A JAKi CHAT: Shared Decision-Making in RA
Sponsored by AbbVie Medical Affairs + Health Impact
#TYK2i #deucravacitinib
#RCT in #SLE
LTE of #PAISLEY #RCT PERSISTENT #LLDAS &#DORIS #remission over 3 more yrs post 1 yr RCT BUT ++dropouts
#POS0695 #EULAR2026 @RheumNow https://t.co/vtrMYrFmJ9
Janet Pope @Janetbirdope( View Tweet )
Who does better in active #RA
b/tsDMARD naive?
Pt choice TNFi or JAKi
OR
Pt randomized to
TNFI or JAKi?
Strangely or not
PT choice did better
✅with satisfaction ~maybe expected
✅better retention on chosen #Rx
🤔unexpected
another arm in #RCTS?”
#EULAR2026 @RheumNow
OP0204 https://t.co/7qx5Rqq6a7
Links:
Janet Pope @Janetbirdope( View Tweet )
Updated SLR on D2T #RA (131 studies): JAKi maintain ACR20 even after 2-3 prior bDMARDs, with UPA outperforming ABA in head-to-head. But evidence on non-pharmacologic strategies in D2T RA remains nearly absent. Clear gap for future trials. @RheumNow #EULAR2026 POS1246
Jiha Lee @JihaRheum( View Tweet )
SELECT-Axis 2 trial and Withdrawal of Upadacitinib - Of 734 pts, 194 were in remission at wk104--> UPA w/d & 22% maintained drug-free remission for >48wks. Rest flared, median time to flare: 3.1 mos (89% regained LDA by wk24 w/ restart) #EULAR2026 #axSpA POS1350 https://t.co/7A7CAHxLxX
Dr. John Cush @RheumNow( View Tweet )
Risk of Parkinsons? RA patients have 28% lower Parkinson's risk vs general population (HR 0.72); axSpA had HIGHER risk (HR 1.29). Non-TNF biologics in RA reduced PD risk further (HR 0.74). No effect seen in PsA/axSpA. #EULAR2026 Abstr #POS1116 https://t.co/1vZoZGEu5Z
Dr. John Cush @RheumNow( View Tweet )
What happens after withdrawal of upadacitinib in patients with axSpA who achieved remission?
Data from 194 patients from the SELECT-AXIS2 RCT:
▶️ Remission maintained in 1/4 at48 weeks
POS1350 #EULAR2026 @RheumNow https://t.co/Z7nDwMuQux
Nelly ZIADE 🍀 @Nellziade( View Tweet )
#EULAR2026 LB0009 It’s like opening Pandora’s box! 2 Open Label RCTs Baricitinib vs TNF-i in RA & =>1 VTE risk:
-VTE:Non-inferiority of BARI wasn’t met (in line with JAK profile)
-No increase in MACE/Cancer (opposed to Oral-Surveillance: TOFA & =>1 MACE risk) @RheumNow #EULARBest https://t.co/nNwtJ3LbkD
Links:
Md Yuzaiful Md Yusof @Yuz6Yusof( View Tweet )
https://t.co/LEnQbCB2Ff https://t.co/CtuFVbde6t
Links:
- https://x.com/Janetbirdope/status/2063179861397536847/photo/1
- https://x.com/Janetbirdope/status/2063179861397536847/photo/1
- https://x.com/Janetbirdope/status/2063179861397536847/photo/1
- https://x.com/Janetbirdope/status/2063179861397536847/photo/1
- https://twitter.com/eular_ard/status/2062509665024344391
Janet Pope @Janetbirdope( View Tweet )
#SLE Rx options
Determining #MOA
#TYK2 #sig w #deucravacitinib
#IFN sig in active #SLE
⬇️ in
#anifrolumab
#upa
#deucra
#repeat renal #bx in #obinutuzimab ➡️
Clears B cells
#Dapriluzimab & other MOAs
⬇️AntiDNA
⬆️complements
#EULARbest @RheumNow #EULAR2026 #POS1364, OP0160,336
Janet Pope @Janetbirdope( View Tweet )
#EULAR2026 LB0005 More promising news in #PMR. Phase 3 RCT of Baricitinib + GC Taper in N=46:
Part 1: BARI vs PBO 65% vs 17% GC-Free Remission at WK16
2: PBO-BARI improved response 17% to 65% at WK28
3: Lower remission rate in those stopped BARI vs continued at WK44 @RheumNow https://t.co/D77aHcACJE
Links:
Md Yuzaiful Md Yusof @Yuz6Yusof( View Tweet )
Baricitinib did not demonstrate non-inferiority w/ TNFi for first VTE in the RA-BRIDGE and RA-BRANCH trials.
Identifying high-risk pts and individualizing tx is paramount.
LB0009 @RheumNow #EULAR2026 https://t.co/MSiBq0FnEq
Links:
sheila @RHEUMarampa( View Tweet )
Abstr LB0009
Baricitinib vs TNFi in RA patients enriched for VTE risk. 3,640 patients. 3.7 years median follow-up.
VTE: HR 1.61 (95% CI 0.97–2.66)
non-inferiority not demonstrated
MACE: HR 1.06 no cardiovascular excess
Serious infections: HR 1.32 (p<0.05)
@RheumNow https://t.co/NSNRJi9B4r
Antoni Chan MD (Prof) @synovialjoints( View Tweet )
Abstr LB0009
Baricitinib vs TNFi in VTE-enriched RA. 3,640 patients. 3.7 years.
