditions like psoriatic arthritis, systemic lupus erythematosus (SLE), and Sjögren’s syndrome.Learn how TYK2 inhibitors—such as deucravacitinib—are reshaping treatment strategies by targeting key cytokines like IL-12, IL-23, and type 1 interferons, offering a potentially effective oral alternative with a differentiated safety profile compared to traditional JAK inhibitors. The discussion highlights pivotal clinical trials including POETYK PSO-1, POETYK PSO-2, and emerging phase 3 data in psoriatic arthritis, as well as promising findings from the PAISLEY trial in lupus. Additionally, the episode explores the unmet need in Sjögren’s syndrome and how evolving trial designs and outcome measures may pave the way for future targeted therapies.Whether you're a rheumatology provider, advanced practice provider (APP), or healthcare professional interested in autoimmune disease management, this episode delivers key clinical insights, trial data, and future considerations shaping the next wave of immunomodulatory therapies. For more rheumatology education, check out the RhAPP Content Rheum or download the RhAPP ACE app.

Explore the latest evidence in obesity management in this journal club review of the SURMOUNT-5 clinical trial, presented by Bharati Bhardwaja, PharmD, from Kaiser Permanente Colorado. This video breaks down a Phase 3b randomized trial comparing tirzepatide and semaglutide in adults with obesity without type 2 diabetes, highlighting key efficacy and safety outcomes over 72 weeks. Learn how tirzepatide demonstrated superior weight loss compared to semaglutide, achieving an average 20.2% reduction in body weight versus 13.7%, along with significantly greater reductions in waist circumference. The discussion also reviews clinically meaningful weight loss thresholds, showing that more patients on tirzepatide achieved ≥10%, ≥15%, ≥20%, and even ≥30% weight reduction. Safety findings are also covered, including common gastrointestinal side effects such as nausea, diarrhea, constipation, and vomiting, as well as considerations during dose escalation. Designed for healthcare professionals and clinicians managing obesity and metabolic disease, this video provides a clear, evidence-based comparison of two leading therapies, offering practical insights to guide treatment decisions and optimize patient outcomes in obesity care. For more expert-led education, visit the Content Rheum and stay up to date with the latest clinical insights in rheumatologic care.

In this educational Medication Review, Claudia Rivera-Salas, DNP, provides a practical overview of deucravacitinib and its role in the treatment of immune-mediated diseases such as psoriatic arthritis and plaque psoriasis. This video highlights why deucravacitinib, a selective TYK2 inhibitor, is gaining attention for its unique mechanism of action and ease of use in clinical practice. Learn how deucravacitinib stands out as a once-daily oral therapy with a fixed dose—requiring no titration, no routine dose adjustments, and the flexibility to be taken with or without food, helping to support patient adherence. Claudia explains how its targeted inhibition of the TYK2 regulatory domain differentiates it from traditional JAK inhibitors, contributing to a favorable safety profile without boxed warnings for major adverse cardiovascular events (MACE), venous thromboembolism (VTE), malignancy, or serious infections observed in clinical trials. The discussion also covers key clinical considerations, including minimal drug-drug interactions, the lack of required routine lab monitoring, and important precautions for patients with severe hepatic impairment or those who are pregnant or breastfeeding. Currently approved for adults with moderate to severe plaque psoriasis and psoriatic arthritis, deucravacitinib is also being investigated across a range of autoimmune conditions. Watch this video to understand how deucravacitinib fits into modern rheumatology and dermatology treatment strategies, and why its balance of efficacy, safety, and convenience makes it a valuable option for both providers and patients managing chronic inflammatory diseases. For more rheumatology resources, visit the RhAPP Content Rheum, RhAPP ACE app, or follow RhAPP on Instagram, LinkedIn, or Facebook.

Discover how obesity impacts outcomes in psoriatic arthritis in this insightful episode featuring expert perspectives from rheumatology clinicians, Amanda Mixon, PA-C and Jeannette Hart, PA-C. This discussion explores the growing recognition of obesity as a chronic, pro-inflammatory condition that not only worsens joint symptoms and physical function but also reduces treatment response in patients with psoriatic arthritis. Learn practical, real-world strategies for integrating weight assessment into routine rheumatology care, including how to approach sensitive conversations with patients in a stigma-free, supportive way. The episode highlights how even modest weight loss (5–10%) can improve disease activity, reduce inflammation, and enhance overall health outcomes. Clinicians will also gain insights into building obesity-focused care pathways within their practice, from lifestyle counseling and patient education to incorporating emerging pharmacologic options like GLP-1 therapies. Designed for healthcare professionals, this episode emphasizes the importance of empathy, patient partnership, and science-driven communication when addressing weight management in psoriatic arthritis. Whether you’re looking to improve patient engagement, optimize treatment response, or expand your approach to comprehensive inflammatory disease care, this conversation offers actionable guidance to elevate your clinical practice. For more expert-led education, visit the Content Rheum and stay up to date with the latest clinical insights in rheumatologic care.

