In this educational rheumatology video, physician assistant Lindsay Tom, PA-C, from the Northern Virginia Center for Arthritis, provides a clear and clinically relevant overview of CD64, also known as FC gamma receptor I, and its role in immune system function. The discussion explores how CD64 is expressed on myeloid lineage cells such as monocytes, macrophages, and dendritic cells, and how it contributes to innate immunity by binding IgG antibodies and triggering phagocytosis and pro-inflammatory cytokine release, including TNF-α. The video also explains CD64’s role in adaptive immunity through antigen processing and presentation to T cells, leading to immune activation and immunologic memory. Importantly, this overview highlights how dysregulated or excessive CD64 activation may contribute to chronic inflammation, tissue damage, and antibody-mediated autoimmune diseases—making it a key concept for clinicians managing inflammatory and rheumatic conditions. This video is part of ongoing educational content designed for advanced practice providers seeking a deeper understanding of immunologic pathways relevant to rheumatology care.
In this short video, pediatric rheumatology advanced practice providers Brandon Ko, APRN, DNP, C-PNP, and Brandi Goble, PNP, share their personal journeys into pediatric rheumatology and discuss the critical role APPs play in expanding access to care—especially in rural and underserved communities. They highlight the challenges of entering a highly specialized field with limited formal training, the importance of mentorship, and how RhAPP and the Step Up to Rheumatology curriculum have helped build community, education, and confidence for pediatric rheumatology APPs nationwide. This conversation offers insight into workforce gaps, real-world training pathways, and the growing impact of APPs in pediatric rheumatology care.
In this video, Audrey Gibson, PA-C, a rheumatology physician assistant with nearly two decades of clinical experience, breaks down the unique dual mechanism of action of guselkumab and its role in targeting IL-23–driven inflammation. The discussion explores how this fully human monoclonal antibody selectively binds the IL-23 p19 subunit to inhibit downstream inflammatory signaling, while also engaging CD64 on inflammatory monocytes through its Fc region, addressing IL-23 at its source. Designed to clarify the science behind dual-acting IL-23 inhibition, this overview provides practical insight for clinicians managing immune-mediated rheumatic diseases and highlights emerging therapeutic strategies in modern rheumatology care.
In this FAQ, William Saalfeld, NP, breaks down why the modified van der Heijde–Sharp (mvdH-S) score remains the most widely used radiographic method in psoriatic arthritis (PsA) clinical trials. He highlights how the score delivers the strongest combination of reliability, sensitivity to change, and validation, making it ideal for detecting small but meaningful structural progression over typical trial timelines. Learn how its consistent use across randomized controlled trials—including recent NEJM studies—supports cross-trial comparability, regulatory acceptance, and its role as a trusted structural endpoint linked to long-term physical function and disability in PsA.
Discover how the APEX trial raised the bar in understanding structural damage risk in psoriatic arthritis. In this quick FAQ video module, William Saalfeld, NP, breaks down why APEX was designed differently from DISCOVER-2, what made its patient population unique, and how these changes help us better evaluate progression and treatment impact. If you want a clearer, faster way to understand the science behind PsA trial design, this is the perfect overview. Learn more on the RhAPP website or through the RhAPP ACE App.
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.#IMID #ObesityMedicine #ObesityCare #ChronicInflammation #APPEducation #DermatologyPA #Gastroenterology #Rheumatology
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.
Welcome to the first episode in our special cross-platform podcast collaboration on IMIDs and Obesity, shared across RhAPPcast, GHAPPcast, and Dermcast—the official podcasts of RhAPP, GHAPP, and SDPA. Hosted by Amanda Mixon, PA-C, President of RhAPP, this conversation titled “Obesity and IMIDs: Unpacking the Epidemic and Its Far-Reaching Impacts” explores one of the most under recognized yet clinically significant intersections in modern medicine—the link between obesity and immune-mediated inflammatory diseases. Joined by Laura Bush, PA-C, Erin Darguzas, NP, and Jennifer Hernandez Parra, APRN, the episode delves into the evidence behind obesity’s role in disease onset and progression across rheumatology, gastroenterology, dermatology, and metabolic health. Together, these experts examine how obesity influences inflammation, treatment response, and patient quality of life while highlighting the importance of multidisciplinary care and open communication between providers and patients. Tune in to gain practical insights on how advanced practice providers can better address obesity as a key driver of IMID burden, and stay tuned for upcoming episodes exploring pathophysiologic mechanisms and clinical management strategies.
