Anti-Rheumatic Rx

TARA trial: Ph3 H2H trial of Girocitinib (JAK1/TYK2i) vs Tofa in RA refractory to bDMARDs Giro achieved higher ACR50 response vs Tofa at wk24 (73 vs 49.5%) Also met secondary endpts Safety data: Infections more common. No VT/malignancy/MACE in Giro arm. @RheumNow #ACR26 LB21 https://t.co/HNVt7WdLc6

REDUCE-2: Ph 3 RCT of oral Pozdeutinurad (highly selective URAT-1i) for #gout Sign reduxn of SU <6 mg/dL at mo 6, 69% for 75mg, 58% for 50mg. Rapid onset of clinically meaningful SU reduxns & sustained thru 12mos Well-tolerated, low renal AEs @RheumNow #ACR26 LB20 https://t.co/nqzDHM6rJP

#unmet need for #urate #lowering in #gout w #URAT1i #pozdeutinurad Tophi 1/4 >8 baseline uric acid (American units) Sustained uric acid over time Benefit from 6mo onward Rare EAs /SAEs DBRCT 2 doses, 75&150mg works Some failed other prior Rx #ACR26 #ACRbest @RheumNow #LB20 https://t.co/83aCtazXwt

We do GCA studies with new-onset & relapsing data mixed in, for practical purposes. Yet this is a sometimes phasic disease in SELECT-GCA (upadacitinib), those randomized to stop upa at 52w relapsed far less if new-onset (vs prev relapsing) *different* ABST2122 #ACR26 @RheumNow https://t.co/NMOIBONjar

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A potential new ULT for gout: URAT1 inhibitor Abstract LB20 found that Pozdeutinurad (HD & LD) vs PBO: - more achieved SU < 6 mg/dl at month 6: 69.2% & 56.6% vs 8.1% - SU < 6 rapid and sustained until month 12 - renal AE similar across all groups @RheumNow #ACR26 https://t.co/5LXOTwwUaa

I've had plenty of time to contemplate BE-BOLD (#EULAR2026, yesterday's #ACR26 plenary) It's still amazes me one good PsA bDMARD clearly outguns the equal next best PsA bDMARD Joints, over time. Not some compound measure early on. Can't wait for paper ABST2804 #ACR26 @RheumNow https://t.co/Wh6tzea7wd

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Wang et al. Retrospective cohort study. Hypogammaglobulinaemia in RA with RTX. The more you give the worse it gets (slowly and steadily). Threshold of 600 mg/dl appears to be tipping point in infection risk, HR 6.25, 95% CI 2.54-15.39; p< 0.001. @RheumNow #ACR26 Abstr#2931 https://t.co/JUtp51yug6

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Ab#2547 #ACR26 @RheumNow Sublingual cylcobenzaprine - now approved for Fibro RELIEF, RESILIENT trials: NNT (# needed for >30% pain reduction) = 7 NNH (# needed for one Rx d/c due AEs) = 26 LHH (NNH/NNL) = 3.7, suggests nearly 4x likelihood of benefit to harm

Eye-opening abstract 1637 on leflunomide (LEF) in uveitis. Experience of single center uveitis population (n=147) 21% on LEF, always 2nd line or > (post MTX and/or ADA), most idiopathic/no SARD, ~ 1/2 of LEF Tx pts acheived remission or low uveitis activity. #ACR26 @RheumNow

Park et al. Phase 2 RCT from Korea. Stem cell and cartilage acellular matrix combination injection for knee OA. Single injection provides 6-month benefits in pain, function, MRI findings, biomarkers vs placebo. @RheumNow #ACR26 Abstr#LB19 #ACRbest https://t.co/iw378MV2OM

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Article

Why Did the Last Drug Fail?

Antoni Chan, MD, PhD Nov 10, 2026

When a patient fails a drug, we tend to consider what will be the next drug. Most of our clinics have patients on their second or third advanced therapy. Drug failure has become more common, not less. A question that we too rarely write in the notes is why did the last drug fail?

