RhAPPcast
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.
Episodes
In this episode, Kyle George, PA-C at St. Luke’s Rheumatology in Idaho, explains the Inflation Reduction Act of 2022 and its impact on the affordability of biologic therapies for patients with chronic conditions. This landmark law introduces sweeping reforms to lower prescription drug costs for Medicare beneficiaries, including giving Medicare the authority to negotiate prices on high-cost drugs, capping annual out-of-pocket expens...
In this episode of RhAPPcast, the official podcast of Rheumatology Advanced Practice Providers, host Amanda Mixon, PA-C, is joined by Bonnie Smeryage, NP, to shed light on X-linked hypophosphatemia (XLH)—a rare hereditary condition that often goes unrecognized or misdiagnosed in rheumatology. XLH can mimic common rheumatologic and musculoskeletal disorders such as rheumatoid arthritis, ankylosing spondylitis, or fibromyalgia, leadi...
In this episode of RhAPPcast, the official podcast of Rheumatology Advanced Practice Providers, host Amanda Mixon, PA-C, is joined by Claudia Rivera Salas, NP, to tackle one of the most challenging areas in rheumatology: managing patients with polymyalgia rheumatica (PMR) who do not respond well to glucocorticoids or struggle with steroid tapering. While steroids remain the cornerstone of PMR treatment, many patients relapse or dev...
In this final episode of the GCA Fireside Chat series on RhAPPcast, host Amanda Mixon, PA-C, is joined again by Naomi Amudala, CRNP, and Jessica Farrell, PharmD, to explore the critical risk-benefit considerations of upadacitinib in the treatment of giant cell arteritis (GCA). With upadacitinib gaining FDA approval, understanding its safety profile is essential for providers treating an older, high-risk patient population. The disc...
In this expert-led video, Heather Mambretti, PA-C, who has over 13 years of experience in rheumatology, reviews the safety profile of sarilumab for patients with polymyalgia rheumatica (PMR) and rheumatoid arthritis (RA). Heather explains how more than 10 years of cumulative safety data—including 7 years from RA clinical trials and 3 years from PMR studies—provides reassurance for patients and clinicians considering sarilumab thera...
Welcome to RhAPPcast, the official podcast of Rheumatology Advanced Practice Providers. In this fourth episode of our GCA Fireside Chat series, host Amanda Mixon is joined by nurse practitioner Naomi Amudala and clinical pharmacist Jessica Farrell to explore the evolving role of JAK inhibitors in the treatment of giant cell arteritis (GCA). Building on insights from the SELECT-GCA study, the discussion dives into how JAK inhibition...
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...
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