30-Second Takeaway
- RZV appears safe but poorly immunogenic in abatacept-treated RA, raising questions about vaccine timing and holds.
- Autoantibody profile plus arthralgia status meaningfully refines short-term progression risk to classifiable RA.
- IL-23 blockade with guselkumab did not improve glucocorticoid-free remission in GCA despite acceptable safety.
- Tight inflammatory control in axSpA may slow subclinical atherosclerosis progression independent of arterial stiffness indices.
- Simple clinical, imaging, and serum markers can sharpen prognostication in myositis-, SSc-, and pSS-associated ILD and cardiac disease.
Week ending February 14, 2026
Targeted risk stratification and organ protection in inflammatory rheumatic disease
Recombinant zoster vaccine is safe but weakly immunogenic in abatacept-treated RA
In this double-blind RCT, 70 RA patients on abatacept received two doses of recombinant zoster vaccine (RZV) or placebo 8 weeks apart. Among RZV recipients, only 42.3% achieved a ≥4-fold rise in anti-gE IgG, and cellular responses occurred in just 10.2%. Disease activity and flare rates were similar between vaccine and placebo groups, with flares in 68% and 64% of patients, respectively. Serious adverse events were infrequent and comparable, suggesting RZV is clinically safe but has attenuated immunogenicity under continuous abatacept. These data support vaccinating abatacept-treated RA patients while highlighting the need to study temporary abatacept interruption to enhance responses.
Autoantibody combinations and arthralgia strongly stratify short-term RA progression risk
This systematic review and meta-analysis included 26 studies evaluating autoantibodies as predictors of rheumatoid arthritis (RA). Presence of RA-related autoantibodies conferred roughly a 3.1–19.3-fold increased risk of future RA versus autoantibody-negative individuals. Anti-CCP2 or CCP3 positivity combined with arthralgia and IgM rheumatoid factor yielded the highest 12‑month RA incidence, at 35.2%. Risk of progression among arthralgia patients was greatest within the first 24 months and changed over time thereafter. These findings support using detailed autoantibody profiles plus symptom status for counseling, follow-up intensity, and potential preventive trial referral.
Guselkumab fails to improve glucocorticoid-free remission in giant cell arteritis
This phase 2, double-blind trial randomised 53 patients with new-onset or relapsing giant cell arteritis to guselkumab or placebo plus standardized glucocorticoid taper. Glucocorticoid-free remission at week 28 occurred in 40% with guselkumab versus 33% with placebo (P = 0.64). Rates and timing of GCA flares through week 28 were similar between groups, and median time to first flare did not differ. By week 60, nearly all patients in both arms experienced adverse events, dominated by GCA worsening and common infections. Results do not support IL‑23 p19 inhibition with guselkumab as an effective add-on to glucocorticoids for GCA remission maintenance.
References
Numbered in order of appearance. Click any reference to view details.
Additional Reads
Optional additional studies from this edition.