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Immune Dimming or Immune Reset in RA: How Far Should We Go?
CD19-directed CAR T-cell therapy has rapidly moved into autoimmune disease, driven in large part by striking reports in SLE, where sustained drug-free remission has raised the possibility of a true immune reset. In RA, where multiple effective therapeutic classes already exist, the relevance of such deep immune interventions remains uncertain.
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CAR-T without the CAR-T risks?
AB-101, an off-the-shelf NK cell therapy + RTX, delivered in refractory RA, Sjögren, and SSc (n=31): RA ACR50 71%, SSc mRSS -9.5, SjD ClinESS DAI -8.6 at 6 mo. Outpatient delivery without CAR-T associated AEs? @RheumNow #EULAR2026 LB0003 https://t.co/xi6ZdLwHcN
Jiha Lee JihaRheum ( View Tweet)
#EULAR2026 LB0003 CAR-T is not scalable. In a Phase 2a of off-the-shelf AB-101 allogenic NK + low dose conditioning (Cyclo & Flud) + Rituximab: preliminary efficacy & safety profile in severe-refractory RA (N=15), SjD (11), SSc (5). Longer FU & Comparator is needed @RheumNow https://t.co/gQniufREQC
Links:
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Baricitinib did not demonstrate non-inferiority w/ TNFi for first VTE in the RA-BRIDGE and RA-BRANCH trials.
Identifying high-risk pts and individualizing tx is paramount.
LB0009 @RheumNow #EULAR2026 https://t.co/MSiBq0FnEq
Links:
sheila RHEUMarampa ( View Tweet)
Abstr LB0009
Baricitinib vs TNFi in RA patients enriched for VTE risk. 3,640 patients. 3.7 years median follow-up.
VTE: HR 1.61 (95% CI 0.97–2.66)
non-inferiority not demonstrated
MACE: HR 1.06 no cardiovascular excess
Serious infections: HR 1.32 (p<0.05)
@RheumNow https://t.co/NSNRJi9B4r
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Abstr LB0009
Baricitinib vs TNFi in VTE-enriched RA. 3,640 patients. 3.7 years.
Safety endpoints
VTE HR 1.61 non inferiority not met
Serious infections HR 1.32 (p<0.05)
MACE HR 1.06 reassuring
@RheumNow #EULAR2026 https://t.co/nR6TMowlYS
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
BARI vs TNFi in VTE-enriched #RA pts (RA-BRIDGE + RA-BRANCH, n=3,640, ~3.7 yrs follow-up): VTE non-inferiority not met (HR 1.61, CI 0.97–2.66).
But absolute rates low (2.5% vs 1.7%) and MACE was similar (HR 1.06). Serious infections ↑ with BARI. @RheumNow #EULAR2026 LB0009
Jiha Lee JihaRheum ( View Tweet)
What drives progression to difficult-to-treat RA?
20-year cohort 675pts
-18.8% developed D2T RA
-Younger age, higher HAQ & prior steroid exposure asso w/ D2T RA
-Earlier b/tsDMARD initiation protective
-No diff TNFi vs non-TNFi first-line strategy
Disease severity and https://t.co/SJDv9HCbLv
Aurelie Najm AurelieRheumo ( View Tweet)
#OP0209 #EULAR2026 SPECIFI-RA
Balinatunfib, oral selective TNFR1 inhibitor designed to preserve TNFR2 signalling in RA. Phase 2b trial missed primary ACR20 endpoint, but 200mg QD arm showed signals for higher ACR50, ACR70 and DAS28 low disease activity & reduced IL-6. @RheumNow https://t.co/emxNQy0cPx
Mrinalini Dey DrMiniDey ( View Tweet)
#EULAR2026 #vaccination #guidelines
➡️be proactive
❎disease activity doesn’t matter
✅it is responsibility of #rheumatologist to discuss and update pt?
@RheumNow @eular_org https://t.co/dRnHd9CThg
Links:
Janet Pope Janetbirdope ( View Tweet)
#OP0207 #EULAR2026: SUPERFIBRES trial suggests dietary fibre supplementation may enhance MTX response in RA. Inulin improved EULAR responses and Th17/Treg balance over 30 days, with strongest effects seen in MTX-treated patients. Fascinating microbiome-linked signal. @RheumNow https://t.co/nCvZlooamF
Mrinalini Dey DrMiniDey ( View Tweet)
Data of #Rituximab
In #SARD-ILD
Small N of #RA-#ILD pts
I think data are sufficient as #RWE of #RTX in RA-ILD
✅benefits in other #CTD ILD
✅benefits in #rheumatoid #arthritis
#EVER-ILD #RCT
HOT #RA-ILD topic June 5
#EULAR2026
@RheumNow https://t.co/61MbsnNsaf
Links:
Janet Pope Janetbirdope ( View Tweet)
Is there enough data to recommend
#rituximab
For #ILD in #rheumatoid #arthritis
@RheumNow #EULAR2026
Janet Pope Janetbirdope ( View Tweet)
#OP0204 #EULAR2026 Shared decision-making in practice! BACH study tested “treat by choice” in RA. Patients preferred oral JAKi over SC TNFi (55% vs 45%)
Importantly, own choice led to higher treatment satisfaction, better drug survival & fewer adverse events. @RheumNow #EULARBest https://t.co/iI1n2OGzqY
Mrinalini Dey DrMiniDey ( View Tweet)
Prospective study of RVZ immunogenicity = heterogeneous cellular immunity across RMDs
12mo 150 pts
-CD4+ gE-T-cell response peaks mo 3
-Response seen in axSpA + GCA, but not RA
-25% of patients no CMI increase after vaccination
Consistent w/other vaccine cellular imm profiles https://t.co/yvDLSHh4Bj
Aurelie Najm AurelieRheumo ( View Tweet)
#OP0203 #EULAR2026: low-dose blinatumomab in multidrug-resistant RA introduced the intriguing concept of “immune dimming”, transient B-cell depletion that appeared to restore responsiveness to previously failed DMARDs, JAK inhibitors and TNFi in several patients. @RheumNow
Mrinalini Dey DrMiniDey ( View Tweet)
Frailty as a long term outcome in RA
Higher frailty in RA vs ctrls HR 1.76 in 910 matched pairs.
-10y: 30.6% vs 19.1%
-20y: 53.8% vs 35.3%
-Stronger in recent RA (HR 2.38)
Driven by age, smoking, comorbidity, steroids/biologics not RF/CCP.
Preventive interventions needed https://t.co/pcJrE73G5O
Aurelie Najm AurelieRheumo ( View Tweet)
Catching up on #EULAR2026 “Advanced management in RA” session: #OP0202 reported positive phase 2b RENOIR data for rosnilimab, a selective pathogenic T-cell depleter, with significant improvements in DAS28-CRP, ACR responses and CDAI LDA vs placebo in RA. @RheumNow https://t.co/IKKtakxpya
Mrinalini Dey DrMiniDey ( View Tweet)
Machine learning identifies a “vulnerable” phenotype in older RA patients n=275
-51% “vulnerable”
-Worse grip strength, gait speed & SARC-F
-Higher disability (HAQ 1.56 vs 0.64)
-More fatigue, poorer QoL
-Higher DAS28 despite greater biologic exposure
Suggests we should assess https://t.co/bv1FbTxGKR
Aurelie Najm AurelieRheumo ( View Tweet)
#EULAR2026 There are over 90 abstracts on CAR-T. Please read my article on a selection of abstracts pertaining to the progress of CAR-T in rheumatic and musculoskeletal diseases @RheumNow
https://t.co/2Uxy3uyF6H https://t.co/VulhEDJTEi
Links:
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
