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New JAK inhibitors in the axSpA treatment landscape
At EULAR 2026, two large phase 3 studies highlight that the JAK story in axSpA is still evolving rapidly, with different selectivity profiles and expanding global development programs continuing to push the field forward.
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What’s New in Psoriatic Arthritis: A Whirlwind Tour
At the "What Is New in Psoriatic Arthritis" session at EULAR 2026, Professor Dennis McGonagle (Leeds, UK) took the audience on a whirlwind yet compact tour of the field, touching on three themes: the pathophysiology of PsA, individualization of clinical management, and emerging research and future directions.
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‘Strong’ treatment predictions in inflammatory myositis
Presented at EULAR 2026 London, Brepocitinib dual TYK2/JAK1 inhibitor with successful Phase 3 VALOR trial demonstrating significant improvement in skin and muscle symptoms in dermatomyositis (DM).
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+#RCT in #dermatomyositis with #brepocitinib
Oral #TYK2/JAK1i
241 pts
+outcomes
#TIS total improvement score
>40%TIS 68% v 44%
#steroid tapering
#skin improved rapidly #CLASI
#OP0166
#POS0264 @RheumNow #EULAR2026 https://t.co/9WZl9RsXXe
Links:
Janet Pope Janetbirdope ( View Tweet)
#EULAR2026 POS0713 Is there a hope for BTK-inhibition in #SLE despite several previous failures? A Phase IIb RCT in China: primary endpoint (SRI-4) was met in Orelabrutinib vs PBO in dose-dependent manner. No new safety signal. Phase 3 RCT is underway @RheumNow https://t.co/4cJ8ezppTS
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Gecacitinib (pan-JAK inhibitor) vs placebo in radiographic #axSpA ASAS40 51.9% vs 12.9% (p<0.0001) at 16 weeks. ASAS20 69.2% vs 21.2% (p<0.0001). Pan-JAK inhibition showed efficacy in TNFi-experienced patients. Abstr OP0240 @RheumNow #EULAR2026
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Does sequential therapy infliximab —> tofacitinib outperform tofa alone in axSpA?
Yes: faster remission at week 4 (84.6% vs 15%)
But: equal at week 24
Prospective study in 46 patients
#POS0201 #EULAR2026 @RheumNow https://t.co/rmtoJQtYc0
Nelly ZIADE 🍀 Nellziade ( View Tweet)
Gecacitinib 100mg BiD vs PBO in active r-axSpA:
Met primary endpt ASAS40 at wk 16 showing efficacy of gecacitinib vs. PBO (51.9%vs12.9%,p<0.0001)
Gecacitinib showed ⬆️ improvements in ASDAS-CRP, physical fnxn, spinal mobility & QOL
Promising tx.
AbsOP0240 @RheumNow #EULAR2026 https://t.co/FytoRgxvnG
Links:
sheila RHEUMarampa ( View Tweet)
JAK Safety Debate Continues: Stronger VTE signal, less clear cancer signal
Few topics in rheumatology have reshaped prescribing behavior as dramatically as the safety concerns surrounding JAK inhibitors following ORAL Surveillance and the subsequent FDA and EMA warnings. Even https://t.co/wfQZn1hO3N
Dr. John Cush RheumNow ( View Tweet)
Ivarmacitinib (selective JAK1 inhibitor) significantly improved ASAS40 vs placebo in nr-#axSpA(39.7% vs 24.8%; p=0.006) at 12 weeks, sustained to 24 weeks. Another oral option for non-radiographic disease. Abstr OP0237 @RheumNow #EULAR2026
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
DR JOHN STONE gives Overview
Of
#IgG4
New non B cell depleter
#obexelimab N=194 in RCT
To add to B cell depletion w
#Inebilizumab
Off label but used also
#Rituximab
#steroids
#Immunesuppressives
Other investigational drugs
Ex #JAKi
#EULAR2026 @RheumNow
#OP018 #RULARbest https://t.co/Y4saGYcdww
Links:
Janet Pope Janetbirdope ( View Tweet)
💉 Does ivarmacitinib (selective #JAK1i work in nr-axSpA?
Phase 3 RCT (n=304):
ASAS40 39.7% vs 24.8% placebo at week 12
with sustained benefit at week 24
#OP0237 #EULAR2026 @RheumNow https://t.co/kofXnPp6qQ
Nelly ZIADE 🍀 Nellziade ( View Tweet)
🔬 Can filgotinib improve axSpA?
OLINGUITO (Phase 3 RCT, n=495):
YES! ASAS40 39.5% vs 21% (r-axSpA) at week 16
#OP0234 #EULAR2026 @RheumNow https://t.co/0vj2KqSS1b
Nelly ZIADE 🍀 Nellziade ( View Tweet)
🧬 Do biomarkers predict #zasocitinib response in PsA?
YES: TYK2/IL-17 pathway markers predict ACR20 in 290pts Phase 2b RCT
#OP0184 #EULAR2026 @RheumNow https://t.co/AVlyrauI5q
Nelly ZIADE 🍀 Nellziade ( View Tweet)
❤️ Do biologics differ in MACE risk in PsA?
YES - JAKi highest risk after 2.5yrs vs TNFi/IL-17i/IL-23i in a retrospective cohort of 22,246pts.
OP0181 #EULAR2026 @RheumNow https://t.co/eQdBtMfRAY
Nelly ZIADE 🍀 Nellziade ( View Tweet)
DESIR Cohort 10-year data (OP0102): SIJ structural lesions in #axSpA progress slowly, but prior MRI bone marrow oedema predicts later structural damage. bDMARD exposure was associated with less erosion progression supporting early biologic treatment Abstr OP0102 @RheumNow
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
JAKi vs ABA in RA-ILD: emulated target trial (n=1,162), JAKi with worse composite respiratory outcomes (HR 1.57) and all-cause mortality (HR 1.59) vs ABA over 5 yrs. JAKi with ↑ pneumonia risk. In RA-ILD, ABA may be the preferred choice? @RheumNow #EULAR2026 POS0813 #EULARBEST
Jiha Lee JihaRheum ( View Tweet)
#OP0241 FASTLANE phase 4 trial showed TOFA was superior to PBO in early active axSpA, achieving significantly higher ASDAS inactive disease rates at 16 weeks (26.4% vs 7.4%) on background of naproxen. MRI osteitis improvement numerically favoured TOFA. #EULAR2026 @RheumNow https://t.co/dGETjkmfrh
Mrinalini Dey DrMiniDey ( View Tweet)
#OP0240 phase 3 data showed that the pan-JAK inhibitor gecacitinib significantly improved disease activity, function, MRI inflammation and quality of life in active radiographic axSpA versus placebo at 16 weeks, with ASAS40 responses of 51.9% vs 12.9%. #EULAR2026 @RheumNow https://t.co/6oojvvFmk0
Mrinalini Dey DrMiniDey ( View Tweet)
#OP0237 reports positive phase 3 data for the selective JAK1 inhibitor ivarmacitinib in active nr-axSpA. ASAS40 responses at Week 12 significantly higher vs placebo (39.7% vs 24.8%), with sustained efficacy through Week 24 and no new safety signals observed. #EULAR2026 @RheumNow https://t.co/JZLQ0Ywlio
Mrinalini Dey DrMiniDey ( View Tweet)
