For years, peripheral spondyloarthritis has been managed with a cautious, stepwise approach: start with NSAIDs, escalate to conventional synthetic DMARDs, and only reach for biologics when everything else fails. The SPARTACUS trial, presented at EULAR 2026 in London, challenges that paradigm head-on. The results make a compelling case for rethinking when, not just whether, to deploy TNF inhibitors.

This update includes new pandemic era evidence, recombinant zoster vaccine data, and new perspectives on vaccination in patients taking novel immunosuppressants. Five overarching principles and 10 vaccine recommendations follow.

Late-breaking abstracts presented at the European Alliance of Associations for Rheumatology's (EULAR) annual meeting, held here last week, addressed a wide range of clinical concerns and suggested that patients and clinicians have much to look forward to in coming months and years.