Generic Tofacitinib (6.26.2026)
Dr. Jack Cush reviews the news and journal articles from RheumNow.com. Updates on tofacitinib, CAR-T therapy and AI.
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Where are we with Biomarkers in Rheumatoid Arthritis?
Biomarker interest has grown considerably in the last 2 decades, owing to advances in genetics, imaging, protein, and multiomics. Despite these advances, biomarkers as the predictive holy grail of RA therapeutics and prognostication have not yet advanced beyond rheumatoid serologies and C-
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Redefining axial spondyloarthritis
An editorial in Lancet Rheumatology calls for "..reframing axSpA as a systemic, autoimmune inflammatory disease with multiorgan involvement and substantial unmet need."
The pathogenesis relies on not only HLA-B27, but also on environmental triggers, immune dysregulation, and
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JAMA Review on Low Back Pain
A comprehensive JAMA review synthesizes current evidence on the epidemiology, pathophysiology, clinical evaluation, and treatment of nonspecific low back pain, drawing on 108 publications identified from a PubMed search (2005–2026) and the most recent guidelines from the WHO, ACP, and NICE.
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EULAR 2026 Recommendations on PMR, GCA, and Takayasu Arteritis
On the final day of EULAR 2026, Mukhtyar et al (on behalf of a large international task force) presented the updated EULAR recommendations for management of polymyalgia rheumatica (PMR), giant cell arteritis (GCA), and Takayasu arteritis (TAK). There were 5 overarching principles and 12
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Imaging in SpA: are we seeing a clearer picture?
As EULAR2026 comes to a close, practical learnings take precedence as clinicians head back to their clinics. Among them, the 2026 EULAR Update on Imaging Recommendations in SpA stands out.
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Renal Biopsies in SLE
Dr. Andrea Fava reporting from EULAR 2026 in London.
https://t.co/naCyEAutbb https://t.co/XgdiXY3hiO
Dr. John Cush @RheumNow( View Tweet )
New: Classification Criteria and Recommendations in SpA
ASAS and SPARTAN have updated their key classification criteria for axSpA. EULAR has also recently revised its recommendations on the role of imaging in the diagnosis and clinical management of SpA. https://t.co/YOWfwTkbqp
Dr. John Cush @RheumNow( View Tweet )
Seeing more or seeing too much? Ultrasound vs MRI in preclinical RA
Imaging in the preclinical phase of RA is moving fast—arguably faster than our ability to interpret what we are actually seeing. Across EULAR 2026 abstracts, a consistent theme emerges: we are improving detection of subclinical inflammation, but still struggling to determine what
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MRI as a novel biomarker in lupus
The clinical abstract sessions at #EULAR2026 on diagnostic tools in lupus showcased interesting studies, including the use of MRI, as potential non-invasive biomarkers.
https://t.co/TK2gqSxAg5 https://t.co/5Qj8KXWgub
Dr. John Cush @RheumNow( View Tweet )
@RheumNow article further exploring the roe of lung ultrasound for RA-ILD screening as shown through 3 #EULAR2026 abstracts
https://t.co/smN8hg51nj
Jiha Lee @JihaRheum( View Tweet )
🏠 Take Home Messages from the early #axSpA session
🔺 Earlier diagnosis is possible and better
🔺 Early axSpA is not synonymous to mild
🔺 Longitudinally, early axSpA is heterogeneous
🔺 MRI has transformed the field
❗️Beware of pitfalls
#EULAR2026 @RheumNow https://t.co/IhGQSxssyd
Links:
Nelly ZIADE 🍀 @Nellziade( View Tweet )
Day 4 EULAR Report
The last day in London was exciting as both the Late-Breaking abstracts and new EULAR guidelines were presented. Guidelines presented addressed several significant unmet need areas including PMR, GCA, Takayasu’s arteritis, Vaccinations in Rheumatic patients, Imaging in spondyloarthritis and
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Thoracic U/S for #RA-ILD screening? Multicenter study (n=272, Argentina/Denmark/Belgium): 86% sensitivity and 94% NPV. Accessible, no radiation, integrates into clinic flow. Time to build TUS into routine RA-ILD pathways? @RheumNow #EULAR2026 POS1265 https://t.co/FGH5iUstxa
Jiha Lee @JihaRheum( View Tweet )
RA-ILD in the Age of Treat-to-Target: Put the Probe on the Chest
At EULAR 2026, speakers of the session “Catching Your Breath: Unravelling RA Associated Interstitial Lung Disease (ILD)” noted RA-ILD is one of the few outcomes not improving in the biologic era. Three abstracts reinforce that message and make the case for a practical, low-cost screening tool
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🏠 Take Home Messages from the early #axSpA session
🔺 Earlier diagnosis is possible and better
🔺 Early axSpA is not synonymous to mild
🔺 Longitudinally, early axSpA is heterogeneous
🔺 MRI has transformed the field
❗️Beware of pitfalls
#EULAR2026 @RheumNow
Nelly ZIADE 🍀 @Nellziade( View Tweet )
#EULAR2026 Recommendations: Vasculitis
-Confirm diagnosis with imaging and biopsy
- Start GC early but with taper plan
- For major flare again confirm dx and restart GC
- Consider IL-6 or UPA
- MTX may be option if biologics not available
@RheumNow https://t.co/DqLZtW630y
Jiha Lee @JihaRheum( View Tweet )
CT imaging in RA
Body composition changes beyond BMI
489 RA vs 397 ctrl
RA asso w/
-increased subcutaneous fat
-increased intermuscular adipose tissue -poorer muscle quality
Looks like it represent “hidden obesity” with more by fat redistribution and myosteatosis
#OP0348
Aurelie Najm @AurelieRheumo( View Tweet )
And now does MRI do better than US at predicting RA progression in at risk pts?
