Rituximab

Patients with autoimmune rheumatic diseases are at higher risk of vaccine-preventable infections, yet coverage for influenza and pneumococcal vaccines is still poor. This Nature Reviews Rheumatology article argues that commonly used vaccines are safe, that flares and new autoimmune disease after vaccination are uncommon, and that real-world data show protection even when antibody responses are blunted. The main problems are timing around methotrexate, rituximab and obinutuzumab, CAR T cells and bispecific T cell engagers, the avoidance of live vaccines, and the hesitancy that keeps uptake low.

The first evidence-based guidelines for adult-onset IgA vasculitis, from the European Vasculitis Society, give 14 recommendation statements and four overarching principles covering diagnosis, work-up, organ-specific treatment and follow-up. Adult disease is rarer than in children but more severe and persistent, and kidney involvement decides the long-term outcome. The strongest evidence behind any statement is level 2b and the highest grade is B, so most of the advice rests on observational data and expert consensus.

The 2026 Sjögren’s Foundation clinical practice guideline for peripheral nervous system involvement in Sjögren’s disease — an aligned neuro-rheumatology nomenclature, 31 evaluation good-practice statements, and 20 treatment recommendations (6 strong), covering mononeuropathies, polyneuropathies, and autonomic disease. Evidence is very low certainty, so most guidance rests on expert consensus.