The edition · Rheumatology
Structured tapering of biologics in stable RA was non-inferior to continuing at 24 weeks
A Korean multicentre trial of 348 patients kept low disease activity in 88% after stepwise tapering, and most who worsened regained control. Ten years after very early peripheral spondyloarthritis, a third of trial patients were in drug-free remission.
The edition in brief
In a 24-week open-label non-inferiority trial of 348 Korean patients with rheumatoid arthritis in low disease activity for at least six months on a biologic or targeted synthetic DMARD, stepwise tapering maintained low disease activity in 88.2% against 89.6% with continuation (risk difference -1.43%, 95% CI -8.09 to 5.23), within the -10% margin. Most patients who worsened regained control after re-escalation, though some secondary activity scores favoured continuation. Ten-year follow-up of the CRESPA trial, which randomised 60 patients with very early peripheral spondyloarthritis to golimumab or placebo, found 40 of 49 assessed in clinical remission and 15 (31%) in long-standing drug-free remission; absence of psoriasis was associated with drug-free remission (OR 9.1), with almost half of non-psoriatic patients drug-free. The FDA recorded a supplement to the baricitinib new drug application on 25 September 2026; the record does not state its content, and it is not a new indication or safety communication. The pearl covers safety screening before starting a JAK inhibitor.
Early peripheral spondyloarthritis: a third drug-free at ten years
Early peripheral spondyloarthritis often settles long term; a third were drug-free at ten years, almost half of those without psoriasis.
FDA records a supplement to the baricitinib licence
An FDA supplement to the baricitinib licence was recorded; its content is not stated, and prescribing is unchanged.
Bimekizumab in axial spondyloarthritis: less MRI inflammation, little radiographic change at two years
Bimekizumab reduced MRI inflammation and showed little radiographic progression over two years in axial spondyloarthritis, without a long-term comparator.
Screen before a JAK inhibitor, not after
Before a JAK inhibitor, document cardiovascular, cancer and clot risk and screen for TB and hepatitis B.
Tapering biologics in stable rheumatoid arthritis kept control in most patients
In rheumatoid arthritis with sustained low disease activity, a structured taper of biologics or JAK inhibitors is reasonable with close monitoring and a step-up plan.
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