RhAPPcast

In this educational video, Heather Mambretti, PA-C with over 13 years of rheumatology experience, explains how sarilumab is dosed and what patients can expect during administration for both rheumatoid arthritis (RA) and polymyalgia rheumatica (PMR). She discusses the convenience of the subcutaneous auto-injector, which allows patients to self-administer at home, and reviews the standard dosing regimen of 200 mg every two weeks with...

Starting a new biologic can be overwhelming for patients with polymyalgia rheumatica (PMR) or rheumatoid arthritis (RA). In this medication review, Heather Mambretti, PA-C, shares the key educational points she discusses when initiating sarilumab. She explains treatment goals—including reducing symptoms, improving quality of life, and, in RA, aiming for remission—while also highlighting why sarilumab is the first and only biologic ...

In this episode of RhAPPcast, the official podcast of rheumatology advanced practice providers, host Amanda Mixon continues the GCA Fireside Chat series with a deep dive into the SELECT-GCA trial—one of the most significant recent studies in giant cell arteritis (GCA). Joined by Naomi Amadala, CRNP, and Dr. Peter Merkel, professor of medicine and epidemiology at the University of Pennsylvania and lead author of the New England Jour...

Welcome back to RhAPPcast, the official podcast of rheumatology advanced practice providers. In this episode, host Amanda Mixon continues the GCA Fireside Chat series, focusing on the evolving treatment landscape for giant cell arteritis (GCA). Together with expert guests Naomi Amudala, CRNP, and Dr. Michael Putman, we explore the real-world challenges and clinical decision-making that go beyond diagnosis. Focusing on the therapeut...

In this video, Claudia Rivera Salas, NP, a rheumatology nurse practitioner in East Lansing, Michigan, discusses the role of sarilumab in the management of polymyalgia rheumatica (PMR). Sarilumab is a fully human IL-6 receptor blocker administered as a 200 mg subcutaneous injection every two weeks. By targeting IL-6, a key pro-inflammatory cytokine driving muscle pain, stiffness, and systemic inflammation in PMR, sarilumab helps red...

In this Journal Club discussion, Jeannette Hart, PA-C, reviews the landmark SAPHYR trial evaluating sarilumab for patients with polymyalgia rheumatica (PMR) who relapse during glucocorticoid tapering. PMR affects thousands of patients worldwide, with nearly half experiencing relapse when reducing prednisone or other glucocorticoids. For decades, treatment options were limited to steroids despite their well-known side effects and lo...

In this FAQ Video Module, Claudia Rivera Salas, NP, a rheumatology nurse practitioner in East Lansing, Michigan, explains how clinicians choose between steroid-sparing agents for the treatment of polymyalgia rheumatica (PMR). She outlines when methotrexate may be used as a cost-effective option for patients with mild to moderate PMR, and when sarilumab (Kevzara), the only FDA-approved biologic for PMR, may be indicated in cases of ...

In this educational session, Jessica Farrell, PharmD, from Albany Medical Center and Albany College of Pharmacy and Health Sciences, provides key clinical pearls on Leflunomide, a lesser-discussed DMARD (disease-modifying antirheumatic drug) used in rheumatology. While not frequently prescribed for new patients, many individuals remain on Leflunomide long-term, making it essential to understand its pharmacokinetics, potential toxic...

In this debut episode of the GCA Fireside Chat series on RhAPPcast, host Amanda Mixon, PA-C, president of Rheumatology Advanced Practice Providers (RhAPP), sits down with expert guests Naomi Amudala, NP, and Rennie Rhee, MD, to explore one of the most critical aspects of giant cell arteritis (GCA) care—recognition. Together, they unpack how to differentiate routine headaches from those signaling GCA, discuss the nuanced role of lab...

In this episode of RhAPPcast, the official podcast of Rheumatology Advanced Practice Providers (RhAPP), host Amanda Mixon, PA-C, is joined by seasoned rheumatology expert Heather Mambretti, PA-C, for a comprehensive discussion on polymyalgia rheumatica (PMR). Together, they explore foundational concepts and clinical challenges, including how to accurately diagnose PMR, differentiate it from mimickers like rheumatoid arthritis and p...

