MRI Sacroiliitis Mimics

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.

June 18, 2026 · 6 min

Pregnancy and Lactation in SLE

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.

June 14, 2026 · 8 min
Interactive case

A 7-Year-Old Girl with a Limp and Leg Pain

Work through a previously healthy 7-year-old girl with six weeks of progressive bilateral leg pain and a limp — one finding at a time. Twelve multiple-choice checkpoints test how you reshape a broad differential as imaging, labs and, crucially, a dietary history land on a diagnosis that is easy to miss.

June 12, 2026 · 15 min

Dosing Biologics in Obesity

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.

June 10, 2026 · 5 min

IL-5 Pathway Inhibitors in EGPA

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.

June 9, 2026 · 6 min

EULAR 2025: Behçet's Syndrome

The 2025 EULAR update to the Behçet’s syndrome recommendations moves monoclonal TNF-alpha inhibitors (especially infliximab) to first-line induction and maintenance for eye, vascular and parenchymal-CNS disease, displacing cyclophosphamide and the azathioprine-first strategy, and broadens treatment targets to angiographic and endoscopic remission.

June 6, 2026 · 9 min

EULAR 2025: Rheumatoid Arthritis Management

The 2025 EULAR update streamlines RA management to 5 overarching principles and 9 recommendations, abandons post-methotrexate prognostic risk stratification, and keeps JAK inhibitors co-equal with biologics after individual risk assessment.

June 5, 2026 · 8 min

Zoster Vaccine Under Immunosuppression

A 2026 RMD Open narrative review of recombinant zoster vaccine (RZV) in inflammatory rheumatic disease — robust efficacy across IRD cohorts (~95% reduction in HZ recurrence; 54–70% effectiveness in SLE), no meaningful short-term flare signal in RCT data, and a practical drug-by-drug timing framework spanning csDMARDs, biologics, JAK inhibitors and B-cell depletion.

May 25, 2026 · 11 min

TELIGAN: Telitacicept in IgA Nephropathy

In the TELIGAN phase 3 trial, telitacicept — a dual BAFF/APRIL inhibitor already approved for SLE — reduced 24-hour proteinuria by 55% relative to placebo at 39 weeks in adults with IgA nephropathy, with eGFR remaining stable on treatment while declining on placebo.

May 24, 2026 · 6 min

B Cell Pathways in Lupus: GC vs Extrafollicular

This 2026 Nature Reviews Rheumatology paper reframes SLE autoantibody production by contrasting the germinal-centre and extrafollicular B cell pathways — their distinct kinetics, affinity profiles, T cell dependence, and therapeutic vulnerabilities — showing that the inflammatory niche, not intrinsic autoreactivity, determines pathogenic B cell fate.

May 21, 2026 · 8 min