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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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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)
It's unclear whether GLP-1agonists inmpvove PsA from weight loss or other MoA
74 PsA patients on GLP-1RA vs 74 matched controls (BMI + disease activity matched)
After adjusting for BMI change PROs still improve cDAPSA (-0.4/mo) DAPSA (-0.6/mo) and pain but not SJC, TJC or CRP https://t.co/dcaU2jwbKJ
Aurelie Najm AurelieRheumo ( 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)
#OP0114 at #EULAR2026: Spanish study finds marked regional disparities in premature mortality from systemic connective tissue diseases. Higher socioeconomic deprivation and longer waits for specialist care were both linked to worse outcomes. @RheumNow https://t.co/04we2H0wdb
Mrinalini Dey DrMiniDey ( View Tweet)
ULT de-escalation in Gout: shall we do it?
Short answer: No
RCT 309 pts 24 mo
Primary outcome remission last 6 mo
79.2% ULT continuation vs 62.9% discontinuation p=0.002
Flare incidence 12% vs 32%
More NSAID/colchicine use after stopping ULT
Stopping ULT = urate rises quickly & https://t.co/bYKr5axu46
Aurelie Najm AurelieRheumo ( View Tweet)
❎HIGH Type 1 #interferon
=
Worse #scleroderma
In both
#limited #lcSSc
&
#diffuse #dcSSc
Leeds cohort
?biomarker
#EULAR2026 @RheumNow ABST#POS1092
ABST#POS0395 https://t.co/cRrBIpLgP9
Links:
Janet Pope Janetbirdope ( View Tweet)
#EULAR2026 OP0126 Long-term extension study up to 108 weeks: Ianalumab demonstrated sustained efficacy (change in ESSDAI) including those who switched from PBO to IAN in #Sjogren. IAN improved most domains apart from lungs, MSK & Haem - important to note @RheumNow #EULARBest https://t.co/x1d4G1s0jw
Links:
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#OP091 at #EULAR2026: RA was associated with a 44% higher risk of ischaemic stroke versus the general population, with higher stroke-related mortality and disability. Encouragingly, excess stroke risk was no longer significant in more recent RA cohorts. @RheumNow
Mrinalini Dey DrMiniDey ( View Tweet)
Izokibep IL-17A Affibody PsA
343 pts RCT PBO crossover wk16
52 wks data
ACR50 50–57% ACR70 36–42% PASI100 64% MDA 47–52%
No diff between QW vs Q2W
AE Injection-site reactions, URTIs most common
No new safety signals
Looks like any other IL17Ai to me
#EULAR2026 #OP073 https://t.co/WiHT8Plitn
Aurelie Najm AurelieRheumo ( 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)
#OP090 at #EULAR2026: In this nationwide Danish study, RA patients with lung cancer had similar survival outcomes to patients without RA. Importantly, immune checkpoint inhibitor treatment did not appear to worsen outcomes in patients with pre-existing RA. @RheumNow
Mrinalini Dey DrMiniDey ( View Tweet)
At Week 52 with izokibep in #PsA PASI90: 63–69%; PASI100: 55–64%; MDA: 47–52%. The small-molecule format may enable deeper tissue penetration. Novel anti-IL-17 approach. Abstr#073 @RheumNow #EULAR2026 #Biologics https://t.co/IaJ1gyECZu
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Izokibep (novel small IL-17A inhibitor, 18.6 kDa) maintained efficacy to Week 52 in active #PsA with ~50% of patients achieving ACR50 and nearly half reaching MDA. Sustained durable response with no new safety signals Abstr#OP073 @RheumNow #EULAR2026 https://t.co/Y6fTirE886
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
#OP089 at #EULAR2026 provides real-world data on biologic use after new cancer diagnoses in RA. Continuing biologics in early-stage cancer, & restarting them in many stage 2-3 cancers, was not associated with worse 5-year survival in this Japanese registry study. @RheumNow https://t.co/OdCPiCxFEq
Mrinalini Dey DrMiniDey ( 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)
#EULAR2025 OP0127 Still trying to get my head around the flat line PBO response. In Sjogren pts with ESSDAI=>5, a Phase 3 RCT of Telitacicept (BAFF/APRIL-i) in China met all endpoints. ESSPRI improved too! Could be because strict concom DMARD inc. GC protocol @RheumNow https://t.co/FEhXfNPvfG
Md Yuzaiful Md Yusof Yuz6Yusof ( 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)
#OP088 at #EULAR2026 found that rare deleterious variants in telomere-related genes were associated with increased RA-ILD risk, independent of MUC5B status. The effect size was similar to that seen in idiopathic pulmonary fibrosis. @RheumNow
Mrinalini Dey DrMiniDey ( View Tweet)
#Autoimmune #progressive #pulmonary #fibrosis
Large Spanish registry
❎more mortality if not on #DMARDs
?underRx of proven #Rx with #antifibrotics
Median survival post #dx #PPF 7.8 yrs
Can we do better?
#ABST POS0430
@RheumNow #EULAR2026 https://t.co/gP7apxfEPS
Links:
Janet Pope Janetbirdope ( View Tweet)
