JAK/TYK2

change,future,lens,clarity

‘Strong’ treatment predictions in inflammatory myositis

Janet Pope, MD, MPH, FRCPC

Presented at EULAR 2026 London, Brepocitinib dual TYK2/JAK1 inhibitor with successful Phase 3 VALOR trial demonstrating significant improvement in skin and muscle symptoms in dermatomyositis (DM).

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💉 Does ivarmacitinib (selective #JAK1i work in nr-axSpA? Phase 3 RCT (n=304): ASAS40 39.7% vs 24.8% placebo at week 12 with sustained benefit at week 24 #OP0237 #EULAR2026 @RheumNow https://t.co/kofXnPp6qQ

Links:

Nelly ZIADE 🍀 @Nellziade( View Tweet )
🔬 Can filgotinib improve axSpA? OLINGUITO (Phase 3 RCT, n=495): YES! ASAS40 39.5% vs 21% (r-axSpA) at week 16 #OP0234 #EULAR2026 @RheumNow https://t.co/0vj2KqSS1b

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Nelly ZIADE 🍀 @Nellziade( View Tweet )
🧬 Do biomarkers predict #zasocitinib response in PsA? YES: TYK2/IL-17 pathway markers predict ACR20 in 290pts Phase 2b RCT #OP0184 #EULAR2026 @RheumNow https://t.co/AVlyrauI5q

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Nelly ZIADE 🍀 @Nellziade( View Tweet )
❤️ Do biologics differ in MACE risk in PsA? YES - JAKi highest risk after 2.5yrs vs TNFi/IL-17i/IL-23i in a retrospective cohort of 22,246pts. OP0181 #EULAR2026 @RheumNow https://t.co/eQdBtMfRAY

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Nelly ZIADE 🍀 @Nellziade( View Tweet )
DESIR Cohort 10-year data (OP0102): SIJ structural lesions in #axSpA progress slowly, but prior MRI bone marrow oedema predicts later structural damage. bDMARD exposure was associated with less erosion progression supporting early biologic treatment Abstr OP0102 @RheumNow

Antoni Chan MD (Prof) @synovialjoints( View Tweet )

JAKi vs ABA in RA-ILD: emulated target trial (n=1,162), JAKi with worse composite respiratory outcomes (HR 1.57) and all-cause mortality (HR 1.59) vs ABA over 5 yrs. JAKi with ↑ pneumonia risk. In RA-ILD, ABA may be the preferred choice? @RheumNow #EULAR2026 POS0813 #EULARBEST

Jiha Lee @JihaRheum( View Tweet )

#OP0241 FASTLANE phase 4 trial showed TOFA was superior to PBO in early active axSpA, achieving significantly higher ASDAS inactive disease rates at 16 weeks (26.4% vs 7.4%) on background of naproxen. MRI osteitis improvement numerically favoured TOFA. #EULAR2026 @RheumNow https://t.co/dGETjkmfrh

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Mrinalini Dey @DrMiniDey( View Tweet )
#OP0240 phase 3 data showed that the pan-JAK inhibitor gecacitinib significantly improved disease activity, function, MRI inflammation and quality of life in active radiographic axSpA versus placebo at 16 weeks, with ASAS40 responses of 51.9% vs 12.9%. #EULAR2026 @RheumNow https://t.co/6oojvvFmk0

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Mrinalini Dey @DrMiniDey( View Tweet )
#OP0237 reports positive phase 3 data for the selective JAK1 inhibitor ivarmacitinib in active nr-axSpA. ASAS40 responses at Week 12 significantly higher vs placebo (39.7% vs 24.8%), with sustained efficacy through Week 24 and no new safety signals observed. #EULAR2026 @RheumNow https://t.co/JZLQ0Ywlio

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Mrinalini Dey @DrMiniDey( View Tweet )
Catching up with the “Optimising care in SpA” at #EULAR2026 #OP0234 Phase 3 OLINGUITO trial showed filgotinib significantly improved ASAS40 responses vs PBO in both radiographic and non-radiographic axSpA by Week 16, with responses maintained through Week 52. @RheumNow #EULARBest https://t.co/axn6Zv52RA

Links:

Mrinalini Dey @DrMiniDey( View Tweet )
FASTLANE study Ph4 RCT on TOFA+NPX vs. PBO+NPX for early active axSpA TOFA arm significantly achieved inactive dse vs. PBO (p=0.006) at wk 16. Similar results seen in secondary efficacy endpts. Interesting results supporting TOFA use AbsOP0241 @RheumNow #EULAR2026 #EULARBest https://t.co/PQYzE1zm0h

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sheila @RHEUMarampa( View Tweet )
TCZ vs ABA head-to-head in #RA after 1-2 prior b/tsDMARDs: SUNSTAR RCT (n=224) didn't hit its primary endpoint (CDAI change at wk 26, p=0.11). But composite response (treatment persistence + LDA + steroid-sparing) favored TCZ: 50.5% vs 35% (p=0.034). @RheumNow #EULAR2026 OP0205

Jiha Lee @JihaRheum( View Tweet )

RENOIR Ph2b pathogenic T-cell depletion rosnilimab RA -Primary endpoint DAS28-CRP change wk12 -2.06 to -2.12 (all doses) vs -1.69 PBO p<0.01 -ACR20/50/70 + CDAI LDA all improved vs PBO -hsCRP reduction across all dose arms -69% CDAI LDA by wk14 -wk 28 extension shows https://t.co/AMfmSded0D

