RhAPPcast

Rheumatology Advanced Practice Providers (RhAPP)
  • 5.0 (5)
  • MEDICINE

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. 1D AGO

    RhAPPcast: Unpacking the Genetics: Low ALP

    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

    19 min

  2. 3D AGO

    FAQ: What Is the Efficacy of Switching MOA to Guselkumab After Inadequate Response to a single TNFi?

    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.

    2 min

  3. MAR 5

    Podcast: Inflammation Intersection: A Rheum-Gi Dialogue

    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.

    36 min

  4. MAR 3

    RhAPPcast: Protecting Joints: Inhibiting Structural Damage in PsA With Guselkumab

    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

    23 min

  5. FEB 26

    FAQ: How Can Clinicians Best Approach Talking to Patients With PsA About Weight Management?

    In this FAQ video, Iris Zink, MSN, ANP-BC, RN-BC, shares practical strategies for discussing weight management with patients living with psoriatic arthritis. She outlines how obesity drives systemic inflammation, increases disease activity, and raises cardiovascular risk, and explains why addressing BMI should be part of routine rheumatology care. This episode explores patient-centered communication techniques, the role of anti-inflammatory nutrition and whole-food approaches, and how to incorporate conversations about GLP-1 medications, diabetes screening, and cardiovascular risk reduction into everyday practice. Designed for rheumatology clinicians and advanced practice providers, this video offers real-world tips to improve outcomes in psoriatic arthritis through compassionate, proactive weight management discussions.

    6 min

  6. FEB 25

    Med Review: What is the Safety and Efficacy Profile of Guselkumab in Juvenile Psoriatic Arthritis?

    In this updated medication review video module, Brandon Ko, DNP, and Pediatric Chair of RhAPP, reviews the recent FDA approval of guselkumab for juvenile psoriatic arthritis (JPsA) in children ages 6 and older weighing more than 40 kg. He covers dosing, mechanism of action as an IL-23 inhibitor, and how the approval was based on extrapolated data from pediatric plaque psoriasis (PROTOSTAR) and adult psoriatic arthritis (DISCOVER-1) trials demonstrating strong efficacy and a favorable safety profile. The video also explains how guselkumab fits into the current JPsA treatment landscape alongside TNF inhibitors, abatacept, ustekinumab, secukinumab, and JAK inhibitors, with key considerations including uveitis risk, inflammatory bowel disease implications, paradoxical TNF-induced psoriasis, and safety profile. This overview provides practical guidance for pediatric rheumatology providers tailoring biologic therapy for children with juvenile psoriatic arthritis. For more rheumatology education, visit the RhAPP Content Rheum or the RhAPP ACE app.

    7 min

  7. FEB 24

    Medication Review: Anti-Drug Antibody Development With Guselkumab in Psoriasis, PsA & IBD

    In this comprehensive medication review, Lisa Asfahani, PA-C, a rheumatology physician assistant with over 14 years of clinical experience, explores the rates of anti-drug antibody development to guselkumab in patients with psoriatic arthritis. Guselkumab, an IL-23 p19 monoclonal antibody inhibitor, is approved for the treatment of plaque psoriasis, psoriatic arthritis, ulcerative colitis, and Crohn’s disease. This video breaks down the mechanisms of immunogenicity, how anti-drug antibodies can reduce treatment efficacy, and their potential role in secondary loss of response and adverse drug reactions. Lisa reviews key data from peer-reviewed studies, including findings on neutralizing antibody rates, ELISA assay detection methods, and long-term safety and efficacy outcomes in biologic-naïve patients. Learn how therapeutic drug monitoring, specialized antibody assays, consistent dosing strategies, and potential concomitant immunosuppressive therapy may help mitigate immunogenicity risks. Whether you manage psoriatic arthritis, psoriasis, or inflammatory bowel disease, this evidence-based overview provides practical insights to support confident biologic prescribing and long-term disease control in rheumatology practice. Visit the RhAPP Content Rheum or RhAPP ACE app for more educational resources.

    5 min

  8. FEB 19

    FAQ: What Role Does Tissue-Nonspecific Alkaline Phosphatase (TNSALP) Play in HPP?

    In this educational FAQ, Heather Mambretti, PA-C, a rheumatology physician assistant and RhAPP faculty and board member, explains the critical role of tissue-nonspecific alkaline phosphatase (TNSALP) in hypophosphatasia (HPP). TNSALP is an essential enzyme involved in bone and tooth mineralization, as well as vitamin B6 transport into cells. Mutations in the ALPL gene, which encodes TNSALP, lead to reduced enzyme activity, accumulation of mineralization substrates, and defective bone formation. This video reviews how inactivating ALPL gene variants—of which more than 450 have been identified—contribute to the clinical spectrum of hypophosphatasia, including differences in autosomal recessive and autosomal dominant inheritance patterns. Severe forms such as perinatal and infantile HPP are often associated with autosomal recessive mutations, while milder presentations may follow a dominant pattern. Clinicians will gain a clear understanding of the pathophysiology of HPP, the genetic variability behind disease expression, and why bone, liver, and kidney involvement are common. For more rheumatology-focused education, visit RhAPP.org, download the RhAPP ACE App, and explore additional expert content on the Content Rheum. #Hypophosphatasia #HPP #TNSALP #ALPL #Rheumatology #BoneMineralization #GeneticDisorders #AdvancedPracticeProviders #RhAPP #RheumEducation

    2 min
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Ratings & Reviews

5
out of 5
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. 

Information

  • Creator
    Rheumatology Advanced Practice Providers (RhAPP)
  • Years Active
    2023 - 2026
  • Episodes
    163
  • Rating
    Clean
  • Copyright
    © 2025 RhAPPcast
  • Show Website
    RhAPPcast

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