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.
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.
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.
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.
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.
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.
The VALOR phase 3 trial shows that brepocitinib 30 mg daily — a selective TYK2–JAK1 inhibitor — significantly improves composite disease activity, skin involvement, and muscle strength while enabling steroid discontinuation in adults with treatment-refractory dermatomyositis, marking the first successful phase 3 RCT of an oral targeted agent in this disease.
A contemporary NEJM review of idiopathic inflammatory myopathies — the five-subtype framework (IBM, IMNM, antisynthetase syndrome, overlap, dermatomyositis), the autoantibody revolution that now anchors classification, and the shift toward subtype-specific therapy with biologics, JAK/TYK2 inhibitors, and CAR-T.
In a 28,781-patient EMR phenome-wide study, a high ANA titer (≥1:640) without autoimmune disease was strongly enriched for non-AI liver disease (NAFLD/NASH, alcohol-related) and metabolic comorbidity — broadening the differential for an unexplained high-titer ANA beyond the usual autoimmune workup.
CD19 CAR-T cellular therapy delivers drug-free remission in 80–85% of refractory SLE patients in early-phase trials, with similar signals in IIM and SSc — the first credible attempt at true immunological reset in autoimmune rheumatic disease.