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Generic Tofacitinib (6.26.2026)
Dr. Jack Cush reviews the news and journal articles from RheumNow.com. Updates on tofacitinib, CAR-T therapy and AI.
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2026 Guidelines for the Treatment of Axial Spondyloarthritis
ACR
New and updated clinical guidelines released today provide comprehensive, evidence-based recommendations for the management of axial spondyloarthritis (axSpA) for both adults and children.
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EULAR 2026 Rheumatology RoundUp
It’s time for Rheumatology RoundUp from EULAR 2026 from London, UK. Drs. Artie Kavanaugh and Jack Cush review their choice presentations from the meeting, offering their perspectives on impact and applicability.
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#TB Infection or reactivation is Psoriasis or Psoriatic Arthritis pts taking IL-23 inhibitors is rare, rare. Literature review showed 34 studies of IL-23i in PsO had no new TB, but 1 case of LTBI reactivation. In 8 IL-23i PsA studies there were NO new TB or LTBI reactivations https://t.co/h0oe3WksK1
Dr. John Cush RheumNow ( View Tweet)
#EULAR2026 LB0001 BOLD results in #PsA. First H2H RCT showing superiority of Bimekizumab (IL17A- & F-i) vs Risankizumab (IL-23-i) in primary endpoint, ACR50 49% vs 38% at WK16. The difference was seen from WK4 & sustained to WK24. May help inform choice of Tx @RheumNow #EULARBest https://t.co/s4zbFiepuP
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
ACR50 at Week 4 was 19.9% (BKZ) vs 7.2% (RZB) nominal p<0.0001. Faster onset, higher sustained joint response. DAPSA LDA/remission 65% vs 55%. Dual IL-17A/F blockade outperforms IL-23 inhibition for joints in #PsA. Abstr LB0001 @RheumNow #EULAR2026 https://t.co/s4z8r1rKte
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
First head-to-head trial to show #PsA joint outcome superiority
BE BOLD: Bimekizumab (BKZ; IL-17A/F dual blockade) beat Risankizumab (RZB: IL-23i) on ACR50 at wk 16 (49.1% vs 38.4%, p=0.0078). BKZ also faster: ACR50 at wk 4 already 19.9% vs 7.2%.
@RheumNow #EULAR2026 LB0001 https://t.co/YMQCpom5xD
Jiha Lee JihaRheum ( View Tweet)
Double targeted therapy in refractory SpA/PsA.
76 patients, 17 Spanish centres, up to 6 years follow-up. Median 4 prior biologics.
Remission achieved in 55.6% during follow-up. 28.6% in remission at final visit.
ASDAS improved significantly from 3 months, sustained to 5 https://t.co/g1IPstYYuX
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
🧬 Does spine vs knee enthesis differ immunologically?
Translational scRNAseq study: YES!
Spine produces more IL-23 but shows attenuated IL-17 response vs knee
#POS0084 #EULAR2026 @RheumNow https://t.co/itFrLEXSzZ
Nelly ZIADE 🍀 Nellziade ( View Tweet)
🧲 Does GUS+GOL combo beat GUS alone on MRI in PsA?
YES for joints - AFFINITY Phase 2a RCT: greater MRI inflammation reduction in 91pts
#OP0186 #EULAR2026 @RheumNow https://t.co/9eIS6lh7WN
Nelly ZIADE 🍀 Nellziade ( View Tweet)
Biopsy-guided treatment in PsA: match the drug to the tissue pathotype with 68% in LDA/remission vs 48% standard of care at 6 months. In myeloid CD117+ patients, mean DAPSA reduction at 6 months: IL-17i: −13.5, IL-23i: −12.8, TNFi: −7.5. Synovial biopsy with myeloid CD117+
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Can we intercept PsA?
Retro study 394 PSO pts 17 yrs follow-up 86 PsA
TNFi linked to higher PsA incidence vs IL- MoA
TNFi 45% vs IL-17i 14% vs IL-23i 10% vs IL-12/23i 11%
After adjustment IL-17i HR 0.35 IL-23i HR 0.17
Needs prospective confirmation!
#OP072 #EULAR2026 https://t.co/88RaukjLjY
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
22% of psoriasis patients developed #PsAover 17 years of follow-up. PsA occurred in 44% of TNFi-treated vs only 9–14% of those on IL-23i or IL-12/23i. Time to discuss "preventive biologics" in PsO? Prospective controlled trials are needed Abstr#072 @RheumNow #EULAR2026
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
In a 17-year real-world psoriasis cohort, patients on IL-17i had 75% lower odds and IL-23i patients had 84% lower odds of developing #PsA vs TNF inhibitors. Is biologic class selection a PsA interception strategy? Prospective controlled trials are needed Abstr#072 @RheumNow https://t.co/jpdZjGK7VV
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Small interventional synovial biopsy precision medicine study
CD117 high pts n=15 = better response to IL17i or IL23i inhibition vs. TNFi w/
-DAPSA -13.5, -12.8 vs. -7.5 respectively
Higher BL levels of tissue inflammation in Responders vs. NR
More robust study design needed https://t.co/7jNff6lUJ6
Aurelie Najm AurelieRheumo ( View Tweet)
💊 Oral IL-23Ri for #PsA #PsO?
ICONIC RCT (n=216):
Yes! Icotrokinra improves pain & disease activity at week 16
#POS0052 #EULAR2026 @RheumNow https://t.co/PA4O36h02Y
Nelly ZIADE 🍀 Nellziade ( View Tweet)
Nail #PsA, hard to treat and often overlooked. APEX trial: guselkumab achieved 43% ↓ in nail severity score (mNAPSI) vs 16% worsening on placebo at wk 24, plus PASI 100 in ~39% vs 11%. IL-23 inhibition delivering where pts often struggle most. @RheumNow #EULAR2026 POS0471
Jiha Lee JihaRheum ( View Tweet)
💉 Risankizumab durable in #PsA?
#POS0047 3 RCT n=964 KEEPsAKE
Yes! ACR50 ~37% & MDA ~34% @w244
no new safety signals 💪
#EULAR2026 @RheumNow https://t.co/911Fi9vxfP
Nelly ZIADE 🍀 Nellziade ( View Tweet)
🤔 GUS or IL-17i for #PsA?
#POS0045: RW study:
Both! ~76% persistence & similar effectiveness
1141 pts @12mo #PsABIOnd 🌍
#EULAR2026 @RheumNow https://t.co/PyuaH5B5V1
Nelly ZIADE 🍀 Nellziade ( View Tweet)
Guselkumab in erosive #PsA: ACR20 68% vs 47% placebo, structural damage progression ↓ across subgroups regardless of sex, BMI, MTX use, or joint counts. Highest inflammation and erosion burden? Biggest benefit. IL-23i holds up where it matters most. @RheumNow #EULAR2026 POS0480
Jiha Lee JihaRheum ( View Tweet)
