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 may fit into clinical practice—covering patient selection, safety monitoring, and the logistical challenges of integrating new therapies into care. Our expert guests share real-world perspectives from both academic and community settings, addressing key considerations such as prednisone tapering, insurance barriers, lab monitoring, vaccination timing, and cost concerns for Medicare patients. Whether you are an APP, pharmacist, or rheumatology provider, this episode offers practical guidance on when to consider JAK inhibitors, how to navigate access issues, and what to watch for when managing patients with GCA. Stay tuned for the final installment of the series, where we’ll take a closer look at the safety data of upadacitinib and its implications for clinical decision-making.

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 no loading dose required. Heather also addresses how to adjust to a lower 150 mg dose in the rare event of side effects such as neutropenia, thrombocytopenia, or hyperlipidemia. Patients will also learn what to expect with potential injection site reactions and why the first dose is often guided in the office before transitioning to home use. This overview provides practical insights into sarilumab dosing, patient support, and real-world considerations for managing RA and PMR. For more resources, visit the RhAPP website or download the RhAPP app.

#Rheumatology #RA #PMR #Sarilumab #APPeducation #PatientCare #RheumatoidArthritis #PolymyalgiaRheumatica #RheumatologyAPPs #AutoInjector

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 approved for PMR (FDA approval in 2023) and its established role in RA since 2017. Heather provides insight into the IL-6 pathway, how sarilumab can yield rapid improvement, and what patients should know about safety considerations, infection risks, and long-term use either in combination with methotrexate or as monotherapy. She also sets realistic expectations around treatment timelines, noting that most patients remain on therapy for at least 12–18 months before tapering is considered.

For more rheumatology education and patient resources, visit RhAPP.org or download the RhAPP ACE App.

#Sarilumab #RheumatoidArthritis #PMR #PolymyalgiaRheumatica #Rheumatology #BiologicTherapy #Kevzara

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 Journal of Medicine paper, this discussion unpacks the study’s design, patient population, primary and secondary outcomes, and what the results mean for clinical practice. Together, they explore how the JAK-STAT pathway has become a new therapeutic target, the role of upadacitinib in GCA, and how this therapy compares to existing options like tocilizumab and methotrexate. The conversation also covers steroid tapering strategies, long-term disease control, safety considerations, and how these findings are shaping the future of vasculitis care. Whether you are a rheumatology provider, researcher, or trainee, this episode offers evidence-based insights and practical takeaways for managing patients with giant cell arteritis.

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 therapeutic landscape prior to upadacitinib approval, this episode ranges from high-dose steroids to steroid-sparing agents, barriers to care, and insights into tapering, patient safety, and long-term disease management. You’ll also hear perspectives on the role of imaging and biomarkers, and how clinicians can better address patient fears, affordability, and treatment accessibility. Whether you are a seasoned rheumatology professional or looking to deepen your understanding of GCA, this conversation offers valuable evidence-based insights to apply in clinical practice.

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 reduce disease activity, prevent flares, and enable more successful steroid tapering. This therapy offers patients faster relief and the ability to lower or even withdraw corticosteroids while maintaining long-term disease control. Compared to placebo and even methotrexate, sarilumab has been shown to improve sustained remission rates with less steroid exposure, providing a safer and more effective treatment option for PMR. Learn how IL-6 inhibition is reshaping treatment strategies and supporting better outcomes for patients living with polymyalgia rheumatica.

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 long-term risks. This episode highlights how IL-6 receptor blockade with sarilumab offers the first FDA-approved steroid-sparing therapy for PMR. Jeannette walks through the trial design, inclusion and exclusion criteria, dosing strategies, endpoints, and key outcomes—demonstrating that patients treated with sarilumab achieved significantly higher sustained remission compared to placebo. We also examine safety findings, glucocorticoid toxicity scores, and the clinical implications for managing PMR in real-world practice. Whether you are a rheumatology provider, trainee, or clinician looking to expand treatment knowledge, this deep dive provides valuable insights into the future of PMR care.

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 moderate to severe disease, relapses, or steroid intolerance. Claudia reviews key differences in side effects, cost, onset of action, and clinical considerations, as well as highlights data from pivotal studies including the SAPHYR trial. This video offers valuable insights into optimizing PMR management, reducing long-term steroid use, and improving patient outcomes.

#PolymyalgiaRheumatica #PMR #Rheumatology #SteroidSparingAgents #Methotrexate #Sarilumab #PMRTreatment #AutoimmuneDisease #RheumatologyEducation