Join Danielle Gatti Palumbo, Clinical Pharmacist at Northwell Health Division of Rheumatology, as she presents an integrated analysis of clinical trials evaluating the efficacy and safety of voclosporin in the treatment of lupus nephritis. Drawing from the AURA-LV and AURORA-1 trials—two of the largest lupus nephritis studies conducted to date—this update highlights voclosporin’s unique role as a novel calcineurin inhibitor that does not require routine therapeutic drug monitoring. The analysis demonstrates voclosporin’s ability to increase complete renal response by over 20% at one year, significantly reduce proteinuria in a shorter timeframe (29 days vs. 58 days), and deliver consistent outcomes across diverse racial and ethnic populations. Safety results were comparable to placebo, with stable blood pressure, glucose levels, and improvements in lipid profiles observed.

This update also explores the long-term extension data from AURORA-2 and aligns these findings with current lupus nephritis treatment guidelines, which now support triple therapy—including voclosporin—for patients with class V or proliferative disease. With its fast-acting and steroid-sparing profile, voclosporin continues to emerge as a valuable therapeutic option for managing active lupus nephritis. For more expert-led rheumatology education, visit RhAPP.org and explore the Content Rheum.

In this video, Iris Zink, rheumatology nurse practitioner and clinic owner in East Lansing, Michigan, breaks down the mechanism of action of deucravacitinib, a first-in-class oral selective TYK2 inhibitor, and explains its role in managing psoriasis and psoriatic arthritis. With over 25 years of experience serving underserved populations, Iris uses memorable analogies to simplify the complex TYK2/STAT signaling pathway and help you understand the immunologic rationale behind TYK2-directed therapy.

Learn how TYK2 selectively mediates cytokines like IL-12, IL-23, and Type I Interferons, and why allos­teric inhibition at the regulatory domain reduces off-target effects compared to traditional JAK inhibitors. Iris explains the differences between orthosteric vs. allosteric binding, and how deucravacitinib offers a more targeted, safer approach to reducing inflammation in autoimmune diseases.

Learn more about TYK2 inhibition and psoriasis treatment options at RhAPP.org or download the RhAPP ACE app for more educational content.

In this episode of RhAPPcast, host Amanda Mixon, PA-C, is joined by Monica Richey, NP, and Danielle Gatti-Palumbo, PharmD, for a practical and engaging discussion on how to apply the 2023 ACR guidelines for lupus nephritis to real-world clinical practice. Together, they walk through a complex patient case, highlighting key decision points including when to order a kidney biopsy, how to interpret proteinuria and complement levels, and how to initiate and escalate treatment. The episode covers critical guidance on balancing disease control with long-term safety—especially in patients considering pregnancy—and offers insight into medication adherence strategies, monitoring protocols for agents like voclosporin, and cardiovascular risk reduction in lupus. Whether you’re a nurse practitioner, physician assistant, or clinical pharmacist, this episode offers actionable insights and clinical pearls for delivering guideline-based, patient-centered care.

Stream the RhAPPcast wherever you get your podcasts, and download the new RhAPP ACE 2.0 App to access exclusive learning modules, expert forums, and more. For additional resources, visit RhAPP.org.

Join Cassie Dolecki, PharmD, a Clinical Pharmacy Specialist in Rheumatology at Allegheny Health Network in Pittsburgh, Pennsylvania, as she explores the real-world effectiveness of Guselkumab in the management of psoriatic arthritis.

This discussion highlights recent findings from the CorEvitas Psoriatic Arthritis and Spondyloarthritis Registry, which assessed six-month persistence and effectiveness rates in adult PsA patients. The study revealed that nearly 80% of patients continued Guselkumab treatment over six months, experiencing significant improvements in disease activity, including joint symptoms, skin manifestations, and patient-reported pain.

