This medication review explores the role of stable pharmacokinetics (PK) in achieving continuous inflammatory control in inflammatory bowel disease (IBD), with a focus on subcutaneous infliximab therapy for Crohn’s disease and ulcerative colitis. Kim Orleck, PA-C, from Atlanta Gastroenterology Associates and United Digestive, reviews how subcutaneous infliximab provides more stable and sustained drug exposure compared with traditional intravenous (IV) infliximab dosing. By minimizing peak-to-trough fluctuations and maintaining higher trough concentrations, subcutaneous infliximab may help support continuous TNF inhibition, reduce immunogenicity risk, and improve long-term disease control in patients with moderate to severe IBD.

The discussion highlights key clinical data from studies including REMSWITCH, LIBERTY Crohn’s, and LIBERTY UC, demonstrating that subcutaneous infliximab delivers durable remission, stable safety outcomes, and consistent therapeutic drug levels through long-term follow-up. Learn how transitioning from IV to subcutaneous infliximab may improve patient convenience, maintain clinical and endoscopic remission, and support treat-to-target goals in IBD management. The review also examines which patients may require closer monitoring or dose escalation strategies following the switch from IV biologic therapy. For more educational content visit the GHAPP Digital Hub and the GHAPP ACE app.

Thank you to J&J for the support of this Journal Club Review Module. In this journal club video, Sharon Dudley Brown, CRNP, PhD, from the IBD Center at Johns Hopkins University, reviews the ASTRO trial published in The Lancet, which evaluated subcutaneous guselkumab for the treatment of moderate to severe ulcerative colitis. The discussion highlights how this IL-23 inhibitor was studied in patients with difficult-to-treat disease who had previously failed or were intolerant to standard therapies. The trial compared different dosing strategies of subcutaneous guselkumab versus placebo and assessed clinical remission, symptom improvement, and endoscopic outcomes over time.

Results showed that patients receiving guselkumab had higher rates of remission and improved colon inflammation compared with placebo, with benefits seen early in treatment and sustained through follow-up. Safety outcomes were generally similar between groups, with no new safety concerns identified. Overall, the ASTRO trial supports subcutaneous guselkumab as an effective and well-tolerated option for patients with moderate to severe ulcerative colitis.

Thank you to AbbVie for the support of this Journal Club Review Module. This journal club review episode explores the benefit–risk profile of Upadacitinib for patients with moderately to severely active Ulcerative Colitis and Crohn’s Disease, based on a post hoc analysis of phase 2b/3 clinical trials. Featuring expert insights from Sally Bowa, APNP, FNP-C and Jennifer Labas, MSN, in both community and academic settings, this discussion breaks down real-world considerations including efficacy, safety outcomes, and long-term disease management. Key topics include rapid symptom relief, induction and maintenance of remission, and how upadacitinib compares to other advanced therapies in IBD treatment sequencing. The episode also highlights important safety considerations such as herpes zoster risk, cardiovascular events, and thrombosis, along with practical strategies like vaccination protocols, lab monitoring, and patient selection. Designed for gastroenterology and hepatology advanced practice providers, this episode provides actionable guidance on balancing risks and benefits, optimizing treatment decisions, and improving patient outcomes in complex IBD care. For more educational content, visit the GHAPP Digital Hub and the GHAPP ACE app.

Learn how to effectively support patients starting treatment for MASH with this practical, clinician-focused discussion featuring expert advanced practice providers. In this episode, hepatology specialists Robin Soto and Alison Moe break down how to set realistic expectations, define meaningful treatment goals beyond the scale, and guide patients through long-term lifestyle and pharmacologic management. Discover why success in MASH care extends beyond weight loss to include improvements in A1C, lipid profiles, energy levels, sleep, and overall metabolic health, and how shifting the conversation away from numbers can improve patient motivation and adherence. This episode also explores how to structure patient journeys through the first 30, 60, and 90 days of treatment, navigate common challenges with compliance, and reinforce sustainable behavior change. Gain insights into emerging therapies, including newly approved medications targeting liver fat and fibrosis, as well as GLP-1 receptor agonists that support both metabolic health and liver outcomes. The discussion highlights how to personalize treatment plans, manage side effects, and empower patients to take control of their disease while preventing progression to cirrhosis and liver-related complications.