In this journal club episode, Jeannette Hart, PA-C—co-founder of PNW Arthritis and Rheumatology and practicing at Kadlec Regional Medical Center in Washington—reviews pivotal findings from the SAPPHIRE trial, which led to the FDA approval of sarilumab for the treatment of polymyalgia rheumatica (PMR). Published in the New England Journal of Medicine in October 2023, this phase 3 randomized controlled trial evaluated the efficacy an...

In this FAQ video, Claudia Rivera, NP, a rheumatology nurse practitioner from East Lansing, Michigan, discusses when to consider a steroid-sparing agent in the management of polymyalgia rheumatica (PMR) and what treatment options are available. While prednisone remains the cornerstone of PMR therapy, long-term steroid use poses significant risks including osteoporosis, diabetes, adrenal suppression, and infection. Claudia reviews g...

In this video, Kyle George, PA-C, a rheumatology physician assistant with St. Luke’s Rheumatology in Idaho, reviews the key clinical takeaways from the 2015 ACR and EULAR treatment guidelines for polymyalgia rheumatica (PMR). PMR is a common inflammatory condition in older adults, marked by bilateral shoulder or hip girdle pain and stiffness. Kyle discusses the diagnostic criteria, the hallmark rapid response to low-dose glucocorti...

In this video, clinical pharmacist and RhAPP faculty member Danielle Gatti Palumbo breaks down the mechanism of action of methotrexate, explaining how this folate antimetabolite works to inhibit DNA synthesis, reduce inflammation, and regulate immune response.

Methotrexate is a folate antimetabolite that plays a crucial role in inhibiting DNA synthesis, repair, and cellular replication, making it a widely used treatment for autoimm...

In this journal club session, Danielle Gatti-Palumbo, PharmD, a clinical pharmacist at Northwell Health Division of Rheumatology, explores the safety and efficacy of deucravacitinib, a first-in-class, oral selective TYK2 inhibitor approved for the treatment of moderate-to-severe plaque psoriasis. Published in the Journal of Drugs in Dermatology (Feb 2025) by Dr. Milan Shaw and colleagues, the expert consensus review highlights six ...

In this episode of RhAPPcast, the official podcast of Rheumatology Advanced Practice Providers (RhAPP), host Amanda Mixon, PA-C, dives into the evolving role of TYK2 inhibition in the treatment of psoriatic arthritis (PsA). Joined by special guest and PsA expert Eileen Lydon, NP, the episode unpacks the science behind the TYK2/STAT signaling pathway, how it differs from traditional JAK inhibition, and what this means for patient ca...

Hydroxychloroquine is a cornerstone therapy in rheumatology, offering significant benefits for mild rheumatoid arthritis (RA) and lupus. In this video, Jessica Farrell, PharmD, clinical pharmacist in rheumatology at Albany Medical Center and faculty at Albany College of Pharmacy and Health Sciences, explores the dosing, safety, and clinical applications of hydroxychloroquine.

Jessica Farrell explains the weight-based dosing strategy...

In this FAQ Video Module, Christy Vath, PA-C, a seasoned rheumatology expert from Seattle Rheumatology Associates, explores how the selectivity of TYK2 and JAK enzyme inhibition impacts safety profiles. She provides a clear comparison between traditional pan-JAK inhibitors and selective TYK2 inhibitors like deucravacitinib, highlighting their differing mechanisms of action and clinical implications.

Christy breaks down how TYK2’s se...

Join Monica Richey, NP, with 20+ years of experience in Rheumatology, as she breaks down the latest 2024 ACR guidelines for monitoring lupus nephritis. Learn the best practices for urine testing, protein-creatinine ratios, and medication adjustments to ensure optimal patient care.

She emphasizes the importance of regular urine tests, protein-creatinine ratio checks, and full blood panels to track disease progression and adjust treat...