Cassie also examines how these findings align with phase three clinical trial data, including DISCOVER-1, DISCOVER-2, and COSMOS trials, where Guselkumab demonstrated high retention rates among patients with active PsA, including those who had previously failed TNF inhibitors. Additionally, she reviews a retrospective study from Spain that found high persistence rates at two years in patients using Guselkumab for PsA or psoriasis in clinical practice.

The discussion underscores Guselkumab’s consistent efficacy in treating psoriatic arthritis both in controlled trials and real-world settings.

For more expert insights on PsA management and biologic therapies, visit RhAPP.org and explore the RhAPP ACE App for the latest updates.

Join Iris Zink, a seasoned rheumatology nurse practitioner with over 25 years of experience, as she explains the TYK2/STAT signaling pathway and the immunologic rationale behind TYK2-directed therapy for treating psoriatic arthritis and psoriasis. This video breaks down how TYK2 inhibitors—like deucravacitinib—selectively target the regulatory domain of the TYK2 enzyme, distinguishing them from traditional JAK inhibitors and minimizing off-target effects.

You'll learn how TYK2 plays a critical role in mediating pro-inflammatory cytokines such as IL-12, IL-23, and type I interferons, all of which contribute to the pathogenesis of autoimmune diseases. Iris uses vivid analogies to simplify complex immunologic mechanisms, covering how cytokine signaling triggers downstream inflammation, keratinocyte hyperproliferation, and joint damage in psoriatic conditions.

Discover how TYK2 inhibition can "dial down" the immune response without fully shutting it off—providing targeted, effective treatment with fewer side effects.

Learn more about TYK2 signaling, cytokine pathways, and innovative therapies in rheumatology at RhAPP.org or download the RhAPP ACE app.

Join Amanda Mixon, PA-C, President of RhAPP, as she hosts an insightful discussion with Will Saalfeld, NP, a leading rheumatology expert and RhAPP faculty member. In this episode, they break down the key differences between IL-17A and IL-17F inhibition and explore how these distinctions impact patient outcomes in rheumatology.

IL-17A and IL-17F play central roles in inflammation and autoimmune disease, but their unique functions mean that blocking them can yield different clinical effects. Will explains the pathophysiology of these cytokines, their impact on diseases like psoriatic arthritis and axial spondyloarthritis, and how emerging therapies are targeting both IL-17A and IL-17F for broader disease control.

They also dive into real-world applications, including the latest clinical trials and how IL-17 inhibitors compare in efficacy, safety, and patient selection. Learn why dual inhibition of IL-17A and IL-17F may offer additional benefits over targeting IL-17A alone and what considerations are essential when prescribing these biologics.

For more expert-driven rheumatology content, visit RhAPP.org and explore the RhAPP ACE App for the latest updates, research, and clinical insights.

In this video, Jessica Farrell, PharmD—clinical pharmacist at Albany Medical Center and professor at Albany College of Pharmacy and Health Sciences—explains the clinically meaningful differences between voclosporin and other calcineurin inhibitors, such as cyclosporine and tacrolimus, in the treatment of lupus nephritis. She highlights how voclosporin’s unique molecular structure leads to increased potency, faster elimination, and more stable pharmacokinetics. Unlike other calcineurin inhibitors, voclosporin offers more consistent oral bioavailability and does not require routine therapeutic drug monitoring. Dr. Farrell also reviews important distinctions in drug-drug interactions, particularly with mycophenolate, and notes that voclosporin may present a lower risk of hyperkalemia and metabolic side effects, such as lipid and glucose abnormalities. While voclosporin is not currently recommended during pregnancy, it remains a promising treatment option for many patients with lupus nephritis. For more expert-led rheumatology education, visit RhAPP.org or explore the RhAPP ACE App.

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 alopecia) or if a pregnancy is planned, a cholestyramine wash can be used to effectively eliminate the drug from the system. While Leflunomide is generally well tolerated, clinicians should be mindful of its impact as patients age, since declining kidney and liver function may necessitate dose adjustments or discontinuation.

For more expert insights and digital resources, visit the RhAPP website and RhAPP ACE App for the latest in rheumatology education.