GHAPPcast

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Welcome to Episode 7 of the GHAPP CLDF PBC Podcast Series, hosted by Andrea Gossard, NP. In this pivotal episode, we explore the cumulative impact of nonresponse to ursodeoxycholic acid (UDCA) in patients with Primary Biliary Cholangitis (PBC). Andrea is joined by Anne Moore, NP, a GHAPP board member and expert in PBC management, to discuss the concept of “area under the curve” as it relates to prolonged biochemical nonresponse and progressive liver injury over time. Together, they emphasize the critical need for early identification of inadequate response, how to define therapeutic targets (such as normalization of alkaline phosphatase and bilirubin), and why timely escalation to second-line therapies is key to preventing long-term complications like advanced fibrosis, cirrhosis, hepatocellular carcinoma (HCC), and portal hypertension. This episode also provides valuable insights into esophageal varices screening, bone health monitoring, and the economic and access-related challenges of liver transplant, particularly in rural areas. With evidence-based commentary and real-world strategies, this conversation empowers hepatology and GI providers to recognize the importance of ongoing monitoring, proactive treatment adjustments, and comprehensive care planning for patients with PBC. Don't miss this essential episode in a series focused on advancing liver care.

Thank you to Intercept for your support of this podcast episode.

Welcome to another episode of the GHAPP CLDF PBC Podcast Series, hosted by Andrea Gossard, NP. In this episode, we explore one of the most challenging aspects of Primary Biliary Cholangitis (PBC): identifying progression rates and implementing timely, personalized management strategies. Andrea is joined by fellow GHAPP member and hepatology expert Ann Moore, MD, who brings decades of clinical experience to the conversation. Together, they discuss how the natural history of PBC has evolved since the approval of ursodeoxycholic acid (UDCA), and why differentiating between slow and rapidly progressing patients is critical to improving long-term outcomes. The episode dives into the importance of monitoring biomarkers such as alkaline phosphatase and bilirubin, interpreting non-invasive tests like FibroScan and ELF, and understanding when to escalate to second-line therapy. Ann shares real-world strategies for risk stratification, including using CBC, imaging, and prognostic scoring tools like the GLOBE and UK-PBC scores. The discussion also touches on disparities in access to liver transplant and the economic burden of late-stage disease. If you’re a hepatology or GI provider managing patients with PBC, this episode provides actionable insights on how to intervene earlier, track disease progression more effectively, and ultimately prevent the need for liver transplantation. Don’t forget to catch the other episodes in this high-impact series on Primary Biliary Cholangitis.

Thank you to Intercept for your support of this podcast episode.

Welcome to the eighth and final episode of the GHAPP CLDF PBC Podcast Series, hosted by Andrea Gossard, ARNP. In this powerful conclusion to our educational journey on Primary Biliary Cholangitis (PBC), we shift focus toward a holistic approach to PBC management, emphasizing lifestyle modifications, integrative medicine, symptom relief, and long-term well-being beyond standard pharmacologic therapy. Andrea is joined once again by Christina Hanson, FNP-C and GHAPP board member, for a deep dive into the comprehensive care strategies that support not just liver health, but the overall quality of life in patients with PBC. Together, they discuss how to manage extrahepatic manifestations such as fatigue, pruritus, bone disease, dyslipidemia, and fat-soluble vitamin deficiencies, while also addressing common patient concerns around statin use, alcohol consumption, and over-the-counter supplements. With insights on lifestyle counseling, diet, exercise, vitamin D, sleep hygiene, and non-pharmacologic approaches like meditation and complementary therapies, this episode offers actionable takeaways for clinicians and patients alike. Whether you're treating PBC in Detroit, Denver, or anywhere across the U.S., this episode reinforces the importance of a patient-centered, multidisciplinary strategy to optimize care in this complex liver disease. Don't forget to explore the full podcast series for more expert-led discussions on PBC.

Thank you to Intercept for your support of this podcast episode.

