30-Second Takeaway
- NGF inhibition and intra-articular MSCs improve OA symptoms but raise important structural safety and selection questions.
- SSc, AAV, and PsA cohorts refine cardiopulmonary and arrhythmic risk stratification beyond traditional factors alone.
- Real-world RA and CSA data support JAK inhibitor equivalence and MRI-based targeting of very-early methotrexate.
Week ending January 24, 2026
Targeted therapies, risk stratification, and early intervention across rheumatic diseases
Fasinumab improves OA pain and function but increases rapid-progressive arthropathy and joint replacement
In knee or hip OA, fasinumab 1 mg every 4 weeks produced greater 16-week WOMAC pain and function improvement than placebo and naproxen. Fasinumab 1 mg every 4 weeks reduced WOMAC pain to -2.90 versus -2.32 with placebo and -2.61 with naproxen. Adjudicated arthropathies occurred more often with fasinumab every 8 and 4 weeks (7.2% and 9.7%) than placebo (1.1%) or naproxen (2.6%). Joint replacement rates were also higher with fasinumab (5.6%–6.4%) versus placebo and naproxen (3.1%–3.4%), largely due to rapid-progressive OA type 1.
New SSc-ILD emerges for a decade after a negative baseline HRCT
Among 5331 SSc patients with negative baseline HRCT, new ILD occurred at 3.83 cases per 100 person-years. Incident ILD continued to be detected for up to 10 years, so a single negative HRCT does not exclude future risk. NYHA class ≥2, muscle weakness, high inflammatory markers, and SSc-specific autoantibodies predicted new ILD, whereas disease duration did not. Incident ILD carried almost double the mortality risk versus ILD-negative patients, despite lower progression risk than prevalent ILD at baseline.
MPO-ANCA AAV shows higher composite MACE and mortality than PR3-ANCA disease
In 402 AAV patients, MACE incidence was higher with MPO-ANCA than PR3-ANCA (33.1 vs 21.4 per 1000 patient-years; p=0.036). MACE, defined as myocardial infarction, stroke, or all-cause death, occurred earlier after diagnosis in MPO-ANCA disease. Adjusted Cox models showed a trend toward more MACE with MPO-ANCA (HR 1.62; 95% CI 0.98–2.66; p=0.06). PR3-ANCA was associated with lower stroke risk (HR 0.61; 95% CI 0.37–0.99) without a significant myocardial infarction difference.
Obinutuzumab and BAFF/APRIL blockade modestly increase overall infection risk in SLE
Across 26 RCTs including 16,338 SLE patients, B-cell–targeted therapy overall did not significantly increase infections compared with controls. Obinutuzumab increased total infections versus placebo (RR 1.18; 95% CrI 1.03–1.36), rituximab (RR 1.22; 95% CrI 1.04–1.43), and epratuzumab (RR 1.24; 95% CrI 1.06–1.45). BAFF/APRIL-targeting agents had higher infection risk than the anti-CD22 agent epratuzumab (RR 1.16; 95% CrI 1.01–1.34). Low-dose regimens showed a small infection increase versus placebo (RR 1.05; 95% CrI 1.00–1.10), without increased serious infections.
References
Numbered in order of appearance. Click any reference to view details.
Additional Reads
Optional additional studies from this edition.