Reviews

A 2026 review of steroid-sparing therapy across the GCA–PMR spectrum: glucocorticoids still induce remission but drive substantial cumulative toxicity, so the field has pivoted to IL-6 receptor inhibition (tocilizumab in GCA, sarilumab in PMR) and JAK inhibition (upadacitinib now approved for GCA) — none of which reliably restores treatment-free remission, against a backdrop of weak monitoring tools and GCA-specific vascular-damage risk.

A 2026 practical review of morphea (localized scleroderma) across age groups — an organ-sparing autoimmune skin disease distinct from systemic sclerosis. Covers classification, the high-stakes subtypes (pansclerotic, facial linear), activity-vs-damage assessment, and management anchored on long-course methotrexate plus a steroid bridge, where depth and site dictate aggressiveness.

A 2026 practical distillation of the 2023 ACR/CHEST guidelines on SSc-ILD — the single leading cause of death in systemic sclerosis. Covers proper screening (full PFTs + non-contrast HRCT), monitoring schedules, the first-line drug evidence (mycophenolate, tocilizumab, rituximab, nintedanib), and the strong recommendation against glucocorticoids.

A 2026 review of renal involvement in systemic sclerosis — a spectrum well beyond scleroderma renal crisis (SRC), covering the diagnostic constellation, five converging mechanisms, risk factors (anti-RNA polymerase III, early dcSSc, steroids), and the management essentials: immediate ACE inhibition, never stopped for a rising creatinine.

A 2026 review of pathogenesis-directed SLE therapeutics anchored to the 2025 ACR SLE and 2024 ACR lupus nephritis guidelines — the FDA-approved and off-label drugs by mechanism, indication and monitoring, plus the metabolic/mitochondrial, IL-1, cardiometabolic and non-pharmacological strategies, mapped by organ manifestation.

A 2026 review of the psoriatic arthritis pipeline, organised around two vectors — greater precision (dual IL-17A/F blockade, engineered molecular formats, selective oral TYK2 inhibition, oral IL-23R antagonism) and moving earlier to intercept the psoriasis-to-PsA transition — alongside metabolic and dual-targeted strategies.

A 2026 pictorial review of the conditions that mimic sacroiliitis on SIJ MRI — bone marrow oedema is sensitive but the least specific sign, and overcalling it risks committing patients to lifelong biologic therapy. Erosion, lesion combinations, topographic location, semi-axial imaging and clinical context are the defences against false-positive reads.

A 2026 narrative review of fertility, pregnancy and lactation in SLE — the bidirectional disease–pregnancy relationship, the immunobiology of placental injury, and contemporary peri-conception, pregnancy and lactation care anchored to BSR, EULAR and ACR guidance, including a drug-by-drug safety framework.

A 2026 clinical-pharmacology perspective arguing that biologic treatment failure in obesity is partly a pharmacokinetic problem: weight-driven clearance leaves many patients on fixed-dose subcutaneous biologics systematically underdosed, and dosing strategy should be matched to the weight–clearance relationship.

A 2026 narrative review of the IL-5/eosinophil axis in eosinophilic granulomatosis with polyangiitis (EGPA) and the two approved IL-5 pathway inhibitors — mepolizumab and benralizumab — covering their mechanisms, MIRRA and MANDARA trial evidence, real-world data, guideline positioning, and the remaining unmet needs.