In this educational FAQ video, Iris Zink, NP, a rheumatology nurse practitioner, provides a comprehensive overview of the TYK2/STAT signaling pathway and its immunologic role in autoimmune diseases like systemic lupus erythematosus (SLE) and Sjögren’s disease. Drawing from clinical experience and real-world insights, Iris explains how dysregulated cytokine signaling—particularly involving type 1 interferon, interleukin-12 (IL-12), and interleukin-23 (IL-23)—drives chronic inflammation, autoantibody production, and organ damage in these complex conditions. The video explores how TYK2, a member of the Janus kinase (JAK) family, plays a central role in mediating immune responses by transmitting intracellular signals from pro-inflammatory cytokines. Unlike other JAK kinases, TYK2 is more selectively involved in immune pathways, making it an attractive therapeutic target. Iris breaks down how over activation of TYK2 contributes to the interferon-driven inflammatory cycle seen in both lupus and Sjögren’s disease, leading to B-cell hyperactivity, increased BAFF production, and a higher risk of complications such as lupus nephritis and lymphoma. Using a relatable analogy, the discussion simplifies complex immunology by comparing dysregulated B-cell activity to a “bubble machine stuck on,” illustrating how unchecked immune signaling leads to abnormal cell proliferation and autoimmunity. The video also highlights how TYK2 inhibition may help restore immune balance by reducing cytokine production, limiting autoreactive B-cell activation, and potentially decreasing long-term organ damage. Watch this video to gain a deeper understanding of the TYK2 pathway, the interferon-BAFF axis, and why TYK2-directed therapies represent a promising, targeted approach for managing SLE and Sjögren’s disease. For more rheumatology education, visit the RhAPP Content Rheum, RhAPP ACE app, or follow RhAPP on Instagram, LinkedIn and Facebook.

In this episode of RhAPPcast, the official podcast of the Rheumatology Advanced Practice Providers, host Amanda Mixon, PA-C, is joined by rheumatology experts Heather Finlayson, PA-C, and Stacey Johnson, NP, to discuss one of the most challenging aspects of rheumatology care: ensuring patient access to advanced therapies. This conversation explores the complexities of Medicare formularies, prior authorizations, step edits, tier placement, and evolving affordability programs that support patients receiving specialty medications.Listeners will gain practical insights into how Medicare Part B and Part D coverage impacts rheumatology prescribing, including formulary restrictions, preferred therapies, and the financial barriers patients often face when accessing biologics and biosimilars. The discussion also highlights programs such as the Medicare Prescription Payment Plan (M3P), CAP, and cost-smoothing initiatives that help reduce out-of-pocket costs and improve treatment access for Medicare beneficiaries.The panel also shares practical strategies for navigating access challenges through patient education, strong documentation, communication with clinic teams and biologics coordinators, and proactive advocacy to help patients stay on therapy.Ideal for rheumatology providers, advanced practice providers, pharmacists, and clinic teams, this episode delivers actionable guidance to improve patient access, reduce treatment delays, and support long-term medication adherence in rheumatology practice.For more expert-led rheumatology education, visit the RhAPP Content Rheum and RhAPP ACE app, and subscribe to RhAPPcast for future episodes.

In this FAQ video, Christy Vath, PA-C of Seattle Rheumatology Associates, breaks down the concept of minimal disease activity (MDA) in psoriatic arthritis (PsA) and explores how deucravacitinib performs in achieving this important treatment target at 52 weeks. With the evolution of targeted biologic therapies since the late 1990s, treatment goals in PsA have shifted toward objective, measurable outcomes like MDA—an established composite endpoint requiring patients to meet 5 of 7 clinical criteria, including low joint counts, reduced skin involvement, improved patient-reported outcomes, and minimal enthesitis. This educational discussion reviews the development and validation of MDA as a treat-to-target strategy in PsA, highlighting its clinical significance in improving disease control and patient quality of life. Christy also dives into the mechanism of action of deucravacitinib, a selective TYK2 inhibitor that targets key inflammatory pathways such as IL-23 and type 1 interferon, central to PsA pathogenesis. Data from the POETYK PsA-1 and PsA-2 phase 3 trials are discussed, showing that deucravacitinib demonstrated superior MDA response rates compared to placebo at week 16, with continued improvement through week 24 and sustained responses at week 52, reaching nearly 34%.Watch now to better understand MDA in PsA, the role of TYK2 inhibition, and how evolving therapies are helping clinicians achieve meaningful, long-term outcomes for patients. For more rheumatology content, visit the RhAPP Content Rheum or the RhAPP ACE app.

