Day 4 Recap EULAR 2026

A landmark study on baricitinib in early polymyalgia rheumatica (PMR) shows a dramatic 65% glucocorticoid-free remission rate at 16 weeks—nearly four times higher than placebo—suggesting JAK inhibitors could revolutionize steroid-sparing therapy. Yet, the data also reveals a concerning trend: nearly 80% of patients relapsed after stopping treatment, raising urgent questions about long-term disease control. This isn't just about efficacy—it's about redefining what 'remission' means in chronic inflammatory diseases. The episode also unpacks the growing tension in rheumatology between breakthrough therapies and real-world constraints: off-the-shelf CAR-NK cells show early promise but lack controls, while a massive post-approval study confirms JAK inhibitors carry a significant VTE risk, challenging the safety assumptions of a widely used class. Most provocatively, a single poster reveals that 22% of patients with axial spondyloarthritis maintained drug-free remission after stopping upadacitinib—suggesting some patients may achieve lasting disease control with a 'big hammer' early intervention, a phenomenon that could reshape treatment paradigms. The panel debates whether these advances are truly transformative or just more complexity in an already crowded field. The episode ends with a sobering reminder: despite decades of progress, RA mortality remains stubbornly high, and we may have become complacent.