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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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πDo GLP-1 agonists improve DMARD persistence in PsA/axSpA?
TriNetX real-world study (n=3,068): YES!
Better b/tsDMARD persistence and lower stroke & mortality risk
#POS0194 #EULAR2026 @rheumnow
Nelly ZIADE π Nellziade ( View Tweet)
β° The question rheumatologists keep asking: Does early axSpA diagnosis reduce long-term spinal damage?
Answer from the SCQM registry (n=376): Early diagnosis linked to 3.85 fewer mSASSS points long-term, esp. in HLA-B27+ males
#POS0191 #EULAR2026 @RheumNow https://t.co/HM5kvqXMEh
Nelly ZIADE π Nellziade ( View Tweet)
π Do 2025 ASAS-SPARTAN criteria classify fewer real-world axSpA patients?
Data from the RABBIT-SpA registry (n=2,236) confirms:
67% vs 73% with 2009 criteria
Clinical arm rarely fulfilled
#POS0190 #EULAR2026 @RheumNow https://t.co/HYie4w8c6r
Nelly ZIADE π Nellziade ( View Tweet)
π Do posterior element lesions progress over 10 years in axSpA?
Data from the DESIR inception cohort (n=320) says RARELY!
But baseline PE inflammation raises facet ankylosis risk ~70-fold
#POS0189 #EULAR2026 @RheumNow https://t.co/PdwlPGjKqK
Nelly ZIADE π Nellziade ( View Tweet)
CyTOF reveals significant sexual dimorphism in monocyte populations in active #axSpA
Women show reduced classical and non-classical monocytes vs healthy controls. Men do not show the same pattern.
Sex is not just a demographic variable in AxSpA it is also an immunological one.
Antoni Chan MD (Prof) synovialjoints ( 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)
𧬠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 π Nellziade ( View Tweet)
π Are 2025 ASAS-SPARTAN criteria valid in early axSpA?
SPACE cohort (n=669):
HIGH specificity (97.5%) but LOWER sensitivity (60%) vs 2009 criteria (83%)
#OP0239 #EULAR2026 @RheumNow https://t.co/9wNbtcbP0l
Nelly ZIADE π Nellziade ( View Tweet)
ποΈ 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 π Nellziade ( View Tweet)
π 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 π Nellziade ( View Tweet)
π 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 π Nellziade ( View Tweet)
π¬ 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 π 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)
Male sex independently associated with greater mSASSS increase (Ξ² 0.29), higher odds of β₯2-unit mSASSS progression (OR 2.08), and new syndesmophyte formation (OR 1.90) in #axSpA despite lower disease activity scores. Treat symptoms and progression Abstr OP0101 @RheumNow
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
RD in #IBD: 18.6% of 650 IBD pts affected, most commonly peripheral arthritis and AxSpa. Key finding: 14% of rheumatic manifestations preceded IBD diagnosis. Rheumatologists may see these pts first. GI-rheum collaboration is essential. @RheumNow #EULAR2026 POS0807 https://t.co/028yzOxJ2R
Jiha Lee JihaRheum ( View Tweet)
Over 10 years in the GESPIC cohort, males with #axSpA had lower ASDAS/BASDAI and enthesitis but double the odds of significant spinal radiographic progression vs females (OR 2.08). Symptoms donβt always correlate to structural damage Abstr OP0101 @RheumNow #EULAR2026
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)
Real-world bimekizumab in SpA/#PsA (BIMPACT, n=223): 76% retention at 12mo, even with 54% having prior IL-17i exposure. Effective after IL-17Ai failure. Oral candidiasis higher in PsA (16.5%) vs SpA (3.3%); led to discontinuation in ~25%. @RheumNow #EULAR2026 POS0798/POS0810
Jiha Lee JihaRheum ( View Tweet)
What defines MRI indicative of axSpA?
This systematic lit review show adapting more stringent cutoffs in BME (>=4 SIJ quads, erosion >=3 quads, fat >=5 SIJ quads) & combined BME + structural lesions inc specificity.
Time for updated definitions?
AbsPOS0866 @RheumNow #EULAR2026 https://t.co/gkVbcOAiD3
sheila RHEUMarampa ( View Tweet)
