This year at EULAR, health inequalities have taken centre stage as fundamental drivers of outcomes in rheumatic and musculoskeletal diseases. Across multiple sessions and studies, delegates are presenting compelling evidence and ground-breaking research demonstrating that who you are, where you live, and what resources you can access truly do shape the trajectory of chronic illness just as much as biological factors.

The concept of Difficult-to-Manage (D2M) axial spondyloarthritis (axSpA) is a recent development, with the first expert consensus definition published by the Assessment of SpondyloArthritis International Society (ASAS) earlier this year. This unified definition has stimulated a wave of new research globally, with multiple studies analysing D2M axSpA in diverse clinical cohorts.