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Aurelie Najm @AurelieRheumo( View Tweet )
#EULAR2026 OP0166 In a phase III RCT in dermatomyositis, brepocitinib, first in class selective SyK-i and JAK1-i showed rapid meaningful improvement in cutaneous DM as early as Week 4 vs PBO. Exciting option and is under FDA Priority Review for approval @RheumNow #EULARBest https://t.co/9b0WurgBkN

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Md Yuzaiful Md Yusof @Yuz6Yusof( View Tweet )
Mean disease duration in the tofacitinib arm was just 0.57 years since diagnosis. This is genuinely early #axSpA and JAK1 inhibition achieves near-remission rates above placebo. An oral option for early axSpA Abstr#0241 @RheumNow #EUlAR2026

Antoni Chan MD (Prof) @synovialjoints( View Tweet )

Tofacitinib achieved ASDAS inactive disease in 26.4% of patients with early #axSpA (back pain ≤2 years) vs 7.4% placebo at 16 weeks (p=0.006). First RCT of advanced therapy in very early axSpA Abstr#0241 @RheumNow #EULAR2026

Antoni Chan MD (Prof) @synovialjoints( View Tweet )

EULAR flags

Understanding Comorbidities in RMD

2026 EULAR Press Release

People with rheumatic and musculoskeletal diseases (RMD) are at risk of a number of comorbidities, from cardiovascular diseases to cognitive impairment and fractures. The 2026 EULAR Congress showcased new data and ideas around various comorbidities and drug safety issues in people with an RMD –

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What if we let RA patients choose ttmt? BACH RCT choice between Filgo / scTNFi vs. standard randomisation 55% JAKi vs 45% TNFi Higher ttmt satisfaction 46 vs 33 p=0.012 Less ttmt switches 6 vs 15 p=0.026 Less AE reported Better drug survival Shared decision making is key! https://t.co/1YS0y6YUEH

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Aurelie Najm @AurelieRheumo( View Tweet )
Does ASA protect against JAKi-associated VTE in #RA? Swedish data (n=26,116): No. JAKi VTE risk remained elevated vs TNFi regardless of concomitant ASA or DOAC use. NSAIDs showed a non-significant trend toward protection. @RheumNow #EULAR2026 POS0068

Jiha Lee @JihaRheum( View Tweet )

📈 Do SIJ lesions progress in #axSpA? DESIR cohort (n=649, 10yrs): Yes, slowly, but bDMARDs reduce erosion progression #OP0102 #EULAR2026 @RheumNow https://t.co/Ap35q9D6B4

Links:

Nelly ZIADE 🍀 @Nellziade( View Tweet )
safety data

JAK Safety Debate Continues: Stronger VTE signal, less clear cancer signal

Mrinalini Dey, MD

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. Even now, years later, the field remains divided over how much of the observed risk reflects real-

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Cancer risk with JAK inhibitors remains a major focus at #EULAR2026. In #OP086, analysis from 14 international RA registries and >60000 treatment courses found no statistically significant increase in overall or subtype-specific malignancy risk with JAKi versus TNFi. @RheumNow https://t.co/JeOmTufYwo

Links:

Mrinalini Dey @DrMiniDey( View Tweet )
#OP085 from Sweden adds more real-world data to the JAKi safety discussion at #EULAR2026. In >26000 RA treatment initiations, JAKis were associated with higher VTE risk vs TNFi (HR 1.89), with similar findings persisting in 2021-2024 data. @RheumNow https://t.co/YRjPNZ8mmo

Links:

Mrinalini Dey @DrMiniDey( View Tweet )
🎯 Does Tofacitinib work in axial #PsA? #POS0049: 1st RCT (PASTOR, n=26): improved MRI & clinical outcomes vs placebo @ wk12 #EULAR2026 @rheumnow

Nelly ZIADE 🍀 @Nellziade( View Tweet )

Therapeutic Updates

A JAKi CHAT: Shared Decision-Making in RA

AbbVie October
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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Recent Blogs

JAKi for PMR: Safe, or a Concern for Older Adults?

David Liew, FRACP
Dr. David Liew
JAK inhibitors obviously have dominated a lot of the discussion in our therapeutic landscape over the last couple of years. What about their use in polymyalgia rheumatica? Let's consider.
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Infections Rheums Should Worry About

Cassandra Calabrese, DO
TB.EMimage.CDC_.jpg
With the increasing development and use of new biologics and oral targeted therapies to treat RA and other immune mediated inflammatory diseases, an awareness of infection risk and prevention has become of increasing interest as well. While our patients may be susceptible to many different types of infections depending on immunosuppressive regimen, age and co-morbidities, I’ll highlight a few of the “usual suspects”.
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Hard Conversations: DMARDs and Malignancy

Michael Putman, MD, MSCI
Risk Option Decision
Cancer is the most difficult DMARD risk to discuss with patients. Few warnings could scare people away from a drug faster than the words “may increase risk of cancer,” yet the risks (even when substantiated) have all been low and may be counterbalanced by the benefits of disease control.
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Podcasts

  • ACR 2025 SpA Topic Podcasts Compilation 1
  • EULAR 2024 Rheumatology Roundup
  • EULAR 2024 JAK/TYK Daily Topic Podcasts
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