In this medication review, Jessica Tapia, NP, a family nurse practitioner in rheumatology at HonorHealth in Phoenix, Arizona, reviews belimumab (Benlysta) dosing for systemic lupus erythematosus (SLE) and lupus nephritis in adult and pediatric patients. This overview explores intravenous (IV) and subcutaneous administration, highlighting how dosing schedules vary by disease state, age, and body weight.

This episode covers initial and maintenance dosing, weight-based pediatric regimens, and considerations for transitioning from IV infusions to subcutaneous injections. Jessica also discusses autoinjector and prefilled syringe options, age-related considerations for each formulation, and key differences between SLE and lupus nephritis dosing. Drawing on her clinical experience, she explains how patient preferences and comfort with self-injection can help guide the choice of administration method.

Designed for rheumatology advanced practice providers, nurse practitioners, physician assistants, and other clinicians managing lupus and lupus nephritis, this medication review offers practical insights into Benlysta dosing, administration, and individualized treatment planning. For more rheumatology education and clinical resources, visit RhAPP’s website, the RhAPP Content Rheum, or the RhAPP ACE app.

In this FAQ video module, Amanda Mixon, PA-C, explains the difference between the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Ankylosing Spondylitis Disease Activity Score (ASDAS), two validated tools used to assess disease activity in axial spondyloarthritis. She reviews how BASDAI uses six patient-reported questions to evaluate fatigue, spinal pain, peripheral joint symptoms, enthesitis-related tenderness, and morning stiffness, providing a quick and practical measure of a patient’s overall symptom burden.

This episode also explores how ASDAS combines patient-reported symptoms with an objective marker of inflammation, such as C-reactive protein or erythrocyte sedimentation rate. Amanda discusses the established ASDAS disease activity categories, its ability to measure clinically important improvement, and its value in monitoring treatment response, predicting radiographic progression, and supporting clinical decision-making. She also explains why BASDAI scores may remain elevated because of factors beyond active inflammation, including structural damage, osteoarthritis, fibromyalgia, sleep disturbances, or mood disorders.

Designed for rheumatology advanced practice providers, nurse practitioners, physician assistants, and clinicians caring for patients with axial spondyloarthritis or ankylosing spondylitis, this FAQ highlights why BASDAI and ASDAS should be viewed as complementary tools. BASDAI helps clinicians understand how the patient feels, while ASDAS adds objective evidence of inflammation to provide a more complete picture of disease activity. For more rheumatology education and clinical resources, visit RhAPP’s website, the RhAPP content rheum, or the RhAPP ACE app.

In this medication review, Amanda Mixon, PA-C, reviews the APEX and SOLSTICE clinical trials and their implications for guselkumab (Tremfya) in active psoriatic arthritis (PsA). This overview highlights the role of IL-23 inhibition in psoriatic arthritis management, including the APEX findings that supported a U.S. prescribing information update addressing inhibition of structural joint damage.

This episode explores the APEX data on radiographic progression and the SOLSTICE findings in patients with an inadequate response or intolerance to prior tumor necrosis factor (TNF) inhibitor therapy. Amanda discusses key outcomes across joint symptoms, physical function, enthesitis, dactylitis, skin psoriasis, and minimal disease activity, along with the reported safety findings. The discussion emphasizes how these studies may inform treatment sequencing and conversations about symptom control, joint preservation, and individualized treatment goals.

Designed for rheumatology advanced practice providers, nurse practitioners, physician assistants, and other clinicians managing psoriatic arthritis, this module offers practical insights into guselkumab clinical trial data, structural damage prevention, and shared decision-making when selecting biologic therapy. For more rheumatology education and clinical resources, visit RhAPP’s website, the RhAPP Content Rheum, or the RhAPP ACE 2.0 app.

Amanda Mixon, PA-C and fellow rheumatology providers Heather Finlayson, PA-C, and Amanda Sell, PA-C, discuss managing glucocorticoid toxicity in polymyalgia rheumatica (PMR), focusing on balancing disease control with long-term patient safety. They explore the challenges of prednisone tapering, recurrent flares, and cumulative steroid exposure, including concerns associated with prolonged use at lower doses. The conversation highlights patient characteristics and comorbidities that may increase toxicity risk, including older age, diabetes, hypertension, osteoporosis, glaucoma, and psychiatric conditions. They review practical monitoring strategies for blood pressure, blood glucose, bone health, infection risk, and changes in weight, sleep, mood, and skin. The discussion also examines treat-to-target approaches and when difficulty tapering, repeated relapses, or steroid-related complications should prompt consideration of steroid-sparing therapy. Throughout the episode, they emphasize patient education, shared decision-making, and coordination across healthcare providers to establish treatment expectations and address patients’ concerns about reducing steroids.