Short answer: No likely too sensitive!
130 anti-CCP+ symptomatic pts
36.9% progressed
BL US positivity predicted progression HR 2.8
MRI showed prevalence of subclinical disease synovitis >80%
Aurelie Najm @AurelieRheumo( View Tweet )
Detecting subclinica tenosynovitis in pts at risk for RA: who does it better US or DixonMRI?
65 pts RA CSA, US detected only ~23% of cases identified by Dixon
US misses most! But are they “real” tenosynovitis?
MRI (5-min, no contrast) higher sens
US higher spe
Shall we do https://t.co/stsMRdj9eY
Aurelie Najm @AurelieRheumo( View Tweet )
Lung US for RA-ILD screening
Comparison with diagnostic scores
147 RA pts (68 ILD on HRCT)
Asymptomatic cohort
Sens 95.4% Spe 77.7%
Risk scores alone performed poorly.
Combining US + risk scores boosted sensitivity to 100% → promising low-cost screening tool alongside HRCT. https://t.co/7C4zClaxry
Aurelie Najm @AurelieRheumo( View Tweet )
Can AI read 20 years of RA X-rays?
And how much faster/better than us?
20 years ESPOIR cohort 7500+ joints
RADAR algorithm
94–95% accuracy compared with expert readers
99% spe 93% sens
#OP0344 #EULAR2026 @RheumNow https://t.co/8hFHCY4SaY
Aurelie Najm @AurelieRheumo( View Tweet )
Can AI spot RA inflammation from a thermal hand scan?
Cohort 100 RA pts
AI model analysing thermal images detected US PD+ wrist inflammation AUC 0.87
Main features wrist temperature & heat-pattern
With all due validation could this be the next mass screening tool for RA? https://t.co/2AzXj5yQJI
Aurelie Najm @AurelieRheumo( View Tweet )
The axSpA classification has been revised with the 2025 ASAS SPARTAN criteria. 5 abstracts at #EULAR2026 Abstr OP0236, OP0100, OP0239, POS0190 and POS1341.
The single most important change in the 2025 criteria: MRI is now the highest-weighted variable and what counts as a https://t.co/xg4R4xRH2D
Antoni Chan MD (Prof) @synovialjoints( View Tweet )
SPARTAN-SSR: New quantitative criteria: BME in ≥3 consecutive slices OR any two of (BME, Erosion, Fat lesion each in ≥3 SIJ quadrants) or ankylosis in ≥3 halves achieves 88-96% sensitivity and 90-98% specificity across 3 cohorts. Precision #axSpA imaging. Abstr OP0100
Antoni Chan MD (Prof) @synovialjoints( View Tweet )
Therapeutic Updates
Diagnosis of PMR
RheumNow
Nine perspectives now available: Red Flags in the Diagnosis of PMR; Epidemiology of PMR; Role of the PCP in Diagnosis and Care; Importance of Diagnostic Imaging; ESR/CRP in PMR; PMR Must Rule Outs; Which PMR Patients Should Rheumatologists See?; Is There Hidden GCA?; and PMR Mimics.
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Recent Blogs
For decades we've been screening GCA with a patient history and exam. Doing so with imaging would be a sharp departure from the current standard of care. And you may be asking yourself, well, yeah, but what could it hurt? Don't you want to catch GCA early?
Let me tell you the problems with this.
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PMR might be one of the most rewarding diagnoses to make in real practice: the patient comes to you in severe debilitating pain, and you prescribe steroids, giving them their lives back! As much as this impressive response makes your intervention appear almost magical, there is the often-forgotten story about the implications of such a diagnosis and treatment on patients' daily lives.
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Podcasts
EULAR 2026 Daily Podcast Day 3a
ACR Podcast - Day1A
