Anti-Rheumatic Rx

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Day 4 EULAR Report

Jack Cush, MD

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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Remember Babies of pts on chronic #immunosuppression with #SARDs ❎delay #vaccinations til 6/12 For safety & to mount sufficient response #rotovirus #vaccine is Ok before 6 months or vaccine is ineffective Pts w #SARDs need #COVID shots @RheumNow #EULAR2026 #vaccine #recom https://t.co/WEzNajWlxY

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Janet Pope @Janetbirdope( View Tweet )
What’s new with the 2026 update of reco for vax in AIIRD? Vaccinate as soon as possible Non-live vaccines are safe Hold MTX for upto 2wks to inc vax yield Strong reco for RZV Catch-up vax for HPV in SLE Rotavirus vax for newborns exposed in utero to TNFi @RheumNow #EULAR2026 https://t.co/RZbyvAcYRI

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sheila @RHEUMarampa( 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 )

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

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Jiha Lee @JihaRheum( View Tweet )
Patient-initiated telemedicine follow-up cut rheumatology visits by 25% in stable #SpA, but not equally for everyone. Reductions were greatest in men, axSpA, bDMARD users, and the oldest patients (64+, 34% fewer visits). Patient-centered care delivery @RheumNow #EULAR2026 POS1345

Jiha Lee @JihaRheum( View Tweet )

T2T works in elderly-onset #RA. tREACH trial (n=425): EORA (mean age 73) achieve LDA similar to young-onset RA; often with lower treatment intensity when seronegative. Drug tolerability comparable in EORA vs YORA despite more comorbidities. @RheumNow #EULAR2026 POS1326 https://t.co/tKRki2KLzP

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Jiha Lee @JihaRheum( View Tweet )
Checklist IgG4

INDIGO: Switching B Cells Off, Not Out, in IgG4-Related Disease

Henrique Dalmolin, MD

B-cell targeting has moved to the centre of IgG4-related disease treatment, with inebilizumab, a CD19 depleter, as the recent benchmark. At EULAR 2026, INDIGO tested whether the disease can be controlled by switching B cells off rather than depleting them.

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TMP-SMX prophylaxis cuts PJP risk by 69% (RR 0.31) & mortality by 59% (RR 0.41) in immunosuppressed rheum dz pts —but ADRs are 26x more common. NNT=323, NNH=5. Risk-adapted approach recommended. #EULAR2026 POS1190 https://t.co/4yjD9CmySM
Dr. John Cush @RheumNow( View Tweet )
#EULAR2026 POS1139 Pay attention in #SLE with anti-Sm+ RNP+. Data from 3 RCTs & a cohort: -enriched in Black patients -poor response to B-cell depletion inc. Obi -non-response is assoc. with BAFF-dependent B-cell repopulation. So, use Belimumab -High ferritin = flare @RheumNow https://t.co/3uDMigY8i2

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Md Yuzaiful Md Yusof @Yuz6Yusof( View Tweet )
Extended-release febuxostat (HR091506) vs standard febuxostat in gout. 442 patients, 36 weeks. SUA <300 μmol/L at Week 36: 63.8% vs 40.7% (p<0.0001) A 23% difference on the most stringent urate target. Well tolerated and acceptable safety profile Abstr LB0008 @RheumNow https://t.co/PSrn7K5BVS

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Antoni Chan MD (Prof) @synovialjoints( View Tweet )
#EULAR2026 LB0008 Phase 3 RCT in China of pts with high urate (SUA) & 2 gout flares within last year (N=142), HR091506, an extended formulation release of Febuxostat to prolong response was superior to Febuxostat at WK36. Unclear if will proceed to regulatory submission @RheumNow https://t.co/9lcVEzcxc1

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Md Yuzaiful Md Yusof @Yuz6Yusof( View Tweet )
https://t.co/LEnQbCB2Ff https://t.co/CtuFVbde6t

