GHAPPcast

Thank you to AbbVie for the support of this podcast episode. In this GHAPP podcast episode, Brooke Hodnik, PA, and Jamie Brogan, APRN, discuss the October 10, 2025 FDA label update for upadacitinib in adults with moderate to severe ulcerative colitis and Crohn’s disease. They break down what the expanded indication means in practice, including how clinicians should interpret terms like “clinically inadvisable” and “approved systemic therapy,” and how this update allows for more individualized treatment decisions beyond mandatory prior TNF exposure in certain scenarios. The conversation highlights key considerations such as high inflammatory burden in IBD, steroid-refractory disease, low albumin, immunogenicity concerns, and real-world barriers to biologic therapy. Brooke and Jamie emphasize the importance of clinical judgment, earlier access to appropriate advanced therapy when needed, and the goal of reducing hospitalizations, surgery risk, and long-term complications—ultimately improving quality of life for patients with moderate to severe IBD. For more educational content visit GHAPP.org, the GHAPP Digital Hub or the GHAPP ACE app.

Thank you to Fujifilm for their support of this FAQ Video Module. In this FAQ video module, Patrick Horne, NP, President of GHAPP and nurse practitioner at the University of Florida, provides a clear, practical overview of FDA-cleared biomarkers used in the detection and risk assessment of hepatocellular carcinoma (HCC). This discussion walks through key blood-based tests including AFP-L3, des-gamma-carboxy prothrombin (DCP), and how these markers—when combined with patient age and sex—are used to calculate the GALAD score to estimate the probability of HCC. The video also introduces newer diagnostic approaches such as the HelioLiver LDT, which evaluates tumor-associated DNA methylation patterns, and the Oncoguard-Liver test, a multi-target liquid biopsy analyzing both protein biomarkers and cancer-associated DNA. Designed for clinicians involved in liver disease management, this module highlights how FDA-cleared biomarkers can support earlier detection, improved risk stratification, and informed clinical decision-making in patients at risk for liver cancer. Visit GHAPP.org, the GHAPP Digital Hub, and the GHAPP ACE app for additional gastroenterology and hepatology education and resources.

Thank you to AbbVie for their support on this FAQ Video Module. In this FAQ video module, Brooke Hodnick, PA-C, breaks down key updates to the expanded upadacitinib label for adults with moderate to severe ulcerative colitis and Crohn’s disease, effective October 10, 2025. The discussion focuses on what qualifies as an “approved systemic therapy” in the context of patients who have had an inadequate response to prior treatments or for whom TNF inhibitors are clinically inadvisable. Viewers will gain clarity on FDA-approved systemic therapies for induction and maintenance of remission, including TNF inhibitors, anti-integrins, IL-12/23 and IL-23 inhibitors, JAK inhibitors, and S1P modulators, as well as important distinctions around therapies such as steroids and immunomodulators that are commonly used but not FDA-approved as systemic maintenance options. The conversation also highlights the role of clinical judgment, individualized risk–benefit assessment, and current guidance from organizations such as the American College of Gastroenterology and the American Gastroenterological Association. For more educational information, please visit GHAPP.org, the GHAPP Digital Hub or the GHAPP ACE app.

Thank you to AbbVie for their support on this FAQ Video Module.In this FAQ video module, Jamie Brogan, APRN from the IBD Center at Northwestern Medicine, breaks down the October 2025 FDA label expansion for upadacitinib in adult patients with moderate to severely active ulcerative colitis and Crohn’s disease. The discussion focuses on the updated indication for patients with an inadequate response or intolerance to TNF inhibitors—and importantly, the newly emphasized language around when TNF therapy may be considered “clinically inadvisable.” Jamie explores what this term means in real-world clinical practice, including patient-specific factors such as contraindications to TNF agents, need for rapid onset of action, prior treatment exposure, comorbidities, and access or adherence challenges. She shares practical insights on how this label expansion has impacted IBD management, increased treatment access, and supported individualized, risk-benefit decision-making between providers and patients.

Thank you to Madrigal for their support on this FAQ Video Module.In this FAQ video, Allysa Saggese, NP, reviews how clinicians can balance systemic and liver-directed therapies in the treatment of metabolic dysfunction–associated steatohepatitis (MASH) and shares insights on the evolving role of combination therapy. The discussion explores current guideline-aligned options, including GLP-1–based systemic therapies and liver-directed agents, and emphasizes individualized treatment decisions based on fibrosis stage, metabolic comorbidities, patient preferences, and access considerations. Designed for APPs and clinicians, this overview highlights why multimodal therapy—alongside lifestyle interventions like diet and exercise—is likely the future of MASH management.

