JAK/TYK2

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EULAR 2026 Rheumatology RoundUp

Jack Cush, MD

It’s time for Rheumatology RoundUp from EULAR 2026 from London, UK. Drs. Artie Kavanaugh and Jack Cush review their choice presentations from the meeting, offering their perspectives on impact and applicability.

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New Oral Option for axSpA: Filgotinib for Radiographic and Non-Radiographic Disease

Antoni Chan, MD, PhD

The Janus kinase inhibitor (JAKi) class has been increasingly used in the management of axial spondyloarthritis (axSpA) over the past five years, offering effective oral alternatives to injectable biologics. But are all JAK inhibitors the same?

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#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

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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

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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

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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

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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 )
#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

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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

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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

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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

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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

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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

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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

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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

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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

Links:

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 )

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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