In this FAQ video, Shannon Ghizzoni, PA-C, of Columbus Arthritis Center reviews the latest guidance on managing obesity in patients with psoriatic arthritis. Referencing the 2018 American College of Rheumatology (ACR) and National Psoriasis Foundation recommendations, she explains why weight loss is conditionally recommended for overweight and obese patients with psoriatic arthritis and how adiposity contributes to systemic inflammation and increased disease activity. This discussion explores evidence behind very low-calorie and hypocaloric diets, the role of the Mediterranean diet in reducing inflammation and cardiovascular risk, and emerging data on gluten-free diets, sugar reduction, and GLP-1 therapies. Designed for rheumatology clinicians and advanced practice providers, this video highlights practical, individualized strategies to support weight management and improve outcomes in psoriatic arthritis.

In this episode of RhAPPcast, the official podcast of Rheumatology Advanced Practice Providers, host Amanda Mixon and Bonnie Smeryage, NP, explore the real-world impact of X-linked hypophosphatemia (XLH) through a powerful patient perspective. Featuring Shannon Sharp, a patient ambassador with Kyowa Kirin, this discussion dives into the genetic basis, diagnostic challenges, and lifelong burden of XLH—a rare, chronic metabolic bone disorder characterized by renal phosphate wasting. Learn how XLH symptoms such as bone pain, muscle weakness, fractures, and joint stiffness can mimic common rheumatologic conditions, often leading to misdiagnosis. This episode highlights the critical role of family history, genetic testing, and fasting serum phosphorus in identifying XLH, while also emphasizing the importance of compassionate, patient-centered care when discussing sensitive topics like family planning. Gain valuable clinical insights into disease progression, surgical considerations, and quality-of-life challenges, along with practical strategies to improve diagnosis and management. Whether you're a rheumatology provider, advanced practice provider (APP), or healthcare professional, this episode offers essential education on recognizing and supporting patients with XLH.

Explore the safety profile of tirzepatide in this clinician-focused medication review led by Bharati Bhardwaja, PharmD, a rheumatology clinical pharmacist at Kaiser Permanente Colorado. This video provides a comprehensive overview of common adverse effects associated with tirzepatide, including gastrointestinal symptoms such as nausea, diarrhea, constipation, abdominal pain, and decreased appetite, as well as other reactions like injection site reactions, fatigue, and hair loss. The discussion also highlights important drug interaction considerations, including the need to adjust doses of insulin or sulfonylureas to reduce hypoglycemia risk, and the impact of delayed gastric emptying on the absorption of medications with narrow therapeutic windows, such as warfarin. Special attention is given to potential considerations with mycophenolate mofetil and oral hormonal contraceptives, along with guidance on monitoring and alternative strategies. Additionally, this review covers key safety considerations for pregnancy and lactation, emphasizing the importance of risk-benefit discussions and appropriate discontinuation when necessary. Designed for healthcare professionals managing patients with metabolic and rheumatologic conditions, this video delivers practical insights to support safe prescribing, minimize adverse effects, and optimize patient outcomes with tirzepatide therapy. Explore more expert-led education and medication reviews on the Content Rheum and stay up to date with the latest clinical insights in rheumatologic care.

Learn the recommended starting dose and titration strategy for tirzepatide in this medication review featuring Jennifer Mylod, DNP, from Arizona Arthritis & Rheumatology Associates in Phoenix, Arizona. This video provides a practical, clinician-focused overview of how to initiate tirzepatide at 2.5 mg once weekly to improve gastrointestinal tolerability and patient adherence, followed by a structured dose escalation approach. Viewers will gain insight into the standard titration schedule—advancing in 2.5 mg increments every 4 weeks up to a maximum of 15 mg—as well as how to individualize treatment based on patient response and side effect profile. The discussion highlights common adverse effects such as nausea, vomiting, diarrhea, and constipation, along with strategies to manage these symptoms, including slower titration, dose adjustments, and patient counseling on diet, hydration, and meal size. This review also explores key clinical outcomes associated with tirzepatide, including glycemic control, weight reduction, and appetite regulation, while emphasizing that not all patients require maximum dosing to achieve meaningful benefits. Special considerations for older adults, patients with gastrointestinal sensitivity, renal impairment, or those on concomitant insulin or sulfonylureas are also addressed to help clinicians minimize risk and optimize safety. Whether you're managing patients with type 2 diabetes or obesity, this video delivers actionable guidance on how to personalize tirzepatide therapy, improve tolerability, and support long-term treatment success. Explore more expert-led education and medication reviews on Content Rheum and stay up to date with the latest clinical insights in metabolic and rheumatologic care.

