RhAPPcast

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 toxicities, and considerations for special populations.

A unique aspect of Leflunomide is its enterohepatic recycling, which allows its active metabolite to persist in the body for an extended period—even years after discontinuation. In cases of toxicity (such as liver enzyme elevations or...

Welcome to RhAPPcast, the official podcast of Rheumatology Advanced Practice Providers (RhAPP). In this episode, host Amanda Mixon, PA-C, kicks off a three-part series exploring some of the most impactful updates in psoriatic arthritis (PsA) from the 2024 ACR Convergence meeting. Joining Amanda is Daric Mueller, PA-C, who shares expert insights on emerging therapies, including zazocitinib (TAK-279), a selective TYK2 inhibitor showing promising results in both joint and skin outcomes for PsA.

Together, Amanda and Daric review key data from several abstracts—highlighting oral treatment options, the significance of dosage on efficacy, and the potential advantages of TYK2 in...

Welcome back to RhAPPcast, the official podcast of Rheumatology Advanced Practice Providers (RhAPP). In the final episode of our three-part series covering highlights from ACR Convergence 2024, host Amanda Mixon, PA-C, is joined once again by Daric Mueller, PA-C, to explore two more important abstracts shaping the future of psoriatic arthritis (PsA) care. This episode dives into new insights on treatment response and real-world outcomes that may help inform clinical decision-making.

First, Daric breaks down a post-hoc analysis from the SPIRIT-H2H trial, comparing ixekizumab vs adalimumab in PsA patients with nail disease. The data suggest that nail...

Welcome back to RhAPPcast, the official podcast of Rheumatology Advanced Practice Providers. In Part 2 of our Psoriatic Arthritis ACR wrap-up series, host Amanda Mixon, PA-C, and guest Daric Mueller, PA-C, explore new data from ACR Convergence 2024 that could change how we think about long-term outcomes in PsA care.

In this episode, we examine two important abstracts with major clinical implications:

Does smoking impact biologic drug retention in PsA? Daric dives into a large European cohort study evaluating how smoking and BMI affect the durability of secukinumab, revealing a notable link between smoking...

In this episode of RhAPPcast, Amanda Mixon, PA-C, President of RhAPP, sits down with Kyle George, PA-C, to explore the real-world impact of Guselkumab in Psoriatic Arthritis (PsA) management. As a leading IL-23 inhibitor, Guselkumab offers durable efficacy, strong persistence, and a favorable safety profile, making it a key option for biologic-naïve patients and those with TNF inhibitor failure.

Clinical trials like VOYAGE, NAVIGATE, ECLIPSE, and DISCOVER highlight its effectiveness in improving joint and skin symptoms, while real-world data from the CorEvitas PsA and SpA Registry shows 72% of patients remain on Guselkumab after 12 months, compared to j...

Learn about the safety profile and monitoring requirements of voclosporin for lupus nephritis with Jessica Farrell, PharmD, an experienced rheumatology pharmacist and faculty member at the Albany College of Pharmacy and Health Sciences. In this video, Jessica Farrell explains what makes voclosporin—a second-generation calcineurin inhibitor—unique, including its increased potency, improved pharmacokinetic profile, and reduced need for therapeutic drug level monitoring compared to cyclosporine.

Jessica Farrell discusses key considerations before initiating voclosporin in patients with lupus nephritis, such as baseline eGFR, blood pressure, and ongoing laboratory assessments. Discover the recommended monitoring schedule for renal function, urine prot...

Join Danielle Gatti Palumbo, PharmD, a clinical pharmacist, RhAPP faculty member, and RhAPP Board member, as she breaks down a network meta-analysis evaluating the efficacy of biologics with and without methotrexate (MTX) in the treatment of psoriatic arthritis (PsA). This insightful journal club discussion highlights key findings on whether MTX is necessary as background therapy when initiating biologics.

Methotrexate, while commonly used in PsA treatment, is not FDA-approved for PsA in the U.S., yet it is often required by insurance companies before biologic therapy. Clinical guidelines, including EULAR, ACR, and GRAPPA, recommend MTX for peripheral arthritis...

Join Jessica Farrell, PharmD, professor at the Albany College of Pharmacy and Health Sciences and clinical pharmacist at Albany Medical Center, as she breaks down the pivotal AURORA 1 and AURORA 2 clinical trials evaluating voclosporin for lupus nephritis. Learn how this second-generation calcineurin inhibitor demonstrated superior renal outcomes, including higher complete and partial renal response rates and faster time to improvement compared to placebo.

Jessica discusses the long-term safety and efficacy findings from AURORA 2, highlighting the sustained renal benefits, lower risk of renal flares, and the drug’s manageable safety profile over three years of treatment. She also ad...

Join Danielle Gatti Palumbo, Clinical Pharmacist at Northwell Health’s Division of Rheumatology in Long Island, New York, as she provides a comprehensive review of Voclosporin (Lupkynis), an FDA-approved calcineurin inhibitor (CNI) for the treatment of lupus nephritis. This discussion is essential for healthcare professionals, pharmacists, and patients seeking a deeper understanding of how Voclosporin enhances lupus nephritis management while optimizing safety and efficacy.

Voclosporin is a next-generation calcineurin inhibitor that works by inhibiting T-cell activation, reducing the inflammatory response that leads to kidney damage in lupus nephritis. Unlike traditional CNIs like cyclosporine and tacrolimus, Voclosporin features a...

In this expert breakdown, Cassie Dolecki, PharmD, a clinical pharmacy specialist in rheumatology at Allegheny Health Network in Pittsburgh, Pennsylvania, discusses the effectiveness of Guselkumab across the GRAPPA domains, drawing insights from the DISCOVER-2 trial and additional post-hoc analyses.

As a phase 3 clinical trial, DISCOVER-2 evaluated Guselkumab in biologic-naïve patients with active PsA over two years, comparing 100 mg every 4 weeks and 100 mg every 8 weeks to placebo. At week 24, significantly more patients on Guselkumab achieved ACR20 response rates, demonstrating its superior ability to control inflammation and joint symptoms.

A post-hoc analysis of DISCOVER-2 stratified patient r...