Join host Amanda Mixon, President of RhAPP, for a special episode of RhAPPcast, recorded live at the 6th Annual RhAPP Conference. In this conversation, Amanda is joined by Jessica Glennie, CNP, from the Cleveland Clinic, to explore the complex intersection of rheumatology and pulmonology, focusing on Interstitial Lung Disease (ILD) and Pulmonary Hypertension in ILD (PH-ILD). Together, they unpack how early recognition, multidisciplinary collaboration, and evidence-based management can improve outcomes for patients with connective tissue disease–related pulmonary complications. Tune in for expert insights, practical diagnostic tips, and highlights from one of the most engaging sessions of the RhAPP National Conference.#RhAPP #Rheumatology #Pulmonology #ILD #PHILD #APPeducation #RheumatologyConference #MedicalPodcast
Join host Amanda Mixon, PA-C, live from the 6th Annual RhAPP National Conference in Denver, as she sits down with Naomi Amudala, CRNP, from Penn Medicine, to break down one of rheumatology’s most complex and life-threatening conditions: ANCA-associated vasculitis. In this insightful RhAPPcast episode, Amanda and Naomi explore the spectrum of AAV—including GPA, MPA, and EGPA—while unpacking early diagnostic clues, real-world treatment strategies, and emerging therapies like rituximab and avacopan. From recognizing red-flag symptoms such as renal involvement and pulmonary hemorrhage to reducing long-term steroid exposure, this conversation offers practical takeaways for advanced practice providers managing vasculitis in the clinic. Stay tuned to RhAPPcast for more expert-driven rheumatology education from the nation’s leading APP conference.
In this educational segment, Wendy Simmons, PA-C, from Carolina Arthritis Associates in Wilmington, North Carolina, shares her nearly three decades of experience in rheumatology to address a critical question: What is the clinical significance of structural damage in psoriatic arthritis? Drawing on insights from decades of evolution in psoriatic arthritis care—from the pre-biologic era of the 1990s to today’s advanced targeted therapies—Wendy explains how persistent inflammation at enthesial sites can lead to periosteal reaction, joint space narrowing, and ultimately irreversible joint destruction. She reflects on early cases that demonstrated severe deformities underscoring the need for early detection and aggressive management to prevent disability and preserve quality of life. This discussion highlights why understanding structural progression is essential for optimizing outcomes in patients with inflammatory arthritis. For additional resources and in-depth data, visit the RhAPP website for expert-led rheumatology education tailored to advanced practice providers.
In this medication review, Wendy Simmons, PA-C, from Carolina Arthritis Associates in Wilmington, North Carolina, draws on nearly three decades of rheumatology experience to explore the clinical efficacy of guselkumab in inhibiting the progression of structural damage in psoriatic arthritis. Referencing the APEX Phase 3B Trial presented at the 2025 EULAR Congress, Wendy reviews key data on guselkumab's dual IL-23 mechanism of action—targeting both the p19 subunit and the CD64 receptor on IL-23–producing myeloid cells. She highlights significant findings in joint space narrowing, bone erosion, and radiographic progression, demonstrating the therapy’s ability to slow disease progression compared to placebo. With efficacy shown across both Q4 and Q8 week dosing intervals, this medication represents a meaningful advancement in psoriatic arthritis management. For a deeper dive into the data and additional resources, visit the RhAPP website to access full clinical insights and educational materials for advanced practice providers.#RheumatologyEducation #APEXTrial #BiologicTherapies #AdvancedPracticeProviders #AutoimmuneDisease #JointHealth
Welcome to RhAPPcast, the official podcast of Rheumatology Advanced Practice Providers. In this episode, hosted by Amanda Mixon, PA-C, current RhAPP President, we bring you exclusive highlights from the 6th Annual RhAPP National Conference. This episode features a powerful discussion with Betsy Kirchner, nurse practitioner at Cleveland Clinic and RhAPP co-founder. Together, Amanda and Betsy explore the evolving landscape of Sjögren’s disease, from underdiagnosis and quality-of-life challenges to breakthroughs in understanding B-cell involvement and the promise of emerging dual-action therapies. The conversation also underscores the importance of multidisciplinary care, early recognition of systemic symptoms, and how APPs can lead in improving patient outcomes. Tune in for expert insights on new diagnostic approaches, patient education, and what’s next in the treatment pipeline. Stay connected to RhAPPcast for more conference spotlights and evidence-based updates designed for APPs, by APPs in rheumatology.