Stay up to date on MASH and MASLD with expert insights from nurse practitioners Sarah Dawkins of Duke University Medical Center and Edith Johannes of UCLA Health. This episode focuses on best practices for identifying at-risk patients, including those with steatosis on imaging, cardiometabolic risk factors, and elevated BMI—highlighting why early screening is critical to preventing progression to cirrhosis and liver transplant.

Learn how to apply practical, non-invasive tools like FIB-4 and FibroScan to assess fibrosis risk, when to refer patients, and how to navigate common challenges such as intermediate scores and normal liver labs. With MASH becoming a leading cause of liver disease, this discussion provides actionable strategies for advanced practice providers and primary care clinicians to improve early detection and patient outcomes.

Visit the GHAPP Digital Hub and GHAPP ACE app for more educational content.

In this episode of RhAPPcast, host Amanda Mixon, PA-C, is joined by Christina Hanson, NP, to explore the growing intersection between rheumatology and gastroenterology, focusing on shared immune pathways and the evolving role of subcutaneous biologic therapies in immune-mediated inflammatory diseases (IMIDs). The conversation highlights how advances in subcutaneous (subQ) biologics for inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis, are improving patient convenience, adherence, and quality of life while offering comparable efficacy to traditional IV infusions.

This expert discussion dives into key clinical considerations such as induction versus maintenance strategies, patient selection, safety, and real-world implementation of SubQ therapies. The episode also emphasizes the importance of multidisciplinary collaboration between rheumatology and GI providers, especially when managing patients with overlapping conditions like psoriatic arthritis and axial spondyloarthritis. Listeners will gain practical insights on optimizing treatment decisions, enhancing patient education, and leveraging a shared “toolbox” of therapies to better manage complex, multi-system disease.

For more expert-driven education and cross-specialty insights, visit the RhAPP Content Rheum, GHAPP Digital Hub & both GHAPP & RhAPP ACE apps.

Thank you to Johnson & Johnson for the support of this FAQ Video Module.

In this FAQ video module, Tedra Gray, a gastroenterology nurse practitioner at Sinai Chicago, breaks down the key differences between treat-through and randomized withdrawal clinical trial designs in inflammatory bowel disease (IBD). This educational overview explains how these two study designs impact the evaluation of new IBD therapies, including their role in assessing safety, efficacy, and long-term patient outcomes. Viewers will learn how treat-through trials randomize patients at baseline to receive either active treatment or placebo throughout the study, offering insights into real-world effectiveness from induction through maintenance. In contrast, randomized withdrawal designs focus on patients who initially respond to therapy, re-randomizing them to continue treatment or switch to placebo—allowing for more efficient study design, reduced placebo exposure, and a focus on maintenance of response.

This video also explores key considerations such as population selection, ethical implications, study objectives, and how these designs are applied in major Phase 3 IBD trials like ASTRO, GRAVITI, GALAXY, and QUASAR. Ideal for gastroenterology providers and advanced practice providers, this content provides practical insights into interpreting clinical trial data and optimizing treatment strategies in IBD.

For more expert-driven GI education, visit the GHAPP Digital Hub and GHAPP ACE app.

In this medication review video module, Kimberly Orleck, PA-C, reviews the long-term efficacy and safety of guselkumab in the treatment of Crohn’s disease, highlighting results from the Phase 3 GALAXI-2, GALAXI-3, and GRAVITI clinical trials and their long-term extension (LTE) data through week 96. The discussion examines outcomes following intravenous (IV) or subcutaneous (SC) induction therapy followed by SC maintenance dosing, demonstrating sustained clinical remission, endoscopic response, endoscopic remission, and deep remission across study populations. The module also reviews steroid-free outcomes and emphasizes the durability of response observed over two years of treatment, with high rates of patients maintaining remission. Safety data across the LTE studies showed a stable safety profile with no new safety signals and low rates of serious adverse events and infections, consistent with the known safety profile of guselkumab. This expert overview provides clinicians and advanced practice providers with important insights into long-term treatment outcomes and real-world implications for managing moderate-to-severe Crohn’s disease with IL-23 pathway inhibition.For more gastroenterology and hepatology educational content, visit the GHAPP Digital Hub and GHAPP ACE app.