Stay up to date with the latest advancements in psoriatic arthritis treatment in this journal club review featuring Jessica Farrell, PharmD, from Albany Medical Center. This video explores a Phase 3 SOLSTICE clinical trial evaluating the efficacy and safety of guselkumab in patients with active psoriatic arthritis who had an inadequate response to a prior TNF inhibitor. The discussion highlights key clinical outcomes, including ACR20, ACR50, and ACR70 response rates, minimal disease activity, and psoriasis improvement, demonstrating that guselkumab significantly outperformed placebo across multiple endpoints. Importantly, the review examines dosing strategies, comparing every-4-week versus every-8-week regimens, and explains why increased dosing frequency did not lead to superior outcomes—offering valuable insights into pharmacokinetics and receptor saturation in IL-23 inhibition. Designed for healthcare professionals managing complex psoriatic arthritis cases, this video provides practical, evidence-based guidance on biologic sequencing after TNF failure, real-world applicability of clinical trial data, and how to optimize treatment strategies for improved patient outcomes. For more expert-led education, visit the Content Rheum and stay up to date with the latest clinical insights in rheumatologic care.

In this educational FAQ video, Wendy Simmons, PA-C from Carolina Arthritis Associates, shares expert insights on hypophosphatasia (HPP)—a rare genetic metabolic bone disorder that is frequently underrecognized in rheumatology practice. With over 25 years of experience in rheumatology and specialization in osteoporosis, she highlights how HPP is characterized by low alkaline phosphatase levels and impaired bone mineralization, leading to chronic pain, fractures, and reduced quality of life. This comprehensive discussion explores why patients with HPP are often misdiagnosed with more common conditions such as fibromyalgia, osteoarthritis, neuropathies, or even psoriatic arthritis, and emphasizes the importance of recognizing overlapping, cross-specialty symptoms. Wendy outlines key clinical pearls to help advanced practice providers and healthcare professionals improve early diagnosis, including the importance of obtaining a detailed childhood history, dental history (early tooth loss with intact roots), and careful interpretation of alkaline phosphatase lab values across adult and pediatric ranges. She also discusses hallmark fracture patterns such as metatarsal stress fractures and atypical femur fractures, as well as the significant diagnostic delay—often averaging over a decade—that many patients experience. This video serves as a practical guide for clinicians to better identify HPP, avoid common diagnostic pitfalls, and ultimately improve patient outcomes through earlier recognition and appropriate management. Perfect for rheumatology APPs, physician assistants, nurse practitioners, and clinicians interested in rare bone diseases, osteoporosis, and metabolic disorders, this video reinforces the importance of a thorough clinical history, targeted lab evaluation, and heightened awareness of hypophosphatasia in everyday practice. For more expert-driven APP education, visit the RhAPP Content Rheum or access resources through the RhAPP ACE app.

Explore the mechanism of action of tirzepatide in this comprehensive medication review led by Bharati Bhardwaja, PharmD, from Kaiser Permanente Colorado. This video breaks down how tirzepatide, a first-in-class dual incretin receptor agonist, targets both glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptors to improve metabolic outcomes. Learn how this once-weekly injectable therapy is FDA-approved for improving glycemic control in patients with Type 2 Diabetes and for chronic weight management in adults with obesity or overweight with comorbidities, including its role in treating obstructive sleep apnea.This educational module provides a detailed, clinically relevant overview of tirzepatide’s effects across multiple organ systems. Discover how GLP-1 receptor activation reduces appetite, slows gastric emptying, enhances insulin secretion, and decreases glucagon release, while GIP receptor agonism further supports insulin regulation, improves tolerability, and enhances fat metabolism. The combined incretin effect results in improved insulin sensitivity, reduced inflammation in adipose tissue, decreased hepatic glucose production, and meaningful weight loss outcomes. Ideal for healthcare professionals and advanced practice providers, this video offers valuable insights into the pharmacology, therapeutic benefits, and real-world applications of tirzepatide in metabolic disease management. For more expert-driven APP education, visit the RhAPP Content Rheum or access resources through the RhAPP ACE app.