In this episode, Wendy Simmons, PA-C from Carolina Arthritis in Wilmington, North Carolina, shares insights from nearly three decades of rheumatology experience to answer an important clinical question. Drawing on the pivotal APEX trial, recently presented at EULAR Congress 2025, Wendy reviews how guselkumab demonstrated inhibition of radiographic progression in PsA patients. Using modified vdH-S scores to assess joint space narrowing and bone erosion, the study showed that patients treated with guselkumab experienced significantly lower rates of structural joint damage compared to placebo. With ACR20 response achieved at week 24 and radiographic outcomes confirming long-term benefit, this trial reinforces the role of guselkumab as an effective therapy for psoriatic arthritis beyond symptom control. For clinicians seeking the latest data on PsA treatment and disease-modifying strategies, this discussion highlights key findings that support improved patient outcomes. For more information and additional resources, visit the RhAPP website.
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 expenses at $2,000 starting in 2025, and requiring manufacturers to pay inflationary rebates if prices rise faster than inflation. Kyle highlights how these provisions will directly affect patients on biologics, offering much-needed financial relief, greater price stability, and improved access to care. He also discusses how the act encourages competition through biosimilars, expands eligibility for low-income subsidies, and limits annual premium increases, all designed to make therapies more affordable and accessible for vulnerable populations. For patients and providers alike, this episode offers a clear, practical look at how the Inflation Reduction Act is reshaping the future of drug pricing and access to biologic medications.
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, leading to delayed diagnosis and treatment. Amanda and Bonnie discuss the underlying causes of XLH, key clinical red flags in both pediatric and adult patients, and the importance of ordering a fasting serum phosphorus level as part of routine evaluation for unexplained bone or joint pain. They highlight how early detection, family history, and multidisciplinary care are critical for improving patient outcomes, and why rheumatology providers are uniquely positioned to recognize and manage this condition. This conversation emphasizes the value of shared decision-making, coordinated care, and practical diagnostic strategies to ensure patients with XLH receive timely and effective treatment.
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 develop serious steroid-related side effects, making it essential to consider steroid-sparing therapies and newer biologic options. Amanda and Claudia define refractory PMR, highlight key diagnostic considerations, and walk through real-world case discussions that illustrate when to escalate therapy. The conversation explores common pitfalls in management, the role of methotrexate and other DMARDs, and the growing impact of IL-6 inhibitors like sarilumab in helping patients achieve remission faster and with fewer toxicities. With practical guidance on shared decision-making, monitoring strategies, and treatment goals, this episode offers clinicians valuable insights to optimize care for patients with PMR while reducing long-term steroid dependence.
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 discussion breaks down results from the SELECT-GCA trial, covering baseline patient characteristics, major adverse cardiovascular events (MACE), venous thromboembolism (VTE), infection risk—including herpes zoster—and how to stratify patients appropriately for therapy. The experts highlight key differences between GCA and RA populations, compare upadacitinib risks to the well-documented toxicities of long-term corticosteroid use, and provide real-world perspectives on lab monitoring, vaccination, and patient counseling. This episode helps clinicians feel more confident in prescribing steroid-sparing therapy while keeping patient safety at the forefront of decision-making.
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 therapy. She highlights important safety considerations such as screening for infections and tuberculosis prior to initiation, managing treatment interruptions in the event of serious infections, and monitoring for adverse events like neutropenia, leukopenia, rash, fatigue, myalgia, constipation, and injection site reactions. Heather also compares the risks of sarilumab to the long-term risks of high-dose corticosteroids, helping patients understand the benefit-risk balance in real-world practice. Viewers will learn about recommended safety monitoring protocols, including early lab checks (CBC, metabolic panel, lipid profile) and ongoing annual tuberculosis screening. This video provides practical, evidence-based guidance for healthcare providers and patients navigating treatment decisions in PMR and RA.