Safety endpoints
VTE HR 1.61 non inferiority not met
Serious infections HR 1.32 (p<0.05)
MACE HR 1.06 reassuring
@RheumNow #EULAR2026 https://t.co/nR6TMowlYS
Antoni Chan MD (Prof) @synovialjoints( View Tweet )
Top 5 abst in #SjD
#anifrolumab +RCT
#ianalumab LTE Rx sustained
#telitatacept +LTE
#iana improves u/s parotids
#TYK2 sig in#SjD
OP0002, 0126, 127, 160 POS0284
#EULARbest #EULAR2026
@RheumNow @eular_org
Janet Pope @Janetbirdope( View Tweet )
Aiming for #DORIS #SLE #remission
Or #LLDAS in #SLE
Related to ⬆️survival
#deep outcome in RCTs
➡️archived in #deucravacitinib ph2 #LTE
&
ph3 #dapirolizumab & #obintuzimab
-achieved in #CAR-T trials in #lupus
POS0683, 1364, 0695, OP0338
& several 🚗 T abst
#EULAR2026 @RheumNow
Janet Pope @Janetbirdope( View Tweet )
JAK-SPARE: Ph3 RCT on baricitinib for rem induxn in early PMR.
BARI was effective vs. PBO in inducing & maintaining GC free rem.
No new safety signals.
New tx option for PMR (esp early). Decreases GC dependence & side effects.
LB0005 @RheumNow #EULAR2026 https://t.co/mWrr1RdPCm
Links:
sheila @RHEUMarampa( View Tweet )
#OP0204 #EULAR2026 Shared decision-making in practice! BACH study tested “treat by choice” in RA. Patients preferred oral JAKi over SC TNFi (55% vs 45%)
Importantly, own choice led to higher treatment satisfaction, better drug survival & fewer adverse events. @RheumNow #EULARBest https://t.co/iI1n2OGzqY
Mrinalini Dey @DrMiniDey( View Tweet )
Key messages in the tx of ax/p-SpA:
>csDMARDs only effective in pSpA
>consider individualized treatment for bDMARDs and JAKis
>Cycling TNFi equally effective to switching
@RheumNow #EULAR2026 https://t.co/oeO3BxmYYo
sheila @RHEUMarampa( View Tweet )
JAK Safety Debate Continues: Stronger VTE signal, less clear cancer signal
Few topics in rheumatology have reshaped prescribing behaviour as dramatically as the safety concerns surrounding JAK inhibitors following ORAL Surveillance and the subsequent FDA and EMA warnings. https://t.co/mvTRRL7srA
Dr. John Cush @RheumNow( View Tweet )
Oral TYK2i deucravacitinib works for #PsA with OR without methotrexate. Pooled POETYK data (n=648): ACR20/50/MDA, enthesitis, dactylitis, skin responses, and PROs all comparable regardless of MTX use at wk 52. Good news for pts who can't tolerate MTX. @RheumNow #EULAR2026 POS0288
Jiha Lee @JihaRheum( View Tweet )
+#RCT in #dermatomyositis with #brepocitinib
Oral #TYK2/JAK1i
241 pts
+outcomes
#TIS total improvement score
>40%TIS 68% v 44%
#steroid tapering
#skin improved rapidly #CLASI
#OP0166
#POS0264 @RheumNow #EULAR2026 https://t.co/9WZl9RsXXe
Links:
Janet Pope @Janetbirdope( View Tweet )
#EULAR2026 POS0713 Is there a hope for BTK-inhibition in #SLE despite several previous failures? A Phase IIb RCT in China: primary endpoint (SRI-4) was met in Orelabrutinib vs PBO in dose-dependent manner. No new safety signal. Phase 3 RCT is underway @RheumNow https://t.co/4cJ8ezppTS
Md Yuzaiful Md Yusof @Yuz6Yusof( View Tweet )
Gecacitinib (pan-JAK inhibitor) vs placebo in radiographic #axSpA ASAS40 51.9% vs 12.9% (p<0.0001) at 16 weeks. ASAS20 69.2% vs 21.2% (p<0.0001). Pan-JAK inhibition showed efficacy in TNFi-experienced patients. Abstr OP0240 @RheumNow #EULAR2026
Antoni Chan MD (Prof) @synovialjoints( View Tweet )
Does sequential therapy infliximab —> tofacitinib outperform tofa alone in axSpA?
Yes: faster remission at week 4 (84.6% vs 15%)
But: equal at week 24
Prospective study in 46 patients
#POS0201 #EULAR2026 @RheumNow https://t.co/rmtoJQtYc0
Nelly ZIADE 🍀 @Nellziade( View Tweet )
Gecacitinib 100mg BiD vs PBO in active r-axSpA:
Met primary endpt ASAS40 at wk 16 showing efficacy of gecacitinib vs. PBO (51.9%vs12.9%,p<0.0001)
Gecacitinib showed ⬆️ improvements in ASDAS-CRP, physical fnxn, spinal mobility & QOL
Promising tx.
AbsOP0240 @RheumNow #EULAR2026 https://t.co/FytoRgxvnG
Links:
sheila @RHEUMarampa( View Tweet )
Therapeutic Updates
Experts Dr. Jeffrey Curtis and Dr. Kevin Winthrop discuss best practices for shared decision-making, how to talk with patients about the risks of poorly controlled RA, and ways to use a new tool for visualizing the long-term safety of a JAKi.
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