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Janet Pope @Janetbirdope( View Tweet )
Abstr LB0004 CC312 is a CD19/CD3/CD28 tri-specific T cell engager and sustains SRI-4 responses beyond one year with rapid, deep B-cell depletion in autoimmune diseases. Not CAR-T. Not a conventional biologic. A T cell engager that redirects your own immune cells to deplete B https://t.co/rTs3Rg7BPe

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Antoni Chan MD (Prof) @synovialjoints( View Tweet )
#EULAR2026 LB0007 Phase 2 RCT of Nipocalimab, an FcRn-i in moderate-to-severe #SLE, with mandatory GC taper =<7.5mg/d by WK16: met primary endpoint at WK24 (SRI-4) vs PBO. Effect size better in Ab+, Ab-High & IFN-High. 23% had IgG<3 at WK58 but SIE. Phase 3 is underway @RheumNow https://t.co/EpgNOHcEqC

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Md Yuzaiful Md Yusof @Yuz6Yusof( View Tweet )
question mark

Immune Dimming or Immune Reset in RA: How Far Should We Go?

Aurelie Najm, MD, PhD

CD19-directed CAR T-cell therapy has rapidly moved into autoimmune disease, driven in large part by striking reports in SLE, where sustained drug-free remission has raised the possibility of a true immune reset. In RA, where multiple effective therapeutic classes already exist, the relevance of

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What drives progression to difficult-to-treat RA? 20-year cohort 675pts -18.8% developed D2T RA -Younger age, higher HAQ & prior steroid exposure asso w/ D2T RA -Earlier b/tsDMARD initiation protective -No diff TNFi vs non-TNFi first-line strategy Disease severity and https://t.co/SJDv9HCbLv

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Aurelie Najm @AurelieRheumo( 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

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sheila @RHEUMarampa( View Tweet )
#EULAR2026 Recommendations: Immunization (new since 2011) - Vaccinate early regardless of dz acitiviry - HBV booster/passive if poor response - Yellow fever may be considered on individual basis - Avoid live vaccines (mostly) in newborn exposed in utero to biologic @RheumNow

Jiha Lee @JihaRheum( View Tweet )

Do you routinely recommend #herpes #zoster #vaccination in all #immune #suppressed pts? #EULAR2026 @RheumNow #vaccination #guidelines

Janet Pope @Janetbirdope( View Tweet )

#OP0207 #EULAR2026: SUPERFIBRES trial suggests dietary fibre supplementation may enhance MTX response in RA. Inulin improved EULAR responses and Th17/Treg balance over 30 days, with strongest effects seen in MTX-treated patients. Fascinating microbiome-linked signal. @RheumNow https://t.co/nCvZlooamF

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Mrinalini Dey @DrMiniDey( View Tweet )
Data of #Rituximab In #SARD-ILD Small N of #RA-#ILD pts I think data are sufficient as #RWE of #RTX in RA-ILD ✅benefits in other #CTD ILD ✅benefits in #rheumatoid #arthritis #EVER-ILD #RCT HOT #RA-ILD topic June 5 #EULAR2026 @RheumNow https://t.co/61MbsnNsaf

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Janet Pope @Janetbirdope( 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

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Mrinalini Dey @DrMiniDey( View Tweet )
Even with tight T2T, ARCTIC 10yr follow-up (n=170) show 9% had RA-ILD on HRCT, plus another 19% with non-specific interstitial findings. Male sex and older age were risk factors. Seropositivity was not. Vigilance remains essential. @RheumNow #EULAR2026 POS1270

Jiha Lee @JihaRheum( View Tweet )

#EULAR2026 POS1355 A cohort study in Japan identified 5-score predictors of GC-free remission in #lupusnephritis: HCQ, pulsed IV GC, Chronicity index=0, =>75% UPCR reduction by 6mo,& 12 mths CRR. Data cutoff 2024. Interested to see impact of current Combo tx from outset @RheumNow https://t.co/qmpgyEyOOV

Links:

Md Yuzaiful Md Yusof @Yuz6Yusof( View Tweet )

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