Thank you to Madrigal for their support on this FAQ Video Module.In this FAQ video, Alison Moe, PA-C, discusses how alcohol consumption impacts the evaluation and progression of metabolic dysfunction–associated steatohepatitis (MASH) and why accurate assessment is critical in clinical practice. The discussion reviews the synergistic effects of alcohol and metabolic liver disease on fibrosis progression, explains current alcohol intake thresholds associated with increased risk, and outlines how biomarkers such as phosphatidylethanol (PEth) can provide objective insight into recent alcohol use. Designed for APPs and clinicians, this practical overview highlights how to differentiate MASH, alcohol-related liver disease (ALD), and MetALD to ensure accurate diagnosis, documentation, and treatment decisions.

Thank you to Madrigal for their support of this Medication Review Video Module.In this medication review module, Michelle Barnett, PA-C, provides an in-depth overview of resmetirom, the first FDA-approved liver-directed thyroid hormone receptor beta (THR-β) agonist for adults with non-cirrhotic metabolic dysfunction–associated steatohepatitis (MASH) and moderate to advanced fibrosis (F2–F3). The discussion reviews MASH risk factors, resmetirom’s mechanism of action, dosing considerations, and key findings from the phase 3 MAESTRO-NASH trial, including improvements in liver histology and lipid parameters. Designed for APPs and clinicians, this concise review highlights how resmetirom fits into contemporary MASH management alongside lifestyle interventions such as diet and exercise.

In this expert-led podcast discussion on hepatitis B management, Elizabeth Goacher, PA-C, from Duke University Medical Center and Allison Moser, NP, from RUSH University Medical Center break down what’s new in chronic hepatitis B care and how evolving guidelines are shaping real-world clinical decision-making. Recorded onsite at GHAPP National, the conversation explores updated treatment thresholds from European Association for the Study of the Liver compared with American Association for the Study of Liver Diseases, including when to initiate antiviral therapy regardless of HBeAg status, the role of HBV DNA and ALT levels, and special considerations such as pregnancy, renal and bone health, adherence, and HIV co-infection. The episode also highlights practical antiviral selection, patient-centered counseling, risks of treatment interruption, and emerging therapies aimed at functional cure. This discussion offers timely, practice-focused insights for APPs and clinicians caring for patients with hepatitis B.

This in-depth conversation explores how advanced practice providers navigate some of the most challenging discussions in the care of patients living with chronic hepatitis B. Drawing from years of real-world hepatology and transplant experience, Jennifer Geremia, PA-C, and Andrea Keller, PA, discuss culturally sensitive communication, addressing stigma, improving health literacy, and building trust with patients and families affected by hepatitis B. The discussion highlights practical strategies for long-term disease management, medication adherence, family screening and vaccination, perinatal transmission counseling, and the importance of regular monitoring to prevent cirrhosis, hepatocellular carcinoma, and end-stage liver disease. The speakers also address common misconceptions, language barriers, and shared decision-making, offering actionable insights for APPs and clinicians caring for diverse hepatitis B populations. #Hepatology #LiverDisease #ChronicHepatitisB #AdvancedPracticeProviders #GHAPP #TransplantHepatology #PatientCommunication #CulturalCompetency #HealthLiteracy #LiverCare #ChronicDiseaseManagement

In this expert-led podcast discussion, Patrick Horne and HoChong Gilles explore the complex management of comorbidities in patients with chronic viral hepatitis, with a focus on hepatitis B, hepatitis C, and HIV co-infection. The conversation highlights practical strategies for treatment sequencing, preventing hepatitis B reactivation during DAA therapy, managing drug–drug interactions, and optimizing long-term liver and systemic outcomes. The episode also examines the growing impact of metabolic dysfunction–associated steatotic liver disease (MASLD/MASH) on fibrosis progression and hepatocellular carcinoma (HCC) risk, along with current surveillance approaches including ultrasound and AFP. Additional insights address renal and bone health considerations with long-term hepatitis B antiviral therapy and the importance of multidisciplinary, whole-patient care when managing cardiovascular, metabolic, and renal co-morbidities in this high-risk population. Visit the GHAPP Digital Hub, Hep B Health Hub or GHAPP ACE app for more educational content.