Danielle Gatti-Palumbo, PharmD reviews the phase 3 APEX trial evaluating Guselkumab in patients with active psoriatic arthritis (PsA), highlighting its role in reducing inflammation, improving clinical outcomes, and preventing structural joint damage. The discussion emphasizes the importance of early biologic intervention in a disease that can quickly lead to irreversible damage and disability. Results show that guselkumab significantly improved ACR response rates and inhibited radiographic progression by week 24 compared to placebo, with benefits seen across multiple disease domains including joints, skin, nails, and physical function. With a favorable safety profile and durable efficacy, this IL-23 inhibitor represents a valuable treatment option for clinicians managing PsA and aiming to prevent long-term disease progression.

In this episode of RhAPPcast, host Amanda Mixon PA-C, is joined by Wendy Simmons, PA-C, they explore the diagnostic challenges of hypophosphatasia (HPP), a rare genetic metabolic bone disease that is frequently overlooked or misdiagnosed. Mixon and Simmons discuss key clinical red flags, including persistently low alkaline phosphatase, fracture patterns, dental history, and musculoskeletal pain that can mimic more common conditions such as osteoporosis or fibromyalgia. The conversation highlights the underlying biology of HPP, common diagnostic pitfalls, and the real-world burden of delayed diagnosis across the lifespan. This episode is designed to sharpen clinical reasoning, improve awareness of hypophosphatasia in rheumatology practice, and support earlier, more accurate diagnosis to improve patient outcomes.

In this Journal Club Review, Eileen Lydon, NP, a rheumatology provider at NYU Hospital, discusses the challenges of diagnosing hypophosphatasia (HPP) in adults, based on a 2023 Osteoporosis International publication from the HPP International Working Group. HPP is a rare genetic metabolic bone disease characterized by low alkaline phosphatase levels and highly variable, non-specific symptoms such as fractures, chronic musculoskeletal pain, and premature tooth loss—often leading to delayed or missed diagnosis. This video highlights key findings from a large literature review that identified major and minor diagnostic criteria to improve recognition of adult HPP. Clinicians will learn how to apply these criteria in practice and better differentiate HPP from conditions like osteoporosis. Designed for rheumatology providers and advanced practice providers, this overview emphasizes the importance of early identification to improve patient outcomes. For more rheumatology education, explore the Content Rheum and the RhAPP ACE app.

In this educational video, Shannon Ghizzoni, a physician assistant at Columbus Arthritis Center, explores the impact of weight reduction on disease activity and treatment outcomes in Psoriatic Arthritis. This discussion highlights the strong connection between obesity—particularly visceral fat—and increased inflammation in patients with psoriatic arthritis and psoriasis. Learn how excess adipose tissue contributes to a pro-inflammatory state by elevating cytokines such as Tumor Necrosis Factor alpha, Interleukin-6, and Interleukin-17—key drivers of joint inflammation, enthesitis, and skin manifestations. The video also explains how obesity may reduce the effectiveness of biologic therapies like TNF inhibitors, making weight management a critical component of comprehensive care. Additionally, this module reviews the link between psoriatic arthritis and Metabolic Syndrome, emphasizing the role of central obesity and metabolic dysfunction in worsening disease burden. A featured 2019 clinical study demonstrates that significant weight loss—achieved through a very low-calorie diet—led to meaningful improvements in disease activity, including reduced joint counts, lower CRP levels, improved psoriasis severity, and enhanced physical function. Notably, patients achieving minimal disease activity nearly doubled, with sustained benefits observed up to 24 months. This video underscores the importance of integrating weight reduction strategies alongside pharmacologic therapy to optimize outcomes in psoriatic arthritis. Discover how lifestyle interventions can create a synergistic effect with disease-modifying treatments to improve long-term patient outcomes. For more expert-driven rheumatology education, visit the RhAPP platform, explore the Content Rheum, or download the RhAPP ACE App for on-the-go learning. #PsoriaticArthritis #Rheumatology #ObesityAndInflammation #APPeducation #BiologicTherapy #TNFinhibitors #MetabolicSyndrome #ContentRheum #RhAPP

In this FAQ video, Jeremy Morgan, NP, from Access Solutions Rheumatology in Tulsa, Oklahoma, discusses the neuromuscular and functional burden of hypophosphatasia (HPP), a rare and often underdiagnosed metabolic bone disease. While severe forms may present in infancy, many patients with milder HPP go unrecognized until adolescence or adulthood, experiencing chronic bone pain, joint pain, enthesitis, and recurrent foot fractures. These symptoms are frequently misdiagnosed as growing pains, fibromyalgia, or osteoporosis, leading to delayed diagnosis and inappropriate management. Patients with HPP often face significant functional limitations, including difficulty standing or walking for extended periods, reduced mobility, and challenges in daily activities, career choices, and social engagement. Dental complications, such as frequent cavities and tooth loss, further impact quality of life. This video highlights the importance of early recognition, accurate diagnosis, and appropriate management strategies for HPP, providing valuable insights for rheumatology providers and advanced practice providers. For more expert-driven rheumatology education, visit the RhAPP Content Rheum and the RhAPP ACE app.

