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      Five years on, are we closer to licensing of the first CAR-T therapy in rheumatic and musculoskeletal diseases (RMD)?
      At EULAR 2026, Dr Nikolaos Kougkas presented data from a unique real-world cohort built within joint dermatology–rheumatology university centers, following 394 patients with psoriasis on bDMARDs for up to 17 years. We sat down with Dr Kougkas to unpack the methodology, challenge the results, and draw out the clinical implications for everyday practice.
      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.
      There are so many SLE trials, and over the last year, many new ideas have been suggested.
      Updates in SLE and APS
      • 2026 EULAR Press Release
      Systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS) often overlap. While there have been some therapeutic advances, significant needs remain around diagnosis and monitoring, with a gap around definitions and biomarkers for refractory disease or specific subsets. EULAR – The European Alliance of Associations for Rheumatology – held its 2026 annual Congress in London, where new data showcased advances in the field. 
      Here is my summary of what EULAR 2026 is presenting to us in the field of biomarker-driven personalized care in RA.
      Exploring Idiopathic Myopathies
      • 2026 EULAR Press Release
      Idiopathic inflammatory myopathies (IIM) are a heterogenous group of autoimmune conditions with substantial morbidity. EULAR in collaboration with the American College of Rheumatology (ACR) introduced classification criteria for the major subgroups in 2017,1 but there is a need for contemporary real-world data to understand the burden – and well as new ways of assessing disease activity.
      Day two at EULAR 2026 was jammed with sessions on advances in immune checkpoint inhhbitors (and irAEs), Lupus, Scleroderma, RA and IgG4 related disease.  Here are a few of my favorites from Day 2. 
      At EULAR 2026, two large phase 3 studies highlight that the JAK story in axSpA is still evolving rapidly, with different selectivity profiles and expanding global development programs continuing to push the field forward.
      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.
      Treatment-refractory RA is more common than we sometimes admit. Roughly 11% of patients fail multiple b/tsDMARD classes, and for the ACPA-positive subset, rituximab has long been the fallback. It works, but it rarely produces durable disease-free intervals. CD19 CAR T-cell therapy was always going to be the question that followed the SLE data. Until EULAR 2026, that question had no prospective answer. The plenary session changed that.
      RA-ILD remains one of the most serious extra-articular manifestations of RA, contributing substantially to morbidity and mortality. Two abstracts presented at EULAR 2026 add important insights into identifying patients at risk for RA-ILD and understanding the genetic mechanisms that may underpin disease development.
      The clinical abstract sessions on diagnostic tools in lupus showcased interesting studies, including the use of MRI as potential non-invasive biomarkers.
      Our therapeutic armamentarium in RA keeps on growing. New studies and new molecules, new mechanisms of action or new ways of using old drugs are presented every year at conferences. But which are the ones who can have an impact on our practice? Here is my selection of 3 abstracts presented at EULAR 2026 that identify therapeutic strategies that are well worth keeping on our radar.
      Presented at EULAR 2026 London, Brepocitinib dual TYK2/JAK1 inhibitor with successful Phase 3 VALOR trial demonstrating significant improvement in skin and muscle symptoms in dermatomyositis (DM).
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