In this episode of RhAPPcast, host Amanda Mixon, PA-C, leads a 2026 Fireside Chat exploring the intersection of rheumatology and gastroenterology. Joined by Kim Orleck, PA-C (GI APP), and Wendy Simmons, PA-C (Rheumatology APP), the panel discusses the shared inflammatory pathways linking Crohn’s disease, ulcerative colitis, psoriatic arthritis, and ankylosing spondylitis, with a focus on the gut–joint–skin axis and the IL-23, IL-17, and TNF pathways.

The conversation highlights early screening for overlapping immune-mediated inflammatory diseases (IMIDs), recognizing subclinical gut inflammation, and selecting cross-indication therapies such as JAK inhibitors and IL-23 inhibitors based on disease severity, comorbidities, and cardiovascular risk. Listeners will gain practical insights into biomarker use (including fecal calprotectin), second-line treatment strategies after TNF failure, and the importance of real-time collaboration between rheumatology and GI providers to optimize patient outcomes.

For more educational content, visit the Content Rheum, RhAPP ACE app, or RhAPP.org.

In this RhAPPcast episode, host Amanda Mixon, PA-C, is joined by Wendy Simmons, PA-C, to discuss the role of guselkumab in inhibiting structural damage in psoriatic arthritis. The conversation explores clinical trial data, real-world experience, and the importance of preventing radiographic progression to preserve long-term joint function. This episode highlights how IL-23 inhibition fits into a domain-based treatment approach, including considerations for skin disease, comorbidities, and overlapping conditions such as inflammatory bowel disease.

In this FAQ video, Iris Zink, MSN, ANP-BC, RN-BC, shares practical strategies for discussing weight management with patients living with psoriatic arthritis. She outlines how obesity drives systemic inflammation, increases disease activity, and raises cardiovascular risk, and explains why addressing BMI should be part of routine rheumatology care. This episode explores patient-centered communication techniques, the role of anti-inflammatory nutrition and whole-food approaches, and how to incorporate conversations about GLP-1 medications, diabetes screening, and cardiovascular risk reduction into everyday practice. Designed for rheumatology clinicians and advanced practice providers, this video offers real-world tips to improve outcomes in psoriatic arthritis through compassionate, proactive weight management discussions.

In this updated medication review video module, Brandon Ko, DNP, and Pediatric Chair of RhAPP, reviews the recent FDA approval of guselkumab for juvenile psoriatic arthritis (JPsA) in children ages 6 and older weighing more than 40 kg. He covers dosing, mechanism of action as an IL-23 inhibitor, and how the approval was based on extrapolated data from pediatric plaque psoriasis (PROTOSTAR) and adult psoriatic arthritis (DISCOVER-1) trials demonstrating strong efficacy and a favorable safety profile.

The video also explains how guselkumab fits into the current JPsA treatment landscape alongside TNF inhibitors, abatacept, ustekinumab, secukinumab, and JAK inhibitors, with key considerations including uveitis risk, inflammatory bowel disease implications, paradoxical TNF-induced psoriasis, and safety profile. This overview provides practical guidance for pediatric rheumatology providers tailoring biologic therapy for children with juvenile psoriatic arthritis.

For more rheumatology education, visit the RhAPP Content Rheum or the RhAPP ACE app.

In this Medication Review, Lisa Asfahani, PA-C, discusses anti-drug antibody development and immunogenicity associated with guselkumab in the treatment of psoriatic arthritis. The video reviews the IL-23 p19 mechanism of action, how neutralizing antibodies can impact drug efficacy and safety, and what current research shows about antibody rates in guselkumab-treated patients. Key studies, available assays for therapeutic drug monitoring, and practical clinical considerations are highlighted to help rheumatology providers optimize long-term treatment outcomes.

In this educational FAQ, Heather Mambretti, PA-C, a rheumatology physician assistant and RhAPP faculty and board member, explains the critical role of tissue-nonspecific alkaline phosphatase (TNSALP) in hypophosphatasia (HPP). TNSALP is an essential enzyme involved in bone and tooth mineralization, as well as vitamin B6 transport into cells. Mutations in the ALPL gene, which encodes TNSALP, lead to reduced enzyme activity, accumulation of mineralization substrates, and defective bone formation. This video reviews how inactivating ALPL gene variants—of which more than 450 have been identified—contribute to the clinical spectrum of hypophosphatasia, including differences in autosomal recessive and autosomal dominant inheritance patterns. Severe forms such as perinatal and infantile HPP are often associated with autosomal recessive mutations, while milder presentations may follow a dominant pattern. Clinicians will gain a clear understanding of the pathophysiology of HPP, the genetic variability behind disease expression, and why bone, liver, and kidney involvement are common. For more rheumatology-focused education, visit RhAPP.org, download the RhAPP ACE App, and explore additional expert content on the Content Rheum.

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In this Medication Review, Lisa Asfahani, PA-C, shares practical laboratory monitoring recommendations for guselkumab across psoriasis, psoriatic arthritis, and inflammatory bowel disease. The discussion reviews FDA-approved indications, dosing basics, and what labs to check before and after initiating therapy, including TB screening and liver function monitoring. Designed for rheumatology, dermatology, and GI clinicians, this overview offers clear, real-world guidance to support safe and effective use of IL-23 inhibition in clinical practice.

In this episode of RhAPPcast, the official podcast of rheumatology advanced practice providers, we explore the complex and often underrecognized relationship between psoriatic arthritis and obesity. Host Amanda Mixon, PA-C, President of RhAPP, is joined by distinguished RhAPP faculty member and rheumatology nurse practitioner Iris Zink for an in-depth, real-world discussion on how obesity functions as an inflammatory driver in psoriatic arthritis and influences disease severity, treatment response, and long-term outcomes.

The conversation examines the immunologic mechanisms linking adiposity to chronic inflammation, including the role of cytokines such as TNF and IL-17, and how obesity amplifies disease across key domains like peripheral arthritis, enthesitis, dactylitis, skin disease, and axial involvement. Drawing from both current evidence and decades of clinical experience, the speakers discuss why weight assessment should be considered an essential component of psoriatic arthritis evaluation and how to approach this topic in a patient-centered, non-stigmatizing way.

For more rheumatology education, check out the Content Rheum on RhAPP.org or explore more education on RhAPP ACE 2.0.