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INDIGO: Switching B Cells Off, Not Out, in IgG4-Related Disease
B-cell targeting has moved to the centre of IgG4-related disease treatment, with inebilizumab, a CD19 depleter, as the recent benchmark. At EULAR 2026, INDIGO tested whether the disease can be controlled by switching B cells off rather than depleting them.
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Immune Dimming or Immune Reset in RA: How Far Should We Go?
CD19-directed CAR T-cell therapy has rapidly moved into autoimmune disease, driven in large part by striking reports in SLE, where sustained drug-free remission has raised the possibility of a true immune reset. In RA, where multiple effective therapeutic classes already exist, the relevance of such deep immune interventions remains uncertain.
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Updated SLR on D2T #RA (131 studies): JAKi maintain ACR20 even after 2-3 prior bDMARDs, with UPA outperforming ABA in head-to-head. But evidence on non-pharmacologic strategies in D2T RA remains nearly absent. Clear gap for future trials. @RheumNow #EULAR2026 POS1246
Jiha Lee JihaRheum ( View Tweet)
Thoracic U/S for #RA-ILD screening? Multicenter study (n=272, Argentina/Denmark/Belgium): 86% sensitivity and 94% NPV. Accessible, no radiation, integrates into clinic flow. Time to build TUS into routine RA-ILD pathways? @RheumNow #EULAR2026 POS1265 https://t.co/FGH5iUstxa
Jiha Lee JihaRheum ( View Tweet)
Patient-initiated telemedicine follow-up cut rheumatology visits by 25% in stable #SpA, but not equally for everyone. Reductions were greatest in men, axSpA, bDMARD users, and the oldest patients (64+, 34% fewer visits). Patient-centered care delivery @RheumNow #EULAR2026 POS1345
Jiha Lee JihaRheum ( View Tweet)
T2T works in elderly-onset #RA. tREACH trial (n=425): EORA (mean age 73) achieve LDA similar to young-onset RA; often with lower treatment intensity when seronegative. Drug tolerability comparable in EORA vs YORA despite more comorbidities. @RheumNow #EULAR2026 POS1326 https://t.co/tKRki2KLzP
Jiha Lee JihaRheum ( View Tweet)
TMP-SMX prophylaxis cuts PJP risk by 69% (RR 0.31) & mortality by 59% (RR 0.41) in immunosuppressed rheum dz pts —but ADRs are 26x more common. NNT=323, NNH=5. Risk-adapted approach recommended. #EULAR2026 POS1190 https://t.co/4yjD9CmySM
Dr. John Cush RheumNow ( View Tweet)
#EULAR2026 POS1139 Pay attention in #SLE with anti-Sm+ RNP+. Data from 3 RCTs & a cohort:
-enriched in Black patients
-poor response to B-cell depletion inc. Obi
-non-response is assoc. with BAFF-dependent B-cell repopulation. So, use Belimumab
-High ferritin = flare @RheumNow https://t.co/3uDMigY8i2
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Extended-release febuxostat (HR091506) vs standard febuxostat in gout. 442 patients, 36 weeks.
SUA <300 μmol/L at Week 36:
63.8% vs 40.7% (p<0.0001)
A 23% difference on the most stringent urate target. Well tolerated and acceptable safety profile
Abstr LB0008 @RheumNow https://t.co/PSrn7K5BVS
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
#EULAR2026 LB0008 Phase 3 RCT in China of pts with high urate (SUA) & 2 gout flares within last year (N=142), HR091506, an extended formulation release of Febuxostat to prolong response was superior to Febuxostat at WK36. Unclear if will proceed to regulatory submission @RheumNow https://t.co/9lcVEzcxc1
Links:
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
https://t.co/LEnQbCB2Ff https://t.co/CtuFVbde6t
Links:
- https://x.com/Janetbirdope/status/2063179861397536847/photo/1
- https://x.com/Janetbirdope/status/2063179861397536847/photo/1
- https://x.com/Janetbirdope/status/2063179861397536847/photo/1
- https://x.com/Janetbirdope/status/2063179861397536847/photo/1
- https://twitter.com/eular_ard/status/2062509665024344391
Janet Pope Janetbirdope ( View Tweet)
Abstr LB0004
CC312 is a CD19/CD3/CD28 tri-specific T cell engager and sustains SRI-4 responses beyond one year with rapid, deep B-cell depletion in autoimmune diseases. Not CAR-T. Not a conventional biologic. A T cell engager that redirects your own immune cells to deplete B https://t.co/rTs3Rg7BPe
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
#EULAR2026 LB0007 Phase 2 RCT of Nipocalimab, an FcRn-i in moderate-to-severe #SLE, with mandatory GC taper =<7.5mg/d by WK16: met primary endpoint at WK24 (SRI-4) vs PBO. Effect size better in Ab+, Ab-High & IFN-High. 23% had IgG<3 at WK58 but SIE. Phase 3 is underway @RheumNow https://t.co/EpgNOHcEqC
Links:
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
What drives progression to difficult-to-treat RA?
20-year cohort 675pts
-18.8% developed D2T RA
-Younger age, higher HAQ & prior steroid exposure asso w/ D2T RA
-Earlier b/tsDMARD initiation protective
-No diff TNFi vs non-TNFi first-line strategy
Disease severity and https://t.co/SJDv9HCbLv
Aurelie Najm AurelieRheumo ( View Tweet)
JAK-SPARE: Ph3 RCT on baricitinib for rem induxn in early PMR.
BARI was effective vs. PBO in inducing & maintaining GC free rem.
No new safety signals.
New tx option for PMR (esp early). Decreases GC dependence & side effects.
LB0005 @RheumNow #EULAR2026 https://t.co/mWrr1RdPCm
Links:
sheila RHEUMarampa ( View Tweet)
#EULAR2026 Recommendations: Immunization (new since 2011)
- Vaccinate early regardless of dz acitiviry
- HBV booster/passive if poor response
- Yellow fever may be considered on individual basis
- Avoid live vaccines (mostly) in newborn exposed in utero to biologic
@RheumNow
Jiha Lee JihaRheum ( View Tweet)
Do you routinely recommend #herpes #zoster #vaccination in all #immune #suppressed pts?
#EULAR2026 @RheumNow
#vaccination #guidelines
Janet Pope Janetbirdope ( View Tweet)
#OP0207 #EULAR2026: SUPERFIBRES trial suggests dietary fibre supplementation may enhance MTX response in RA. Inulin improved EULAR responses and Th17/Treg balance over 30 days, with strongest effects seen in MTX-treated patients. Fascinating microbiome-linked signal. @RheumNow https://t.co/nCvZlooamF
Mrinalini Dey DrMiniDey ( View Tweet)
Data of #Rituximab
In #SARD-ILD
Small N of #RA-#ILD pts
I think data are sufficient as #RWE of #RTX in RA-ILD
✅benefits in other #CTD ILD
✅benefits in #rheumatoid #arthritis
#EVER-ILD #RCT
HOT #RA-ILD topic June 5
#EULAR2026
@RheumNow https://t.co/61MbsnNsaf
Links:
Janet Pope Janetbirdope ( View Tweet)
#OP0204 #EULAR2026 Shared decision-making in practice! BACH study tested “treat by choice” in RA. Patients preferred oral JAKi over SC TNFi (55% vs 45%)
Importantly, own choice led to higher treatment satisfaction, better drug survival & fewer adverse events. @RheumNow #EULARBest https://t.co/iI1n2OGzqY
Mrinalini Dey DrMiniDey ( View Tweet)
