At a EULAR 2025 session titled “What makes ‘Difficult-to-treat RA’ so difficult to treat? And what can we do?”, Drs. Paula David and Dennis McGonagle introduced the emerging concept of polyrefractory rheumatoid arthritis (RA), a term now being used to describe a subset of patients who have failed to respond to five or more biologic or targeted synthetic DMARDs. This new classification, derived from recent multinational registry data,

The diagnosis of axial spondyloarthritis (axSpA) is clinical, however, there are still unmet needs, particularly in the diagnosis of early disease and evaluation of disease activity and progression. As imaging technology continues to evolve, its role in axSpA management is expected to expand, offering more precise, individualized care. Here are two studies presented at EULAR 2025.

Most patients with early, active axial spondyloarthritis (axSpA) who quickly received a tumor necrosis factor (TNF) inhibitor experienced remission, and it didn't matter whether or not they had intestinal inflammation at baseline, a small single-arm study found.

The “Difficult” framework has now reached PsA. At EULAR 2025, two independent definitions were presented: one by the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis and another by EULAR. This short review explores the similarities and differences between these definitions and discusses their potential implications for clinical practice and research, especially for the increasingly perplexed rheumatologist.