Day 1 Report from EULAR 2026 Save

The first day of EULAR 2026 in London featured the opening ceremonies, a plenary session, posters nd the first round of major oral presentations to an audience of nearly 15,000 attendees. Here are a few of my favorites from the first day.

• CAR-T Cell Therapy in Rheumatoid Arthritis (OP008) - The COMPARE Trial was an early phase study of CD19 CAR-T cell therapy in ACPA positive refractory active rheumatoid arthritis patients. This open label uncontrolled study enrolled only 6 refractory RA patients who had failed 3-8 prior b/tsDMARDs before enrolling. At baseline, the DAS28-CRPs  ranged from 4.7 to 6.2.  All patients stopped their DMARD therapy and were treated with one infusion of mivocabtagene autoleucel (a fully human CD 19 directed CAR-T cell therapy), after fludarabine cyclophosphamide lymphodepletion. Full B cell depletion and neutropenia was seen in all patients. While they claimed that all patients achieved remission, this was clearly rapid in 3 patients. At week 12 the ACR20 response was 50% and ACR50 response was 33%. Maximal improvement was noted after 12 mos. ACPA and RF titers dropped in all. While this was a positive report with good efficacy and acceptable safety, these were not the kind of responses seen in lupus. While CAR-T cell therapy has been impressive in SLE, these early results in RA were not nearly as dramatic.  More research is needed, especially in rheumatoid arthritis patients.

• REPLENISH Trial (OP0116) - Dr. Anisha Dua presented the result of this randomized placebo controlled trial of 381 recently relapsed polymyalgia rheumatic patients were were treated with either recently relapsed polymyalgia rheumatica and randomly assigned them, in a 1:1:1 ratio, to receive secukinumab 300 mg or 150 mg or placebo for 52 weeks. All were on prednisone that was tapered over 24 weeks. The primary outcome was sustained remission at week 52. At week 52, Sustained remission was superior in SEC vs placebo treated patients (SEC 300 - 41.2% SEC 150 - 40.6% and PBO 20.4%; P<0.001). Importantly SEC patients had significantly less corticosteroid exposure.  The current study was also published in the New England Journal of Medicine. Interestingly, prior studies of SEC in giant cell arteritis (GCA) gave mixed results as the phase II TITain Trial showed SEC to be effective in GCA, the followup phase III trial failed to prove efficacy of SEC in GCA patients. 

• NLRP3 Inhibitor in Knee Osteoarthritis (OP062) - was an early phase 2 study of DFV890 (NLRP3 inhibitor) in 115 patients with painful inflammatory OA of the knee. DFV890 is an oral, twice daily antiinflammatory capable of inhibiting IL-1, IL-18.  Uniquely patients were required to have painful knee OA (KOOS score < 60; pain 5-9/10) with evidence of inflammation (CRP greater than 1.8 and synovial inflammation on MRI). While the \week 12 results showed more rescue pain med use in the placebo arm and significant reductions in hsCRP and neutrophil counts, the primary endpoint (reduction in KOOS score) not achieved in the primary analysis of 86 patient, but was achieved by an intent to treat analysis of 107 patients.This is a novel new approach to inflammation by targeting the NLRP3 inflammasome. Clearly more research is needed.