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Strike First: TNFi vs. Step-Up Therapy in Early Peripheral SpA
The approach to the treatment of peripheral SpA has been the same for a long time. The guidelines recommend starting with NSAIDs, escalate to conventional synthetic DMARDs, typically sulfasalazine or methotrexate and reserve biologics for patients who fail those. According to a new phase 3 trial presented at EULAR 2026, there may be a different way to approach this.
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New biomarkers in RA: Who to treat, Who to watch, Who to taper?
Here is my summary of what EULAR 2026 is presenting to us in the field of biomarker-driven personalized care in RA.
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Can we have an effective, comprehensive score for
#SLE #arthritis?
#SLEDAI has a problem
SJC>2 scores dames as ex #SJC=12
Meet
#LAMBDA
An attempt to improve a true positive #MSK OUTCOME in #lupus
Needs validation esp in pts over time
#EULAR2026 @RheumNow #POS1072
@eular_org https://t.co/fr0xuVqFnM
Janet Pope Janetbirdope ( View Tweet)
Large French nationwide cohort (n=56,591 SpA patients) showed that >6 months/year of targeted therapy exposure was associated with reduced overall cancer risk (wHR 0.86), especially for haematological malignancies (wHR 0.65). Reassuring long-term safety signal. Abstr OP0238
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Not all #RA pts respond equally to advanced therapy. 10-variable risk model >18k US pts: low baseline disease activity, fewer comorbidities, and no prior biologics 5x more likely to achieve remission at 1yr (34% vs 7%). RWD for precision care @RheumNow #EULAR2026 POS0257
Jiha Lee JihaRheum ( View Tweet)
+#RCT in #dermatomyositis with #brepocitinib
Oral #TYK2/JAK1i
241 pts
+outcomes
#TIS total improvement score
>40%TIS 68% v 44%
#steroid tapering
#skin improved rapidly #CLASI
#OP0166
#POS0264 @RheumNow #EULAR2026 https://t.co/9WZl9RsXXe
Links:
Janet Pope Janetbirdope ( View Tweet)
SPARTAN-SSR: New quantitative criteria: BME in ≥3 consecutive slices OR any two of (BME, Erosion, Fat lesion each in ≥3 SIJ quadrants) or ankylosis in ≥3 halves achieves 88-96% sensitivity and 90-98% specificity across 3 cohorts. Precision #axSpA imaging. Abstr OP0100
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Interim results from ASTER, a study on real world effectiveness of ANI in SLE: Pts receiving ANI had improvements in total SLEDAI-2K scores after 1 yr ffup period
MCT, MSK & hema had the highest decrease in SLEDAI-2K scores from pre-tx to 1yr ffup
OP342 @RheumNow #EULAR2026 https://t.co/DArOwQtxM6
Links:
sheila RHEUMarampa ( View Tweet)
ETA+MTX vs triple therapy after MTX failure in #RA: machine learning-emulated RACAT trial (n=3,472 VA pts) confirms ETA+MTX modestly better overall. But smoking matters: benefit disappears in current smokers. Precision medicine from RWD. @RheumNow #EULAR2026 POS0255
Jiha Lee JihaRheum ( View Tweet)
Hypertension was the most robust and consistent predictor of pre term labor. Data from germany nationwide #POS1062 @RheumNow ##EULAR2026 https://t.co/Uccf11PpAK
Bella Mehta bella_mehta ( View Tweet)
What do you think about this cartoon-style format for posters?
A- I love it!
B- It’s Ok but I prefer classic
As for the content: Axia digital therapeutic app improves mobility, BASDAI, sleep an sexual function in 32 patients
#POS0199 #EULAR2026 @rheumnow https://t.co/mV83dMF4vi
Nelly ZIADE 🍀 Nellziade ( View Tweet)
#EULAR2026 OP0340 WK84 data of single arm Phase 2 Daratumumab (CD38 plasma depleter) weekly for 8 doses with background IS in N=10 #SLE: rapid reduction of antidsDNA & efficacy. 6/10 relapsed from WK20; 5/10 had low IgG and needed IVIG. Promising but Not so durable @RheumNow https://t.co/UrTywqkQ4F
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
What does remission look like for people living with PsA?
Much more than the absence of swollen joints
Absence of pain
Skin management
Ability to resume daily activities
Sustained over time
A definition not always reflected in our disease activity scores
#POS0294 #EULAR2026 https://t.co/VCnMGAOVYm
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
#EULAR2026 OP0338 More evidence for treatment-to-target in #SLE. Longitudinal renal function analysis of Asia Pacific cohort: achieving LLDAS at least 50% of the time (LLDAS50) is assoc. with reduced eGFR decline independent of age, baseline eGFR, & renal involvement @RheumNow https://t.co/KduU1qtkhF
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#CAR_T cell therapy in #SSc
Promising results from the Breakfree-1 study
(Zola-cel) on safety and preliminary efficacy on pFVC in 26 patients
More data is needed
#HOT session Pr Oliver Distler
#EULAR2026 @RheumNow https://t.co/ZS1LnBLMu5
Links:
Nelly ZIADE 🍀 Nellziade ( View Tweet)
103 patients with ICI-induced inflammatory arthritis. 37.9% died during follow-up.
Maximum prednisone dose above 20mg to treat rheumatologic immune-related adverse events was associated with significantly worse overall survival HR 2.35 (95% CI 1.18–4.69, p=0.015). Cumulative https://t.co/vAmIAH7B64
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Gecacitinib 100mg BiD vs PBO in active r-axSpA:
Met primary endpt ASAS40 at wk 16 showing efficacy of gecacitinib vs. PBO (51.9%vs12.9%,p<0.0001)
Gecacitinib showed ⬆️ improvements in ASDAS-CRP, physical fnxn, spinal mobility & QOL
Promising tx.
AbsOP0240 @RheumNow #EULAR2026 https://t.co/FytoRgxvnG
Links:
sheila RHEUMarampa ( View Tweet)
Personalized #RA treatment based on Ab status and early response: better than routine care? PRIMERA RCT (n=308) says not yet. b/tsDMARD use at 10m: 21% tailored vs 17% routine. Disease activity curves identical. MTX + T2T still the standard for most. @RheumNow #EULAR2026 POS0258 https://t.co/W9FVoqTcMq
Jiha Lee JihaRheum ( View Tweet)
Treat-to-target in inflammatory arthritis recommended by every guideline. Followed in only 40% of SpA visits.
The main reason was activity simply wasn’t documented using a validated index.
You can’t target what you don’t measure.
Abstr 0351 @ RheumNow #EULAR2026
#axSpA #PsA https://t.co/VAcoZfCXsR
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
#OP0344 RADAR, AI-automated scoring of RA radiographic damage, was applied to 20yr ESPOIR imaging data. Strong performance vs expert readers, w binary classification accuracy up to 0.95 & ICC 0.86. Supports AI-assisted long-term structural assessment in RA. #EULAR2026 @RheumNow
Mrinalini Dey DrMiniDey ( View Tweet)
