More effective treatments in patients with rheumatic diseases have resulted in less need for major surgery, yet a substantial number of RMD patients will undergo surgery often in the setting of DMARDs use. A scoping review looked at numerous clinical practice guidelines/recommendations for the perioperative management of DMARDs and found inconsistencies and low quality evidence, with great reliance on conditional (expert opinion) recommendations.

The European Respiratory Society (ERS) and European Alliance of Associations for Rheumatology (EULAR) have published clinical practice guidelines for the evaluation and management of connective tissue diseases (CTD) associated interstitial lung disease (ILD) in two simultaneous publications in the European Respiratory Journal and Annals of Rheumatic Diseases.

Sattar et al. has published an informative overview of the effect of obesity on rheumatic and musculoskeletal diseases (RMDs). They estimate that nearly 70% of RMD patients are overweight or obese.

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.