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Beyond the Scale: Do GLP-1RAs Offer More Than Weight Loss in PsA?

Nelly Ziade

Over 70% of patients with PsA struggle with excess weight, amplifying synovio-entheseal inflammation and blunting biologic response. The rapid uptake of GLP-1RAs in rheumatology has raised an urgent mechanistic question: are clinical gains in PsA driven purely by weight reduction, or do these agents carry intrinsic anti-inflammatory properties? EULAR 2026 offered six abstracts that together illuminate, without fully resolving, this question.

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safety data

JAK Safety Debate Continues: Stronger VTE signal, less clear cancer signal

Mrinalini Dey, MD

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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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

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Janet Pope Janetbirdope ( View Tweet)
Brand new #MOA in #Rx of #skin #lupus! #Litifilimab - acts on #dendritic cells ⬇️decreases #chemokines & #cytokines +RCT in #cutaneous features of lupus N=93 2:1 randomized #liti v #pbo Rapid onset <4wks HIgh #CLASI response #EULARbest #EULAR226 @RheumNow @eular_org POS438 https://t.co/TXqggO1jCU

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Janet Pope Janetbirdope ( View Tweet)

#EULAR2026 OP Are we closer to controlled trials of CAR-T? Miv-cel KYV-101 autologous CD19 CAR-T reported efficacy and safety profile in 6 patients with severe refractory #RA (median prior bDMARDs: 6) in Phase I COMPARE. Will proceed to Phase II with RTX as a comparator @RheumNow https://t.co/Rb4BFgBDZE

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Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)

FASTLANE study Ph4 RCT on TOFA+NPX vs. PBO+NPX for early active axSpA TOFA arm significantly achieved inactive dse vs. PBO (p=0.006) at wk 16. Similar results seen in secondary efficacy endpts. Interesting results supporting TOFA use AbsOP0241 @RheumNow #EULAR2026 #EULARBest https://t.co/PQYzE1zm0h

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sheila RHEUMarampa ( 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

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Aurelie Najm AurelieRheumo ( View Tweet)

#EULAR2026 OP0166 In a phase III RCT in dermatomyositis, brepocitinib, first in class selective SyK-i and JAK1-i showed rapid meaningful improvement in cutaneous DM as early as Week 4 vs PBO. Exciting option and is under FDA Priority Review for approval @RheumNow #EULARBest https://t.co/9b0WurgBkN

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Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Mean disease duration in the tofacitinib arm was just 0.57 years since diagnosis. This is genuinely early #axSpA and JAK1 inhibition achieves near-remission rates above placebo. An oral option for early axSpA Abstr#0241 @RheumNow #EUlAR2026

Antoni Chan MD (Prof) synovialjoints ( View Tweet)

#OP0219 at #EULAR2026: Real-world ASTER data suggest DORIS remission & LLDAS are achievable with anifrolumab in routine practice, assoc w ⬇️risk of organ damage accrual. Over 12m, 43% attained DORIS remission & 74% LLDAS. Low serious adverse event rates reported. @RheumNow

Mrinalini Dey DrMiniDey ( View Tweet)

#EULAR2026 OP0216 With the advances in biologics/cell-based therapies in #SLE, we need to define “severe refractory.” Data-driven analysis from 13 nations suggested: SLEDAI≥6 + PGA>1 + mild-moderate or severe flare (MMSf) + GC≥10 +IS. Need validation study before use @RheumNow https://t.co/K2dMSQUIgB

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Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
💉 Is Izokibep (Novel IL-17i) durable in PsA at 1yr? Phase2b/3 RCT: ~50% ACR50 at week in 343pts OP073 #EULAR2026 @RheumNow https://t.co/M3nrKFTA7c

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Nelly ZIADE 🍀 Nellziade ( View Tweet)
#Rosnilimab works!! #PD1 agonist In #moderate to severe #RA showed fast deep responses in Ph2 #PBO CONTROLLED #rheumatoid #athritis Seemed NOT to have sig side effects compared to some PD1 drugs that ceased development in RA #EULAR2026 @RheumNow #OP0202 #EULARbest https://t.co/Jz92npXdgd

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Janet Pope Janetbirdope ( View Tweet)
SUNSTAR head-to-head after failure of 1 (80+%)–2 prior b/tsDMARDs in RA TCZ vs. ABA Confirms what we already knew: -Primary endpoint CDAI change wk26 not different -Composite response (persistence + low disease activity + low steroid use) 51% vs 35% p=0.034 -Better response in https://t.co/002n3sWtKs

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Aurelie Najm AurelieRheumo ( View Tweet)
Tofacitinib achieved ASDAS inactive disease in 26.4% of patients with early #axSpA (back pain ≤2 years) vs 7.4% placebo at 16 weeks (p=0.006). First RCT of advanced therapy in very early axSpA Abstr#0241 @RheumNow #EULAR2026

Antoni Chan MD (Prof) synovialjoints ( 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

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Aurelie Najm AurelieRheumo ( View Tweet)
#EULAR2026 OP002 More encouraging news in #Sjogren. A Phase II RCT in N=30 patients with ESSDAI=>5 and/or ESSPRI=>5: Anifrolumab (IFN-IR mAb) improved CRESS response vs PBO (80% vs 30%). Impressive effect size for other endpoints too. Need definitive Phase III RCT @RheumNow https://t.co/W3GbA3gKIs

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Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#EULAR2026 OP028 In 16 patients with AID (SSc,IIM, RA, IgG4,SjD, Grave’s), CD3xBCMA BiTE, Teclistamab was effective in 15/16. Duration of GC & DMARD-free was 11 mths. 2/16 need retreatment. All had low IgG and needed IVIG. Need long-term safety data & comparative study @RheumNow https://t.co/97MUPnXRua

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Md Yuzaiful Md Yusof Yuz6Yusof ( 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

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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)
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