Article

Making the Case for Early Biologics in Lupus

Akhil Sood, MD Nov 10, 2026

Several abstracts presented at ACR 2026 provide new insights into the potential benefits of early biologic treatment in SLE.

Article

ACR 2026 Day 3 Report

Jack Cush, MD Nov 10, 2026

Today the ACR began with the Great Debate, an intriguing set of Plenary presentations, a never-ending poster hall and a plethora of stimulation oral presentation sessions. Here are a few of my favorites from today:

If #rituximab doesn’t improve #mrRSS #skin #score at 1 yr; unlikely to improve in Yr 2 in #SSc Didn’t matter if sustained B cell depletion and Rx effect Strange as I think mRSS can still work in Y2 Rx in #scleroderma #dcSSc but with some effect in yr1 #2906 #ACR26 @RheumNow https://t.co/5pEy45W6uh

RTX for joint manifestations of SSc? Abs 2158 Study of 80 SSc pts from Uni of Lübeck with documented DAS-CRP treated with RTX suggesting improvement and possible remission by this measure. Concomitant MMF one feature that favored remission? Small, uncontrolled #ACR26 @RheumNow https://t.co/vphSxCfeBJ

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Cytopenias in SLE - could be disease, but also our meds Most associated with lymphopenia: - RTX - Tacro - AZA - MTX MMF not associated w lymphopenia RTX also associated w neutropenia @rheumnow #ACR26 https://t.co/HmXXZWaUpJ

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Who with oligoarticular PsA progresses to polyarticular disease? Risk factors: - 4 active joints - F sex - enthesitis - swollen upper extremity joint Apremilast reduced progression in all-comers but most impactful in those with +risk factors @RheumNow #ACR26 Abst2307 https://t.co/chXL2z7ZQK

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2 Weeks off Methotrexate Boosts Zoster Response Consider holding methotrexate for two weeks after each recombinant zoster vaccine dose when disease is stable, and give the vaccine before rituximab when timing allows. Those are the messages from a pair of abstracts presented by https://t.co/qeEQp0LeHB

Jamshaid & Gomaa (Tirzepatide vs semaglutide cohort): A large real-world comparison found less steroid use with tirzepatide than semaglutide at 3 years: 27.2% vs 37.5%.@rheumnow #ACR2026 Abstract#2641

Anti-drug antibodies against inebilizumab were not impactful in MITIGATE Incidence of ADAs similar in INE arm (8.8%) and PBO arm (7.5%) NO impact of ADA on drug concentrations NO efficacy difference by flares in ADA+/- INE pt @RheumNow #ACR26 #ABST2109 https://t.co/rfOlUMGc2N

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Jamshaid et al: Tirzepatide vs semaglutide in inflammatory arthritis: 3-year steroid use was 27.2% vs 37.5%. Less treatment escalation is intriguing. @rheumnow #ACR2026 #ACRBest Abstract#2641

Could familiar DMARDs become a treatment strategy for Sjögren's? The NECESSITY trial reports efficacy with HCQ + leflunomide and HCQ + MMF combinations. An intriguing potential option while targeted treatment development continues. #LB15 @RheumNow #ACR26

van Schaik et al: SYNBIOSE-2 found less treatment failure with belimumab + rituximab vs standard care in severe SLE/LN (HR 0.39; p=0.005). Renal flares: 1 vs 10. Could sequential B-cell targeting reshape lupus care? @rheumnow #ACR2026 Abstract#LB07 #Lupus

An ORAL IL-23 receptor inhibitor for PsA? Phase 3 data evaluate icotrokinra, an oral peptide targeting IL-23R, through Week 24 in biologic-naïve PsA. Could oral targeted therapy expand our options beyond injectable biologics? Kishimoto et al. | #LB12 @RheumNow #ACR26

FASTLANE study: Significantly higher proportion of pts w/early active axSpA on Tofa 5mg BID/naproxen achieved ASDAS inactive dse vs. PBO/naproxen at wk 16 (26.4% vs. 7% p0.006) AEs occured in 50% of pts on TOFA vs. 33% on PBO. AEs: infections, GI @RheumNow #ACR26 Abs2314 #ACRbest https://t.co/QkxaNCDQsu