In this episode of RhAPPcast, Amanda Mixon, PA-C, and Laura Hoover, PharmD, break down the clinical use of intravenous immunoglobulin (IVIG) in rheumatology. They explore how IVIG works to modulate the immune system, where it is most effective—particularly in dermatomyositis and polymyositis—and its role as a second- or third-line option in refractory autoimmune conditions. The discussion highlights practical considerations for advanced practice providers, including weight-based dosing, infusion strategies, and the importance of premedication and hydration to reduce adverse effects. Key safety risks such as thrombosis, renal complications, and infusion reactions are reviewed, along with strategies to minimize these risks. The episode also addresses common challenges with insurance approval and patient access, offering real-world tips to navigate these barriers. With additional insights on subcutaneous options, brand differences, and monitoring considerations like IgA levels, this episode provides a concise, practical guide to safely and effectively incorporate IVIG into rheumatology care. #IVIG #Rheumatology #AutoimmuneDisease #APPs #ClinicalEducation #Immunology

In this journal club review module, Danielle Gatti Palumbo, PharmD, explores a post hoc analysis of a phase 3 clinical trial evaluating the efficacy of Guselkumab in biologic-naive patients with severe psoriatic arthritis (PsA). The discussion breaks down how guselkumab performs across multiple PsA disease domains, including joint involvement, skin and nail disease, enthesitis, dactylitis, and patient-reported outcomes. Psoriatic arthritis is a complex, multi-domain inflammatory condition that significantly impacts quality of life, making effective and durable treatment strategies essential for long-term disease control. The analysis highlights rapid and sustained improvements with guselkumab, with joint symptom relief seen as early as week 2 and broader disease activity improvements by week 8, maintained through 2 years. Across multiple severity cohorts, patients treated with guselkumab were significantly more likely to achieve and maintain low disease activity compared to placebo, with consistent efficacy across both every-4-week and every-8-week dosing regimens. These findings reinforce the importance of early biologic intervention and support guselkumab as a strong first-line treatment option for patients with severe PsA. Visit the RhAPP Content Rheum and the RhAPP ACE app for more rheumatology education.

In this FAQ, Libby Allen, a rheumatology nurse practitioner, explains how obesity impacts psoriatic arthritis outcomes and why it plays a critical role in disease severity and treatment response. Obesity is known to increase pro-inflammatory cytokines such as TNF-alpha (TNFA), IL-6, and IL-1B, creating a chronic low-grade inflammatory state that directly worsens psoriatic arthritis. This inflammation activates key immune pathways, including the IL-23 and IL-17 axis, which are central to psoriatic arthritis pathogenesis and progression. Patients with both obesity and psoriatic arthritis often experience poorer outcomes, including higher disease activity scores (DAPSA), increased joint pain, and reduced likelihood of achieving low disease activity or remission. Obesity also contributes to reduced effectiveness of conventional DMARDs and biologic therapies, making disease management more challenging. In addition to systemic inflammation, increased adiposity places mechanical stress on joints, further worsening pain and functional limitations. This video highlights the complex relationship between metabolic dysfunction and immune response, emphasizing that obesity is not just a comorbidity but a key driver of more severe psoriatic arthritis and diminished therapeutic response. Understanding this connection is essential for improving patient outcomes and optimizing treatment strategies in rheumatology. For more educational content, visit the RhAPP content rheum or explore the RhAPP ACE app.

In this educational FAQ video, Jeremy Morgan, NP, of Access Solutions Rheumatology in Tulsa, Oklahoma, explores the key skeletal and dental manifestations associated with hypophosphatasia (HPP), a rare metabolic bone disease that is often under recognized in clinical practice. This overview highlights important dental findings such as recurrent cavities, early tooth loss, frequent fillings, crowns, and root canals, which may serve as early indicators of HPP. On the musculoskeletal side, patients commonly present with chronic foot pain, shin pain, enthesitis, and frequent stress fractures—often going unnoticed due to persistent discomfort. Many individuals are misdiagnosed with conditions like fibromyalgia or osteoporosis at a young age, and notably, treatment with bisphosphonates may worsen bone health in patients with HPP. This video provides valuable clinical insights for rheumatology providers and advanced practice providers to help improve early recognition, avoid misdiagnosis, and optimize management of hypophosphatasia. For more rheumatology-focused education, visit the RhAPP Content Rheum and RhAPP ACE app.

