Introducing Polyrefractory RA: A New Frontier in Difficult-to-Treat RA

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At a EULAR 2025 session titled “What makes ‘Difficult-to-treat RA’ so difficult to treat? And what can we do?”, Drs. Paula David and Dennis McGonagle introduced the emerging concept of polyrefractory rheumatoid arthritis (RA), a term now being used to describe a subset of patients who have failed to respond to five or more biologic or targeted synthetic DMARDs. This new classification, derived from recent multinational registry data, represents a significant step in refining our understanding and management of the most treatment-resistant forms of RA.

Predictors and Outcomes in Systemic Sclerosis

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The VEDOSS project has previously shown that 70% of patients with Raynaud’s phenomenon and at least one red flag – systemic sclerosis (SSc)-specific antibodies, puffy fingers, or an SSc pattern on nailfold capillaroscopy –will fulfil the 2013 ACR/EULAR SSc criteria within 5 years.

Expanding the IL-17 Therapeutic Landscape

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IL-17 inhibitors are an effective therapeutic for a broad spectrum of inflammatory and autoimmune diseases and its blockade has revolutionized management of diseases such as psoriasis, psoriatic arthritis and SpA. Is there a need for more medications within the same therapeutic class?

Safety of Recombinant Zoster Vaccine in Rheumatic Patients

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New work presented at the 2025 annual EULAR congress in Barcelona focuses on the recombinant zoster vaccine (RZV), which contains recombinant glycoprotein E – the major target of CD4+T-cells.

Social Determinants of Health in SLE

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Social determinants of health (SDH), such as socioeconomic status and educational background are factors that are increasingly recognised as critical contributors to health outcomes in chronic diseases.

Cancer risk in rheumatoid arthritis: anything new?

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Is there a higher risk of cancer that comes with the disease? Or with the treatments? So many confounding parameters, such as disease duration, disease state, and disease activity come into play. A promising session explored comorbidities in Rheumatoid Arthritis, in particular cancer and cardiovascular events. Here are my takeaways.

EULAR 2025 – Day 2 Report

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Day 2 was a full agenda for those attending EULAR 2025 in Barcelona with sessions on the management of RA, Behcets, Lupus and Hand Osteoarthritis. Clinical overviews on MAS, Ehlers-Danlos, Difficult to treat RA and PsA offered a wide variety of options to rheumatologists. Here are a few interesting presentations from today.

Putting IL17i into ‘focus’ for SpA-associated uveitis

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The longest studied drug for uveitis in SpA has been monocolonal TNFi Abs. Reductions of acute anterior uveitis have been found with etanercept but less impressively than adalimumab, infliximab, and in my opinion less than golimumab and certolizumab pegol. Other data have emerged for JAKi and IL17i, with respect to acute anterior uveitis.

Clinical and Therapeutic Challenges in Connective Tissue Disease and ILD

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Connective tissue diseases (CTDs) and interstitial lung disease (ILD) represent a challenging intersection of systemic autoimmunity and progressive respiratory impairment. Research presented at EULAR 2025 continues to highlight the importance of CTD-ILD and the evolving landscape of therapeutic options for patients with autoimmune ILDs.

Psoriatic Arthritis: Hit hard and Early

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Two recent studies suggest there is no significant benefit of early biologics over standard step-up care with methotrexate^2,3, but these did not select for poor prognosis.

EULAR 2025 - Day 1 Report

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Wednesday was Day One at EULAR 2025 in Barcelona. Thousands from around the world gathered, eager to reunite at this international educational forum. Below are a few of my favorites from Day 1.

Combination treatments in Psoriatic Arthritis

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Despite the advances in the treatment of PsA with biologic (bDMARD) and targeted synthetic (tsDMARD), less than half of patients with this condition achieved remission or low disease activity. Combination DMARD treatment is often used in order to achieve remission or minimal disease activity. The standard practice is to use a conventional synthetic (csDMARD) with a bDMARD. The use of the combination of bDMARD with a tsDMARD such as a JAKi or TYK2i is a new order in the treatment of PsA.