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Understanding Comorbidities in RMD
2026 EULAR Press Release
People with rheumatic and musculoskeletal diseases (RMD) are at risk of a number of comorbidities, from cardiovascular diseases to cognitive impairment and fractures. The 2026 EULAR Congress showcased new data and ideas around various comorbidities and drug safety issues in people with an RMD – highlighting the need for integrated care. Here are five abstracts to consider.
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JAK Safety Debate Continues: Stronger VTE signal, less clear cancer signal
Few topics in rheumatology have reshaped prescribing behaviour as dramatically as the safety concerns surrounding JAK inhibitors following ORAL Surveillance and the subsequent FDA and EMA warnings.
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🎗️ Do targeted therapies raise cancer risk in SpA?
French nationwide cohort (n=56,591): NO
In fact, prolonged exposure REDUCES risk (wHR 0.86), especially haematological.
#OP0238 #EULAR2026 @RheumNow https://t.co/dDveAmWpdX
Nelly ZIADE 🍀 Nellziade ( View Tweet)
💊 After TNFi failure in axSpA, switch to IL-17Ai or cycle TNFi?
ROC-SpA (Phase 4 RCT, n=300):
NO difference: ASAS40 15.2% vs 14.5% at week 24
#OP0235 #EULAR2026 @RheumNow https://t.co/45gisWiuoM
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)
After TNFi secondary failure: does MOA switch beat TNFi cycling? UK RWD (n=155): yes for #PsA (76% vs 57% drug survival at 12m) and axSpA (80% vs 68%), but not RA. Yet 74% of axSpA pts still got another TNFi. Evidence vs practice gap in plain sight. @RheumNow #EULAR2026 POS0776
Jiha Lee JihaRheum ( View Tweet)
#OP0238: French SNDS cohort found longer exposure to targeted therapies in SpA (>6months) was assoc with a lower overall cancer risk vs shorter exposure, esp for haematologic malignancies. Data add to long-term safety evidence for targeted therapies in SpA. #EULAR2026 @RheumNow
Mrinalini Dey DrMiniDey ( View Tweet)
After failure of a first TNFi in axSpA, #OP0235 from ROC-SpA trial found no superiority of switching to an IL-17A inhibitor over cycling to second TNFi. ASAS40 responses at Week 24 similar with both strategies, supporting individualised treatment decisions. #EULAR2026 @RheumNow
Mrinalini Dey DrMiniDey ( View Tweet)
What to use in #RA #IL6i v #abatacept post #TNFi-IR?
H2H #TCZ v #Abatacept
Same on primary outcome
#CDAI change wk26
BUT
If #monoRx TCZ better
Better retention #TCZ
So you decide which is better! Equal v some advantages w #tocilizumab
#EULAR2026 @RheumNow @eular_org
#OP0205 https://t.co/xdOx4kQCTC
Links:
Janet Pope Janetbirdope ( View Tweet)
RENOIR Ph2b pathogenic T-cell depletion rosnilimab RA
-Primary endpoint DAS28-CRP change wk12
-2.06 to -2.12 (all doses) vs -1.69 PBO p<0.01
-ACR20/50/70 + CDAI LDA all improved vs PBO
-hsCRP reduction across all dose arms
-69% CDAI LDA by wk14
-wk 28 extension shows https://t.co/AMfmSded0D
Aurelie Najm AurelieRheumo ( View Tweet)
A new MoA that does not meet it's primary endpoint in RA
SPECIFI-RA Ph2b oral TNFR1 signal inhibitor balinatunfib
ACR20 wk12 NOT significantly diff vs PBO
~48.5–61.8% across doses vs 52.3% PBO
Secondary BALI 200 mg QD:
ACR50: 36.9% vs 18.5% (nominal p=0.0179)
Mechanistic https://t.co/hmZ93JisiO
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
Roc-SpA study
Active axSpA dse + inad response to TNFi ➡️switch or cycled
No significant diff in ASDAS40 at wk24 bet IL-17i & 2nd TNFi
Switching to IL-17i not superior to cycling to 2nd TNFi after inad. response to 1st TNFi
Shared decision is key
AbsOP0235 @RheumNow #EULAR2026 https://t.co/3UP37IEgXv
sheila RHEUMarampa ( View Tweet)
What if we let RA patients choose ttmt?
BACH RCT choice between Filgo / scTNFi vs. standard randomisation
55% JAKi vs 45% TNFi
Higher ttmt satisfaction 46 vs 33 p=0.012
Less ttmt switches 6 vs 15 p=0.026
Less AE reported
Better drug survival
Shared decision making is key! https://t.co/1YS0y6YUEH
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
Is there a ‘window
Of opportunity’ for Rx
#GCA w #IL6i
🤞
Obtain a better response
Rx GCA #GC
#TCZ
#Upadacitinib
#MTX
Study tries to answer if effects of #tocilizumab early vs >8wks is diff
N=471, 19% new GCA
Early vs late TCZ no dif
❎No
Not RCT
POS0624 #EULAR2026 @RheumNow
Janet Pope Janetbirdope ( View Tweet)
📈 Do SIJ lesions progress in #axSpA?
DESIR cohort (n=649, 10yrs):
Yes, slowly, but bDMARDs reduce erosion progression
#OP0102 #EULAR2026 @RheumNow https://t.co/Ap35q9D6B4
Nelly ZIADE 🍀 Nellziade ( View Tweet)
🔍Can early TNFi beat step-up csDMARDs in pSpA?
SPARTACUS RCT (n=97) says YES
60% vs 33% remission at 24 wks
#EULAR2026 @rheumnow #OP0107 https://t.co/1odtcRdTLQ
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)
Guselkumab gets FDA Nod for X-ray Protection
The U.S. Food and Drug Administration (FDA) has approved Johnson & Johnson's supplemental Biologics License (sBLA) to include evidence in the guselkumab (Tremfya) label for the inhibition of progression of structural joint damage in https://t.co/tlH7WM5gil
Dr. John Cush RheumNow ( 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)