Designed for nurse practitioners, physician assistants, and other healthcare professionals caring for patients with PMR, this podcast offers practical insights into glucocorticoid safety, individualized treatment decisions, and reducing steroid burden while maintaining symptom control and quality of life. For more expert-led education, visit the Content Rheum and download the RhAPP Ace app to stay up to date with the latest clinical insights in rheumatologic care.

In this FAQ video module, Jennifer Mylod, a rheumatology nurse practitioner in Phoenix, Arizona, compares the mechanisms of action of guselkumab and icotrokinra within the interleukin-23 (IL-23)/T-helper 17 (Th17) signaling pathway. This overview highlights the differences between an injectable monoclonal antibody that targets the IL-23 cytokine and an oral peptide that selectively binds the IL-23 receptor.

This episode explores guselkumab’s binding to the IL-23 p19 subunit and its interaction with CD64 on IL-23-producing immune cells, alongside icotrokinra’s receptor-targeted approach to blocking IL-23 signaling. Jennifer also discusses downstream inflammatory cytokines, including IL-17A, IL-17F, and IL-22, and their connection to the inflammatory processes involved in psoriasis and psoriatic arthritis. The discussion helps clarify how these different molecular targets intersect within the same inflammatory pathway.

Designed for rheumatology advanced practice providers, nurse practitioners, physician assistants, and other clinicians caring for patients with psoriasis and psoriatic arthritis, this module offers an overview of IL-23 signaling, targeted therapies, and the distinction between cytokine inhibition and receptor blockade. For more rheumatology education and clinical resources, visit RhAPP’s website, the RhAPP Content Rheum, or the RhAPP ACE app.

In this FAQ video, Heather Finlayson, PA-C, discusses how treatment duration should be approached after achieving remission or low disease activity in systemic lupus erythematosus (SLE). As treatment options continue to expand and more patients achieve sustained disease control, questions about when and how to taper therapy have become increasingly important.

This educational discussion reviews current guideline recommendations for long-term lupus management, including the ongoing role of hydroxychloroquine, strategies for minimizing corticosteroid exposure, and considerations for tapering immunosuppressive therapies after sustained remission. Heather also explores the challenges of determining when treatment reduction may be appropriate, as biologic therapies become more widely used in lupus care.

Watch now to learn more about maintaining remission, reducing treatment burden, and the evolving approach to long-term disease management in SLE. For more expert-led education, visit the Content Rheum and download the RhAPP Ace app to stay up to date with the latest clinical insights in rheumatologic care.

In this episode of RhAPPcast, host Amanda Mixon, PA-C, is joined by Jeannette Hart, PA-C, to discuss lupus disease activity assessment and the distinction between active disease and irreversible organ damage. The conversation explores how the SLEDAI-2K can help clinicians organize comprehensive assessments, monitor disease activity across multiple organ systems, and guide treatment decisions for patients with systemic lupus erythematosus (SLE).

This episode highlights practical strategies for incorporating disease activity scoring into busy clinic visits, monitoring for lupus nephritis, and recognizing changes that may warrant treatment escalation. Amanda and Jeannette also discuss the limitations of disease activity scores, the importance of clinical judgment when evaluating partial improvements, and balancing inflammation control with reducing long-term glucocorticoid exposure. Through clinical examples, they emphasize individualized patient education, shared decision-making, and collaboration between rheumatology, nephrology, and other specialists to support coordinated lupus care.

Designed for rheumatology advanced practice providers, nurse practitioners, physician assistants, and other clinicians managing lupus, this discussion offers practical insights into disease monitoring, organ damage prevention, and patient communication. For more rheumatology education and clinical resources, visit RhAPP’s website, the RhAPP Content Rheum, or the RhAPP ACE 2.0 app.

In this educational Medication Review, Jennifer Mylod, DNP, provides an overview of the biologic and targeted therapies currently available for the treatment of systemic lupus erythematosus (SLE) and lupus nephritis (LN). This video reviews the different mechanisms of action used to target key immune pathways involved in lupus and highlights how these therapies help manage disease activity and improve patient outcomes.

Learn how currently available treatments work by targeting B cells, B-cell activating factor (BAFF/BLyS), type I interferon signaling, and other immune pathways that contribute to inflammation and autoantibody production. Jennifer discusses important therapies used in the management of SLE and lupus nephritis, including belimumab, anifrolumab, rituximab, obinutuzumab, and voclosporin, and explains how their mechanisms differ.

The discussion also explores the evolving treatment landscape for lupus, emphasizing the growing number of therapeutic options available to help reduce disease activity, preserve organ function, and support long-term disease control. Understanding these mechanisms can help clinicians make informed treatment decisions and optimize care for patients with SLE and lupus nephritis.

Watch this video to gain a better understanding of the biologic and targeted therapies used in lupus care and the science behind their clinical use. For more expert-led education, visit the Content Rheum and download the RhAPP Ace app to stay up to date with the latest clinical insights in rheumatologic care.