RhAPPcast

Rheumatology Advanced Practice Providers (RhAPP)

This is the official podcast of Rheumatology Advanced Practice Providers (RhAPP), a non-profit 501c3 organization dedicated to developing educational programs, providing professional advancement services, and assembling resources for—and guided by—advanced practice providers (APPs).    Through our peer-to-peer network, we seek to support the integral role APPs play in the rheumatology healthcare community by providing the most relevant and timely information and communication for the treatment of their patients with rheumatic diseases. 

  1. 15h ago

    RhAPPcast: Introducing the RhAPP Advocacy Program

    In this special edition of RhAPPcast, the official podcast of Rheumatology Advanced Practice Providers (RhAPP), Heather Finlayson and Kevin Daley discuss rheumatology advocacy and the importance of strengthening the APP voice in healthcare policy. They introduce the RhAPP Advocacy Committee and explore how nurse practitioners, physician assistants, and pharmacists can get involved in addressing insurance barriers, supporting medication access, and advocating for their patients and practices. This episode highlights key advocacy issues in rheumatology, including step therapy, non-medical switching, prior authorization, prescription drug affordability boards (PDABs), and the federal 340B Drug Pricing Program. Heather and Kevin discuss how insurance requirements and policy decisions intersect with everyday patient care, sharing practical ways clinicians can participate through legislative outreach, letter writing, virtual testimony, and patient education. The conversation also explores payer advocacy and the importance of bringing clinical experiences and patient perspectives into state and federal policy discussions. Designed for rheumatology APPs and other healthcare professionals, this discussion outlines the committee’s plans for regional leadership, virtual meetings, and ongoing advocacy education. Whether you are new to healthcare advocacy or looking for ways to become more involved, this episode offers an approachable starting point for making your voice heard and helping patients do the same. For more rheumatology education and podcasts, visit RhAPP’s website and explore the RhAPP ACE app.

  2. 2d ago

    FAQ: How Does Combination Therapy of Guselkumab and Golimumab Work in PsA?

    In this FAQ video module, William Saalfeld, NP, explains the rationale for investigational combination therapy with guselkumab and golimumab in psoriatic arthritis (PsA). He reviews how guselkumab targets interleukin-23 (IL-23) and golimumab inhibits tumor necrosis factor (TNF), highlighting how these medications address complementary inflammatory pathways involved in immune activation, synovitis, and joint inflammation. This episode examines the phase 2a AFFINITY study, which compared guselkumab plus golimumab with guselkumab monotherapy. William discusses the primary endpoint of minimal disease activity (MDA), American College of Rheumatology (ACR) response measures, and exploratory findings in patients with elevated C-reactive protein (CRP). He explains that the primary endpoint was not met, while secondary and exploratory analyses suggested potential additional benefits in peripheral joint disease and physical function. The discussion also considers why improvements in psoriasis, enthesitis, and dactylitis did not show a clear additional benefit with combination therapy. Designed for rheumatology advanced practice providers, nurse practitioners, physician assistants, and other healthcare professionals, this FAQ offers a concise overview of dual IL-23 and TNF inhibition in psoriatic arthritis. William emphasizes that guselkumab plus golimumab remains investigational, with further research needed to clarify which patients may benefit and its potential role in future PsA treatment strategies. For more expert-led education, visit the Content Rheum and download the RhAPP Ace app to stay up to date with the latest clinical insights in rheumatologic care.

  3. 4d ago

    FAQ: How Does Guselkumab Affect Pregnancy Outcomes?

    In this FAQ video module, Candace Ryan, PA-C, reviews guselkumab and pregnancy outcomes in patients with psoriatic arthritis, psoriasis, and inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis. She discusses how the timing of exposure to this IL-23 inhibitor and changes in placental antibody transfer inform conversations about biologic therapy during pregnancy. This episode examines pregnancy safety findings from the Janssen Global Safety Database and a World Health Organization (WHO) pharmacovigilance analysis. Candace reviews reported miscarriages, congenital abnormalities, live births, and comparisons with TNF inhibitors, while explaining the limitations of observational data and spontaneous reporting. She emphasizes why reassuring findings do not establish guselkumab as definitively safe during pregnancy or demonstrate greater safety than TNF inhibitors, particularly given limited data on exposure later in pregnancy. The discussion also explores ACR and EULAR guidance on biologic use during pregnancy and the importance of balancing potential medication risks with the consequences of uncontrolled maternal inflammatory disease. Topics include disease severity, timing of exposure, alternative therapies compatible with pregnancy, and shared decision-making to individualize treatment. Designed for rheumatology advanced practice providers, nurse practitioners, physician assistants, and other healthcare professionals, this FAQ offers practical context for reproductive health counseling and treatment decisions involving guselkumab during pregnancy. For more rheumatology education and clinical resources, visit RhAPP’s website, the RhAPP content rheum, or the RhAPP ACE app.