In this episode of RhAPPcast, host Amanda Mixon, PA-C, is joined by Christina Hanson, FNP-C, to explore the growing intersection between rheumatology and gastroenterology, focusing on shared immune pathways and the evolving role of subcutaneous biologic therapies in immune-mediated inflammatory diseases (IMIDs). The conversation highlights how advances in subcutaneous (SubQ) biologics for inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis, are improving patient convenience, adherence, and quality of life while offering comparable efficacy to traditional IV infusions. This expert discussion dives into key clinical considerations such as induction versus maintenance strategies, patient selection, safety, and real-world implementation of SubQ therapies. The episode also emphasizes the importance of multidisciplinary collaboration between rheumatology and GI providers, especially when managing patients with overlapping conditions like psoriatic arthritis and axial spondyloarthritis. Listeners will gain practical insights on optimizing treatment decisions, enhancing patient education, and leveraging a shared “toolbox” of therapies to better manage complex, multi-system disease. For more expert-driven education and cross-specialty insights, subscribe to RhAPPcast and visit RhAPP.org, the Content Rheum & the RhAPP ACE app.

Stay up to date on the latest advances in giant cell arteritis (GCA) management with this Fireside Chat episode featuring expert insights from Naomi Amudala, NP, and Dr. Peter Merkel. Hosted by Amanda Mixon, PA-C, this discussion breaks down the two-year SELECT-GCA trial data, highlighting the efficacy and safety of upadacitinib as a steroid-sparing therapy in patients with GCA. Learn how long-term outcomes impact clinical decision-making, including strategies for sustained remission, glucocorticoid tapering, relapse prevention, and real-world patient management. This episode is designed for rheumatology advanced practice providers and clinicians seeking to better interpret clinical trial data and apply it in practice, with a focus on balancing treatment benefits, safety considerations, and patient-specific risk factors. Explore key takeaways on JAK inhibitors, long-term disease control, and evolving therapeutic approaches in vasculitis care. For more rheumatology education, podcasts, and expert-led content, explore the Content Rheum and the RhAPP ACE app.

In this video, rheumatology physician assistant Amanda Mixon, PA-C, discusses the critical role of MRI in identifying axial involvement in psoriatic arthritis. While clinicians often focus on peripheral joint and skin symptoms, up to 20–40% of patients may have axial disease, which can sometimes be the presenting feature. Key symptoms such as inflammatory back pain, nighttime discomfort, and morning stiffness that improves with activity should prompt further evaluation. Amanda highlights how MRI enables early detection of inflammatory changes like sacroiliitis that may not appear on X-rays, making it an essential tool for accurate diagnosis. Early identification of axial involvement supports a domain-based treatment approach, helping clinicians select the most appropriate therapy and improve patient outcomes. For more rheumatology education and APP-focused resources, visit the RhAPP Content Rheum and RhAPP ACE app. #PsoriaticArthritis #AxialPsA #MRIImaging #Rheumatology #APPeducation #Sacroiliitis #InflammatoryBackPain

Obesity can significantly impact immune system function and contribute to chronic inflammation. In this educational segment, rheumatology nurse practitioner Libby Allen, ARNP, FNP, explains how obesogenic diets alter the gut microbiome and trigger inflammatory pathways that increase cytokines such as TNF-alpha and IL-6, placing the immune system in a persistent low-grade inflammatory state. The discussion also highlights the role of leptin, a hormone produced by fat cells that regulates appetite and immune signaling. In obesity, elevated leptin levels can disrupt normal metabolic signals and promote immune dysregulation, which may worsen inflammatory and autoimmune conditions such as rheumatoid arthritis, psoriatic arthritis, and psoriasis. For more rheumatology education and APP-focused learning, visit the RhAPP Content Rheum or the RhAPP ACE app.