Thank you to Madrigal for your support on this FAQ Video Module.In this short FAQ video module, Patrick Horne, President of GHAPP and a nurse practitioner at the University of Florida, discusses the critical role of noninvasive tests (NITs) in risk stratification and patient selection for patients with metabolic dysfunction–associated steatohepatitis (MASH). He explains how serum biomarkers and imaging help establish baseline fibrosis, clarify disease severity, and guide clinical decision-making in a condition with variable and non-linear progression. This overview emphasizes the importance of integrating NITs with a thorough patient history and physical exam to better understand fibrosis stage and optimize patient evaluation.Visit the GHAPP Digital Hub or GHAPP ACE 2.0 app for more gastroenterology and hepatology education.

Thank you to Madrigal for your support on this Journal Club Review video module.This journal club review explores the 2025 focused recommendations for the management of metabolic dysfunction–associated steatohepatitis (MASH) developed by advanced practice providers (APPs) across the United States and published in the Journal of Clinical Gastroenterology. Brian Lam, PA-C, reviews the evolving role of APPs in MASH care, key epidemiology insights, risk stratification using non-invasive tests, and practical guidance on identifying and treating at-risk patients with F2–F3 fibrosis. The discussion highlights real-world use of ELF, FibroScan, and FIB-4, an overview of resmetirom therapy, monitoring strategies, and a look ahead at emerging therapies shaping the future of MASH management.

Thank you to Madrigal for your support of this Medication Review Video Module.Discover how Resmetirom is reshaping the treatment landscape for metabolic dysfunction–associated steatohepatitis (MASH) in this expert-led medication review with HoChong Gilles, DNP. This short medication review breaks down the therapy’s mechanism of action, pivotal MAESTRO-NASH trial data, fibrosis and steatohepatitis endpoints, ideal patient selection (F2–F3 disease), and key safety considerations. Learn how this first-in-class THR-β agonist delivers meaningful improvements in fibrosis and steatohepatitis without worsening disease, and why 2024 marked a turning point in MASH care. Perfect for APPs and clinicians looking to stay ahead in the rapidly evolving world of liver disease management.

Thank you to Madrigal for your support on this FAQ Video Module.In this episode, Christina Hanson, NP, breaks down the key functional and prognostic differences between fibrosis stage F3 and F4, explaining how liver architecture, portal hypertension, and risk of decompensation shape patient outcomes. Learn how staging impacts mortality risk in MASLD/MASH, why accurate identification of advanced fibrosis is critical, and how management strategies differ for patients with severe fibrosis versus cirrhosis. Christina reviews how clinicians can intervene early, slow progression, and monitor for complications such as variceal bleeding, ascites, and hepatic encephalopathy, while emphasizing the importance of addressing underlying liver disease to improve long-term survival.#Fibrosis #LiverDisease #MASLD #MASH #Cirrhosis #F3Fibrosis #F4Fibrosis #LiverHealth #Hepatology #AdvancedFibrosis #LiverCare #NAFLD #NASH #PortalHypertension #LiverTransplant

In this final episode of our RhAPP, MAPP, GHAPP, and SDPA crosscast series, expert APPs from dermatology, gastroenterology, rheumatology, and obesity medicine break down the most important conversation of all—how to talk to patients about obesity and immune-mediated inflammatory diseases (IMIDs). This discussion focuses on real-world communication strategies, reducing stigma, motivational interviewing, shared decision-making, and setting small, achievable goals that improve outcomes. Learn how to approach sensitive weight-related conversations with empathy, build trust, and empower patients to better manage obesity and chronic inflammation in everyday practice.

In this cross-specialty episode of our RhAPP, GHAPP, MAPP and SDPA collaborative series, leading APPs from dermatology, gastroenterology, rheumatology, and metabolic medicine break down real-world strategies to improve outcomes for patients living with both obesity and immune-mediated inflammatory diseases (IMIDs). Building on earlier discussions about epidemiology and pathophysiology, this conversation focuses on practical, clinic-ready approaches—from shared decision-making and compassionate patient communication to interdisciplinary coordination, GLP-1 utilization, and lifestyle guidance. Learn how APPs across specialties are uniting to reduce systemic inflammation, personalize care, and translate education into meaningful action for patients with obesity and IMIDs.

