2026 EULAR Preview

追加: 2026-06-03

[00:00:00]Hi everyone, welcome to EULAR 2026. I'm in London. We're going to do a little preview of the meeting that starts tomorrow, Wednesday.

[00:00:10]And we've been over the program. There's a lot of really exciting stuff. I'll just give you some highlights of things I'm going to be looking forward to, things that I think are maybe game-changing in in rheumatology.

[00:00:27]Two late breakers, actually there's a bunch of late breakers that come to mind. The B Bold data is going to be presented by John Morola on Saturday.

[00:00:36]There are other late breakers that also look really, really good.

[00:00:40]I like the Jack spare study. That's LB 005.

[00:00:48]This is a phase three trial of baricitinib given to people with early PMR.

[00:00:55]They have less than three weeks. It's a 46 patient study. It's not a big study, but they either get Barry 4 mg or placebo for 16 weeks. And part two, they either continue or they cross over. The primary endpoint is glucocorticoid-free remission, and Barry is a clear-cut winner.

[00:01:17]And it's not surprising that a Jack inhibitor would work. There's a lot of other data out there about other Jack inhibitors working in polymyalgia rheumatica, and I think it will be something we'll see more of in the future. Another really important abstract that's coming up as part of the late breakers is a long-awaited study uh as a follow-up to oral surveillance where we found out that Jack inhibitors don't do as well as TNF inhibitors when it comes to cardiovascular outcomes and cancer and infection in high-risk individuals. Uh the follow-up to that, another big study not with tofacitinib but with baricitinib, was a regulatory commitment by Lilly to study baricitinib and its venous thromboembolic risk.

[00:02:14]So, they set up many years ago these studies called RA Bridge and RA Branch.

[00:02:19]It's baricitinib versus TNF inhibitors in over um 3,500 patients who have risk factors for um VTE events, DVT, PE. And so, we're talking there age, BMI uh are the main risk factors. Oh, and having uh had a prior event. Um and the bottom line on that study is that it confirmed what we already knew. Baricitinib was the first of the JAK inhibitors to be um labeled.

[00:02:50]And right out of the gate, uh labeled with a uh VTE indica- uh risk and and warning. Uh and it this study confirms it. But interestingly, again, another high-risk population, they were average age around 60, but it did not show. The study did not show that baricitinib compared to uh a TNF inhibitor was associated with either a risk of um cardiovascular MACE events, uh cancer events, or um uh it did show infection um serious infectious events, but did not show an increased risk of uh uh uh um opportunistic infection.

[00:03:34]So, in some ways it argues against the data for the oral surveillance study, but those are two very important studies that I think will be coming up this week as late breakers.

[00:03:46]Um there's a lot of data that I'm going to be covering with my colleagues on uh ILD. The bottom line there is it looks like all the risk factors everyone's saying um suggest yeah, risk factors for ILD in RA is being male, being older, being seropositive. Throw in there smoking, throw in there disease activity uh and and now you've got the profile.

[00:04:11]Uh the question is who needs to be screened? There are a number of studies here this week that look at that issue and they all say the same thing. ACR guideline says you need to have one risk factor. The ERS EULAR guidelines from last year say you need to have two risk factors.

[00:04:26]But the bottom line is that almost all RA patients have one or two of these risk factors. Does that mean you do high-risk CT in everyone? Well, that re- remains to be seen. I like this report. It's going to be um an oral presentation maybe tomorrow uh on uh it's called the SUNSTAR study and it is a head-to-head study of uh tocalizumab or abatacept after someone fails a biologic or targeted synthetic and turns out in this study 95 96% of people were TNF inhibitor failures uh and it looked like there was no real difference except for when you do the analysis a new way a different way there was an edge for tocalizumab but we need to cover that to see where that's going to go. Other things there are a lot of studies that have been recently published that are going to get big airtime at this meeting. The TOGETHER PsA study, that's the combination of uh of terzepatide and the IL-17 inhibitor inhibitor ixekizumab. That data is going to be presented in full here. The affinity study of uh with golimumab, the um what else is another one that's out there that's going to be presented again um but I I like this uh data on um there's going to be follow-up data.

[00:05:51]There's a lot of uh CAR-T cell therapies and B cell depletion therapies.

[00:05:58]And everybody's [snorts] excited about it except for me.

[00:06:01]Because one, we're a long ways off from seeing CAR-T cell in the clinic.

[00:06:05]Two, I'm not seeing studies that have good controls and are blinded. I'm seeing, you know, 12 people with Munchausen syndrome getting CAR-T and being cured. I'm making that up, that's a joke. But it looks very good as you would imagine in lupus and um somewhat good in um scleroderma. Um maybe not so good in um in the synthetase myositis patients. And a big question about what it's going to do in RA.

[00:06:37]The early report on the what's going to be presented here is a small study showing that not everybody gets better, but a few people do. And the question is who are they and why are they getting better?

[00:06:50]The Neptunus study um in Sjogren's syndrome, there'll be a number of Sjogren's presentations. Neptunus was presented at ACR, that's uh inalimumab showing its success. Now they have some long-term data that they're going to uh look at. They have telitacicept in Sjogren's, it's also going to be presented here.

[00:07:08]Um and what else? Uh anifrolumab study with uh Sjogren's. And then the uh Phonic study was just recently presented uh and that's going to be shown here as well.

[00:07:23]Uh that seems to look good as far as the data goes. So, anyway, um this is how you can best follow uh EULAR um when you're not in London with the with a few of us who are here.

[00:07:37]I think the best way depends on how you like to learn.

[00:07:40]The Twitter feed's going to be active.

[00:07:41]The Room Now faculty is going to be out there. They're going to do, you know, six, seven, 800 tweets. You can follow that.

[00:07:49]There'll be daily recaps starting Thursday night. We're going to do a day one, day two recap that will um play Thursday evening, probably 7:00 p.m. Uh and then there'll be a day three recap on Friday and a day four, final day recap on Saturday. The recap is where a few of the faculty and myself get together and say what was great today and what do do you want everyone to know about. There'll be great articles that you can follow on your phone and uh on the website and they'll come to you as emails. And the other way to follow is um to look at take the quiz at the end of the week. Do the weekly quiz on this Saturday and next Saturday and you'll learn just by doing 20 or 30 quiz questions about uh what the take-home message from the meeting was.

[00:08:42]Anyway, it's going to be a fun time in London. Hopefully, you'll have fun listening to our coverage. Take care.