Power Doppler ultrasound is transforming how clinicians detect subclinical enthesitis in conditions like psoriatic arthritis (PsA) and spondyloarthritis (SpA). In this educational segment, Audrey Gibson, PA-C explains how Power Doppler imaging can identify active inflammation at tendon and ligament insertion sites by visualizing increased blood flow—often before symptoms appear on physical exam. This technology helps clinicians uncover hidden disease activity, risk-stratify patients with psoriasis who may develop psoriatic arthritis, and monitor response to biologic therapies. By detecting inflammation earlier, Power Doppler ultrasound supports more proactive treatment decisions and improved long-term outcomes for patients with inflammatory arthritis. For more rheumatology education and APP-focused clinical insights, visit the RhAPP website or explore the RhAPP ACE app. #Rheumatology #PsoriaticArthritis #Spondyloarthritis #Enthesitis #Ultrasound #APPeducation

In this episode of RhAPPcast, the official podcast of Rheumatology Advanced Practice Providers, host Amanda Mixon sits down with rheumatology PA Heather Mambretti to explore the clinical significance of low alkaline phosphatase (ALP) and why this often overlooked lab value may signal important genetic conditions such as hypophosphatasia (HPP). The conversation highlights how persistently low ALP can be a key clue in patients presenting with vague musculoskeletal symptoms, unexplained fractures, dental abnormalities, or chronic fatigue—symptoms frequently encountered in rheumatology clinics. Heather explains how clinicians should approach the diagnostic workup, including trending ALP levels over time, reviewing dental and family history, evaluating radiographic findings, and considering ALPL gene testing when hypophosphatasia is suspected. The episode also provides practical guidance for rheumatology clinicians and advanced practice providers on integrating low ALP awareness into routine clinical assessments, avoiding missed diagnoses, and recognizing that adult hypophosphatasia may be more common than previously thought. Listeners will learn how identifying genetic causes of low ALP can improve patient outcomes, guide appropriate management, and even help uncover undiagnosed cases within families. This discussion offers valuable insights for rheumatology providers involved in bone health, osteoporosis evaluation, and the investigation of unexplained musculoskeletal complaints. For more rheumatology education visit the Content Rheum or the RhAPP ACE app. #Rheumatology #Hypophosphatasia #LowALP #BoneHealth #Osteoporosis #GeneticDisorders #RheumatologyAPP #MedicalEducation #MusculoskeletalHealth

In this FAQ video, Will Saalfeld, NP, reviews the clinical efficacy of switching to guselkumab after an inadequate response to a TNF inhibitor in psoriatic arthritis. The discussion highlights key trial data from DISCOVER-1 and COSMOS, real-world outcomes, and improvements in joint and skin disease, including ACR20 response rates, low disease activity, and remission through one year. Safety, durability, and the rationale for IL-23 pathway targeting are also reviewed to support evidence-based treatment decisions in TNF-experienced patients.

In this episode of RhAPPcast, host Amanda Mixon, PA-C, leads a 2026 Fireside Chat exploring the intersection of rheumatology and gastroenterology. Joined by Kim Orleck, PA-C (GI APP), and Wendy Simmons, PA-C (Rheumatology APP), the panel discusses the shared inflammatory pathways linking Crohn’s disease, ulcerative colitis, psoriatic arthritis, and ankylosing spondylitis, with a focus on the gut–joint–skin axis and the IL-23, IL-17, and TNF pathways. The conversation highlights early screening for overlapping immune-mediated inflammatory diseases (IMIDs), recognizing subclinical gut inflammation, and selecting cross-indication therapies such as JAK inhibitors and IL-23 inhibitors based on disease severity, comorbidities, and cardiovascular risk. Listeners will gain practical insights into biomarker use (including fecal calprotectin), second-line treatment strategies after TNF failure, and the importance of real-time collaboration between rheumatology and GI providers to optimize patient outcomes. For more educational content, visit the Content Rheum, RhAPP ACE app, or RhAPP.org.

In this episode of RhAPPcast, Amanda Mixon and Wendy Simmons explore how guselkumab may help protect joints and slow structural damage in psoriatic arthritis, an important goal in long-term disease management. The discussion reviews clinical trial data, radiographic progression, and real-world considerations for using this IL-23 inhibitor in patients with active psoriatic arthritis, especially those at risk for irreversible joint damage, skin disease, and overlapping inflammatory conditions. Listeners will also hear practical insights on patient selection, treatment goals, safety considerations, and how to talk with patients about preventing permanent joint damage before it occurs. This episode is a helpful resource for rheumatology clinicians and advanced practice providers looking to better understand the role of guselkumab in psoriatic arthritis treatment and long-term joint preservation. For more educational content, visit RhAPP.org, Content Rheum or the RhAPP ACE app. #PsoriaticArthritis #Guselkumab #Rheumatology #IL23 #JointDamage #Biologics #PsA #RheumatologyAPP #RhAPPcast #MedicalEducation