Welcome to the CLDF GHAPP PBC Podcast Series! In this episode of our eight-part series, host Andrea Gossard, NP, is joined by Christina Hanson, FNP and CLDF GHAPP board member, to explore the evolving role of biomarkers in the diagnosis, monitoring, and personalized treatment of Primary Biliary Cholangitis (PBC). Together, they examine how clinicians are rethinking the utility of traditional markers such as alkaline phosphatase and bilirubin, and how newer data support the use of additional biomarkers—including ALT, AST, and GGT—for a more comprehensive picture of disease activity and therapeutic response. This discussion includes practical guidance on baseline evaluation with FibroScan, interpretation of liver stiffness measurements, and when to consider second-line therapies. Christina shares her clinical insights from real-world hepatology practice, emphasizing the importance of early intervention, individualized timelines for assessing treatment response, and the growing recognition that even small elevations in liver enzymes may signal a need for more aggressive care. This episode is a must-listen for hepatology providers and GI specialists who want to stay up to date with the latest evidence-based strategies in PBC management. Subscribe and follow along as we continue this educational journey throughout the full series.

Thank you to Johnson & Johnson for your support of this Journal Club Video Module.

The GALAXI 2 and 3 Phase 3 trials provide critical insights into the 48-week efficacy of guselkumab and ustekinumab in patients with moderate to severely active Crohn’s disease, evaluating outcomes based on prior biologic therapy response. In this Journal Club video module, Alison Moe, PA-C, from Atlanta Gastroenterology, breaks down the trial results, highlighting endoscopic and clinical remission rates, deep remission outcomes, and safety data. Both guselkumab dosing regimens (200 mg and 100 mg subcutaneous maintenance) demonstrated superiority to ustekinumab across key endoscopic response endpoints at week 48, particularly in biologic-naïve and biologic-experienced patients. The study also confirms guselkumab as a viable option for Crohn’s disease patients who have failed previous therapies, offering a targeted IL-23 therapy with consistent clinical benefits in deep remission and long-term disease control.

For more details on the GALAXI trials and the latest in IBD treatment advancements, visit the GHAPP website or download the GHAPP ACE app.

In the final installment of our Simplified Access Series, we turn our focus to the evolving drug distribution landscape, including specialty pharmacy dynamics, hospital-based models, and the increasing influence of white bagging, brown bagging, and payer mandates.

Join host Allison Moser, NP, with returning guests Tedra Gray, NP, and Jeff Dunn, PharmD (President of a transparent PBM), as they explore how these shifts are impacting real-world patient access and clinical workflow.

In this episode, we break down the rising use of limited distribution drugs, strategies for navigating specialty pharmacy restrictions, and how clinicians are adapting to maintain timely access to infusion therapies. Allison and Tedra share how close collaboration with hospital-based specialty pharmacists is helping to overcome administrative and logistical hurdles, while Jeff offers an industry view on why payers are pushing toward pharmacy benefit distribution and the cost pressures behind it.

We also explore the disconnect between payers and hospitals in negotiating drug costs, and how silos in coverage, formularies, and rebates may be contributing to access barriers. The episode wraps with a forward-looking conversation on shared risk models, value-based care, and the need for stronger collaboration across healthcare stakeholders to build a more sustainable and equitable system.

To catch up on the full series, watch Episodes 1 and 2 on the GHAPP digital hub.

In Episode 2 of our Simplified Access Series, we continue our deep dive into practical strategies to streamline the prior authorization (PA) process and reduce delays in patient care. Nurse practitioners Tedra Gray and Allison Moser return alongside Jeff Dunn, PharmD, a veteran in managed care and president of a transparent PBM, to explore real-world solutions for improving first-attempt PA success.

This episode focuses on the proactive steps clinicians can take to avoid common PA denials, including accurate documentation, ICD coding, benefit verification, use of electronic prior authorization tools, and collaboration with pharmacy liaisons. We also unpack how templates, test claims, and payer-specific nuances can strengthen submissions.

Jeff offers valuable insights from the payer perspective, detailing the most common reasons for PA denials—such as missing clinical information or lack of step therapy documentation—and how providers can better align their approach with evidence-based policies. The conversation wraps with actionable ideas on how APPs and payers can build trust, improve communication, and leverage technology and AI to reduce administrative burden and deliver faster access to care.

