In this episode of RhAPPcast, the official podcast of Rheumatology Advanced Practice Providers, host Amanda Mixon and Bonnie Smeryage, NP, explore the real-world impact of X-linked hypophosphatemia (XLH) through a powerful patient perspective. Featuring Shannon Sharp, a patient ambassador with Kyowa Kirin, this discussion dives into the genetic basis, diagnostic challenges, and lifelong burden of XLH—a rare, chronic metabolic bone disorder characterized by renal phosphate wasting. Learn how XLH symptoms such as bone pain, muscle weakness, fractures, and joint stiffness can mimic common rheumatologic conditions, often leading to misdiagnosis. This episode highlights the critical role of family history, genetic testing, and fasting serum phosphorus in identifying XLH, while also emphasizing the importance of compassionate, patient-centered care when discussing sensitive topics like family planning. Gain valuable clinical insights into disease progression, surgical considerations, and quality-of-life challenges, along with practical strategies to improve diagnosis and management. Whether you're a rheumatology provider, advanced practice provider (APP), or healthcare professional, this episode offers essential education on recognizing and supporting patients with XLH.

Explore the safety profile of tirzepatide in this clinician-focused medication review led by Bharati Bhardwaja, PharmD, a rheumatology clinical pharmacist at Kaiser Permanente Colorado. This video provides a comprehensive overview of common adverse effects associated with tirzepatide, including gastrointestinal symptoms such as nausea, diarrhea, constipation, abdominal pain, and decreased appetite, as well as other reactions like injection site reactions, fatigue, and hair loss.

The discussion also highlights important drug interaction considerations, including the need to adjust doses of insulin or sulfonylureas to reduce hypoglycemia risk, and the impact of delayed gastric emptying on the absorption of medications with narrow therapeutic windows, such as warfarin. Special attention is given to potential considerations with mycophenolate mofetil and oral hormonal contraceptives, along with guidance on monitoring and alternative strategies. Additionally, this review covers key safety considerations for pregnancy and lactation, emphasizing the importance of risk-benefit discussions and appropriate discontinuation when necessary.

Designed for healthcare professionals managing patients with metabolic and rheumatologic conditions, this video delivers practical insights to support safe prescribing, minimize adverse effects, and optimize patient outcomes with tirzepatide therapy. Explore more expert-led education and medication reviews on the Content Rheum and stay up to date with the latest clinical insights in rheumatologic care.

Learn the recommended starting dose and titration strategy for tirzepatide in this medication review featuring Jennifer Mylod, DNP, from Arizona Arthritis & Rheumatology Associates in Phoenix, Arizona. This video provides a practical, clinician-focused overview of how to initiate tirzepatide at 2.5 mg once weekly to improve gastrointestinal tolerability and patient adherence, followed by a structured dose escalation approach. Viewers will gain insight into the standard titration schedule—advancing in 2.5 mg increments every 4 weeks up to a maximum of 15 mg—as well as how to individualize treatment based on patient response and side effect profile.

The discussion highlights common adverse effects such as nausea, vomiting, diarrhea, and constipation, along with strategies to manage these symptoms, including slower titration, dose adjustments, and patient counseling on diet, hydration, and meal size. This review also explores key clinical outcomes associated with tirzepatide, including glycemic control, weight reduction, and appetite regulation, while emphasizing that not all patients require maximum dosing to achieve meaningful benefits. Special considerations for older adults, patients with gastrointestinal sensitivity, renal impairment, or those on concomitant insulin or sulfonylureas are also addressed to help clinicians minimize risk and optimize safety.

Whether you're managing patients with type 2 diabetes or obesity, this video delivers actionable guidance on how to personalize tirzepatide therapy, improve tolerability, and support long-term treatment success. Explore more expert-led education and medication reviews on Content Rheum and stay up to date with the latest clinical insights in metabolic and rheumatologic care.