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.
sheila RHEUMarampa
6 days 10 hours ago
Key messages in the tx of ax/p-SpA:
>csDMARDs only effective in pSpA
>consider individualized treatment for bDMARDs and JAKis
>Cycling TNFi equally effective to switching
@RheumNow #EULAR2026 https://t.co/oeO3BxmYYo
sheila RHEUMarampa
6 days 11 hours ago
What b/ts DMARDs are effective and not effective in axSpA?
Prof. Astrid van Tubergen presents this very informative summary slide summarizing treatment in axSpA.
@RheumNow #EULAR2026 https://t.co/5udGPB1Hrr
sheila RHEUMarampa
6 days 11 hours ago
Not just ticking boxes!
Prof. Rudwaleit on the revised 2025 ASAS/SPARTAN criteria for axSpA
What’s new?
Providing a stem so criteria will be applied only if w/SpA dx, not just imaging
MRI:active inflamm + structural lesions
Some SpA features omitted
@RheumNow #EULAR2026 https://t.co/NCV0EFvjYa
Antoni Chan MD (Prof) synovialjoints
6 days 12 hours ago
Gecacitinib (pan-JAK inhibitor) vs placebo in radiographic #axSpA ASAS40 51.9% vs 12.9% (p<0.0001) at 16 weeks. ASAS20 69.2% vs 21.2% (p<0.0001). Pan-JAK inhibition showed efficacy in TNFi-experienced patients. Abstr OP0240 @RheumNow #EULAR2026
Nelly ZIADE 🍀 Nellziade
6 days 12 hours ago
Does sequential therapy infliximab —> tofacitinib outperform tofa alone in axSpA?
Yes: faster remission at week 4 (84.6% vs 15%)
But: equal at week 24
Prospective study in 46 patients
#POS0201 #EULAR2026 @RheumNow https://t.co/rmtoJQtYc0
sheila RHEUMarampa
6 days 13 hours ago
10yr ffup data on 49pts from the OG CRESPA study (GOL vs PBO in very early pSpA):
81.6% (40/49) were in clinical remission
15 pts on drug-free remission
21 pts w/remission on meds still on GOL, no unSSAEs
Early aggressive tx is key!
AbsPOS0931 @RheumNow #EULAR2026 https://t.co/HrTF5XtAZt
At the "What Is New in Psoriatic Arthritis" session at EULAR 2026, Professor Dennis McGonagle (Leeds, UK) took the audience on a whirlwind yet compact tour of the field, touching on three themes: the pathophysiology of PsA, individualization of clinical management, and emerging research and future directions.
Nelly ZIADE 🍀 Nellziade
1 week ago
🧪 Can genetics predict TNFi response in PsA?
OUTPASS GWAS (n=329): High BMI, comorbidities & novel XKR4 locus linked to non-response at 6 months
#POS0087 #EULAR2026 @rheumnow
Nelly ZIADE 🍀 Nellziade
1 week ago
🎗️ Do targeted therapies raise cancer risk in SpA?
French nationwide cohort (n=56,591): NO
In fact, prolonged exposure REDUCES risk (wHR 0.86), especially haematological.
#OP0238 #EULAR2026 @RheumNow https://t.co/dDveAmWpdX
Nelly ZIADE 🍀 Nellziade
1 week ago
💊 After TNFi failure in axSpA, switch to IL-17Ai or cycle TNFi?
ROC-SpA (Phase 4 RCT, n=300):
NO difference: ASAS40 15.2% vs 14.5% at week 24
#OP0235 #EULAR2026 @RheumNow https://t.co/45gisWiuoM
Nelly ZIADE 🍀 Nellziade
1 week ago
❤️ Do biologics differ in MACE risk in PsA?
YES - JAKi highest risk after 2.5yrs vs TNFi/IL-17i/IL-23i in a retrospective cohort of 22,246pts.
OP0181 #EULAR2026 @RheumNow https://t.co/eQdBtMfRAY