  4. Oct 22

    Journal Club: Guselkumab + Golimumab in Active PsA: Week 24 Phase 2a Results

    In this Journal Club, Claudia Rivera-Salas, DNP, discusses the phase 2a AFFINITY trial evaluating combination therapy for active psoriatic arthritis (PsA). She reviews a randomized, double-blind study comparing guselkumab, an interleukin-23 (IL-23) inhibitor, plus golimumab, a tumor necrosis factor (TNF) inhibitor, with guselkumab alone in adults who had an inadequate response to prior TNF inhibitor treatment. This episode explores the week 24 results, including the study’s primary endpoint of minimal disease activity (MDA), which was not met. Claudia discusses exploratory secondary findings involving ACR20 and ACR50 responses and patient-reported physical health outcomes, along with subgroup findings in participants with elevated baseline C-reactive protein (CRP). She also reviews safety observations through week 36 and considers the questions these early results raise about targeting two inflammatory pathways simultaneously in patients with persistent psoriatic arthritis disease activity. Designed for rheumatology advanced practice providers, nurse practitioners, physician assistants, and other healthcare professionals caring for patients with psoriatic arthritis, this discussion offers insight into emerging research on dual IL-23 and TNF inhibition. The review highlights the rationale for combination biologic therapy and the need for further research to clarify its efficacy, safety, and potential role in patients with an inadequate response to TNF inhibitors. Visit the RhAPP Content Rheum or RhAPP ACE app for more rheumatology education, medication reviews, and journal clubs.

  5. Oct 15

    FAQ: What is the difference between BASDAI and ASDAS?

    In this FAQ video module, Amanda Mixon, PA-C, explains the difference between the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Ankylosing Spondylitis Disease Activity Score (ASDAS), two validated tools used to assess disease activity in axial spondyloarthritis. She reviews how BASDAI uses six patient-reported questions to evaluate fatigue, spinal pain, peripheral joint symptoms, enthesitis-related tenderness, and morning stiffness, providing a quick and practical measure of a patient’s overall symptom burden. This episode also explores how ASDAS combines patient-reported symptoms with an objective marker of inflammation, such as C-reactive protein or erythrocyte sedimentation rate. Amanda discusses the established ASDAS disease activity categories, its ability to measure clinically important improvement, and its value in monitoring treatment response, predicting radiographic progression, and supporting clinical decision-making. She also explains why BASDAI scores may remain elevated because of factors beyond active inflammation, including structural damage, osteoarthritis, fibromyalgia, sleep disturbances, or mood disorders. Designed for rheumatology advanced practice providers, nurse practitioners, physician assistants, and clinicians caring for patients with axial spondyloarthritis or ankylosing spondylitis, this FAQ highlights why BASDAI and ASDAS should be viewed as complementary tools. BASDAI helps clinicians understand how the patient feels, while ASDAS adds objective evidence of inflammation to provide a more complete picture of disease activity. For more rheumatology education and clinical resources, visit RhAPP’s website, the RhAPP content rheum, or the RhAPP ACE app.

  6. Oct 13

    Medication Review: Guselkumab Label Updates Secondary to Data From the APEX and SOLSTICE Studies

    In this medication review, Amanda Mixon, PA-C, reviews the APEX and SOLSTICE clinical trials and their implications for guselkumab (Tremfya) in active psoriatic arthritis (PsA). This overview highlights the role of IL-23 inhibition in psoriatic arthritis management, including the APEX findings that supported a U.S. prescribing information update addressing inhibition of structural joint damage. This episode explores the APEX data on radiographic progression and the SOLSTICE findings in patients with an inadequate response or intolerance to prior tumor necrosis factor (TNF) inhibitor therapy. Amanda discusses key outcomes across joint symptoms, physical function, enthesitis, dactylitis, skin psoriasis, and minimal disease activity, along with the reported safety findings. The discussion emphasizes how these studies may inform treatment sequencing and conversations about symptom control, joint preservation, and individualized treatment goals. Designed for rheumatology advanced practice providers, nurse practitioners, physician assistants, and other clinicians managing psoriatic arthritis, this module offers practical insights into guselkumab clinical trial data, structural damage prevention, and shared decision-making when selecting biologic therapy. For more rheumatology education and clinical resources, visit RhAPP’s website, the RhAPP Content Rheum, or the RhAPP ACE 2.0 app.

  7. Oct 9

    RhAPPcast: The Steroid Tightrope: Managing GC Toxicity in PMR

    Amanda Mixon, PA-C and fellow rheumatology providers Heather Finlayson, PA-C, and Amanda Sell, PA-C, discuss managing glucocorticoid toxicity in polymyalgia rheumatica (PMR), focusing on balancing disease control with long-term patient safety. They explore the challenges of prednisone tapering, recurrent flares, and cumulative steroid exposure, including concerns associated with prolonged use at lower doses. The conversation highlights patient characteristics and comorbidities that may increase toxicity risk, including older age, diabetes, hypertension, osteoporosis, glaucoma, and psychiatric conditions. They review practical monitoring strategies for blood pressure, blood glucose, bone health, infection risk, and changes in weight, sleep, mood, and skin. The discussion also examines treat-to-target approaches and when difficulty tapering, repeated relapses, or steroid-related complications should prompt consideration of steroid-sparing therapy. Throughout the episode, they emphasize patient education, shared decision-making, and coordination across healthcare providers to establish treatment expectations and address patients’ concerns about reducing steroids. Designed for nurse practitioners, physician assistants, and other healthcare professionals caring for patients with PMR, this podcast offers practical insights into glucocorticoid safety, individualized treatment decisions, and reducing steroid burden while maintaining symptom control and quality of life. For more expert-led education, visit the Content Rheum and download the RhAPP Ace app to stay up to date with the latest clinical insights in rheumatologic care.

Ratings & Reviews

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5 Ratings

About

This is the official podcast of Rheumatology Advanced Practice Providers (RhAPP), a non-profit 501c3 organization dedicated to developing educational programs, providing professional advancement services, and assembling resources for—and guided by—advanced practice providers (APPs).    Through our peer-to-peer network, we seek to support the integral role APPs play in the rheumatology healthcare community by providing the most relevant and timely information and communication for the treatment of their patients with rheumatic diseases. 

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