Thank you to AbbVie for your support on this podcast episode.Navigating pregnancy with inflammatory bowel disease (IBD) can bring unique questions, concerns, and misconceptions—especially for women of childbearing age. In this expert-led episode, Janette Villalon, PA and Angelina Collins, MSN, ANP-BC, two dedicated IBD specialists break down the latest evidence and global consensus recommendations on pregnancy and IBD. Together, they explore fertility considerations, preconception counseling, voluntary childlessness, medication safety during pregnancy and breastfeeding, the impact of disease activity on maternal and fetal outcomes, and how to debunk persistent myths around IBD and pregnancy. Learn why remission at conception is critical, how to approach family planning conversations in the clinic, which therapies—including biologics and biosimilars—can be safely continued, and when to involve maternal–fetal medicine or colorectal surgery. The hosts also discuss managing flares during pregnancy, monitoring strategies such as fecal calprotectin each trimester, and when C-section may be recommended. This conversation provides timely, practical guidance to help clinicians counsel women with Crohn’s disease or ulcerative colitis with confidence, reduce fears, and support healthy pregnancies and postpartum outcomes for IBD patients.

In this episode of our crosscast series shared across RhAPPcast, GHAPPcast, and Dermcast, we explore the hidden costs of obesity in immune-mediated inflammatory diseases (IMIDs) and how excess adiposity drives poorer outcomes, reduced treatment response, and increased healthcare burden. Hosted by Amanda Mixon, PA-C, president of RhAPP, this discussion brings together expert APPs from rheumatology, dermatology, gastroenterology, and metabolic health to unpack the pathophysiologic link between obesity and IMID progression. Our panel breaks down how adipose tissue fuels systemic inflammation, why cytokines like TNF-α and IL-6 worsen disease activity in psoriasis, psoriatic arthritis, and IBD, and how obesity accelerates drug clearance and impacts biologic efficacy. We also examine clinical misconceptions, challenges with pharmacokinetics, and the real-world cycle of flares, surgeries, and increased healthcare utilization seen in this high-risk population. APPs will gain practical insight into addressing weight as part of comprehensive IMID care, improving patient conversations, and leveraging collaborative, cross-specialty management strategies. Stream this episode and the full series on RhAPPcast, GHAPPcast, and Dermcast, or access every installment through the RhAPP ACE 2.0 and GHAPP ACE 2.0 mobile apps for on-the-go learning. Stay tuned for our next episode, where we shift from mechanisms to action and discuss practical strategies APPs can use to improve outcomes for patients living with both obesity and IMIDs.

Thank you to AbbVie for your support on this FAQ Video Module.In this GHAPP FAQ Video Module, Christie Morrison, from Oshi Health and Texas Digestive Disease Consultants, explains how to discuss clinical remission with patients living with inflammatory bowel disease (IBD), including both Crohn’s disease and ulcerative colitis. She breaks down the different types of remission—clinical, biochemical, endoscopic, and steroid-free—and offers clear, practical ways for APPs and healthcare providers to communicate these concepts during patient visits. Christie discusses how to use objective markers such as CRP, ESR, fecal calprotectin, and lactoferrin, and how endoscopic scoring tools like the SES-CD and Mayo score can help track improvement and long-term disease control. She also emphasizes setting realistic expectations, the importance of treat-to-target goals, and the ultimate aim of achieving deep remission while minimizing steroid use. Watch to gain actionable strategies to educate your IBD patients about their treatment journey and the steps toward sustained remission.#IBD #CrohnsDisease #UlcerativeColitis #ClinicalRemission #GHAPP #IBDTreatment #APPeducation #TreatToTarget #IBDManagement

Thank you to AbbVie for your support on this podcast.In this episode of the GHAPP Podcast, Alison Krustapentus, NP-C and Christie Morrison, NP, join for an open discussion on mental and sexual health in inflammatory bowel disease (IBD). Together they explore the often-overlooked psychological and relational challenges that accompany chronic conditions like Crohn’s disease and ulcerative colitis—covering strategies to normalize sensitive conversations, screen for anxiety and depression using PHQ-2, PHQ-9, and GAD tools, and incorporate behavioral-health collaboration into routine care. The conversation also highlights practical ways to integrate IBD mental-health screening, sexual-wellness counseling, vaccine and health-maintenance checklists, and patient-partner communication into everyday gastroenterology practice. This episode underscores the importance of whole-person care in IBD management and offers real-world insights for APPs and healthcare professionals supporting patients living with chronic inflammatory disease.#IBD #CrohnsDisease #UlcerativeColitis #MentalHealth #SexualHealth #Gastroenterology #InflammatoryBowelDisease #AdvancedPracticeProviders #GHAPPodcast #IBDCare