If you're a GI or hepatology clinician, pharmacist, or APP navigating the complexities of the medication approval process, this episode is packed with expert guidance and proven strategies to elevate your access workflow.

Don’t forget to watch Part 1 on our GHAPP digital hub, and stay tuned for Part 3 of this essential series on simplifying access.

Welcome to Episode 1 of our Simplified Access Series, where we explore real-world strategies to navigate prior authorizations and medication distribution challenges in hepatology and gastroenterology. In this conversation, hepatology nurse practitioners Allison Moser, Rush University Medical Center, Chicago, and Tedra Gray, Sinai, Chicago, are joined by Jeff Dunn, PharmD, a managed care veteran and CEO of a transparent pass-through PBM.

Together, they break down the daily clinical and administrative impact of prior authorization (PA), explore common frustrations providers face, and share actionable solutions to streamline the process. From documenting medical necessity to collaborating with payers and pharmacists, this episode offers practical tips to reduce delays, improve patient outcomes, and strengthen the provider-payer dynamic.

Jeff also offers an insider's view on what payers are really looking for when reviewing PA requests, why payer priorities can influence approval timelines, and how evidence-based decision-making intersects with healthcare cost trends.

If you're an advanced practice provider, pharmacist, or clinician navigating medication access barriers, this episode delivers valuable insights to advocate more effectively for your patients.

Be sure to subscribe to GHAPPcast to stay updated as we continue this three-part series on simplifying access. Visit ghapp.org for more tools and resources to support gastroenterology and hepatology APPs.

Thank you to Johnson & Johnson for your support of this Journal Club Video Module.

The GRAVITI study provides compelling Phase 3 data on guselkumab, an IL-23 p19 subunit inhibitor, demonstrating its efficacy and safety in patients with moderate to severely active Crohn’s disease. In this Journal Club video module, Alison Moe, PA-C, from Atlanta Gastroenterology, breaks down the key findings, discussing clinical remission rates, endoscopic outcomes, and patient safety data at week 12, week 24, and week 48. The study highlights guselkumab’s dual mechanism of action, blocking IL-23 and binding to CD64, with both IV induction and subcutaneous maintenance proving effective in both biologic-naïve patients and those with prior biologic failure. The data show significant improvements in clinical and endoscopic remission rates, with no major serious adverse events beyond mild upper respiratory infections. The findings reinforce guselkumab’s role as a treatment option for patients needing a targeted IL-23 therapy with flexible dosing options.

For more details on the GRAVITI study and the latest updates in IBD management, visit the GHAPP website or download the GHAPP ACE app.

Thank you to Johnson & Johnson for your support of this GHAPPcast episode.

Join us for a compelling episode of GHAPPcast, the official podcast for advanced practice providers in gastroenterology and hepatology. In this episode, host Gabriella McCarty, NP-C, welcomes esteemed guest Sharon Dudley-Brown, PhD, a leading expert from Johns Hopkins and a professor at the University of Delaware. Together, they dive deep into the clinical role of guselkumab, a newly approved IL-23 inhibitor for ulcerative colitis (UC).

This discussion unpacks the mechanism of action, efficacy, safety profile, and potential patient candidates for this innovative therapy. Sharon provides expert insights on how guselkumab compares to other biologics and small molecules, its advantages in targeting the IL-23 pathway, and the latest clinical trial data supporting its use. The episode also covers key considerations for patient selection, dosing flexibility, and the evolving role of combination therapy in inflammatory bowel disease (IBD) management.

Whether you’re a healthcare provider looking to optimize UC treatment strategies or seeking clarity on the latest biologic advancements, this episode offers practical takeaways to enhance your clinical decision-making.

Tune in now to stay ahead in the evolving landscape of ulcerative colitis treatments!

Subscribe to GHAPPcast on your favorite podcast platform and visit GHAPP.org for more expert-led education in gastroenterology and hepatology. Download the GHAPP ACE app to continue watching expert-led educational modules in gastroenterology and hepatology.