Joint Ventures: EULAR 2026 Congress Preview

In this episode of Joint Ventures, hosts Jack Arnold, MBBS, PhD, an academic clinical lecturer in rheumatology at the University of Leeds, and Rihards Buss, MD, a consultant rheumatologist at Freeman Hospital, Newcastle, preview their unofficial countdown of the sessions, themes, and abstracts they are most excited about heading into the 2026 European Alliance of Associations for Rheumatology (EULAR) Annual Meeting in London, June 3–6.

Arnold and Buss each selected 4 themes that they believe offer the highest yield for clinicians working across the rheumatology spectrum. With BE BOLD and SUNSTAR among the headline data presentations and sessions on CAR-T failure and upstream innate immunity rounding out the program, EULAR 2026 looks set to be one of the more consequential meetings in recent years.

Watch their wide-ranging preview spanning metabolic immunology, mitochondrial biology, artificial intelligence, axial imaging, fatigue in connective tissue disease, personalized medicine, and the growing case for head-to-head superiority trials, listed below.

1. Obesity, Weight Management, and Psoriatic Arthritis Session: Basic and Clinical Abstract Session on Unconventional Targets in Psoriatic Arthritis

Presentation: Wednesday, June 3

Chairs:
Prof. Dennis McGonagle, PhD, and Josefina Marin, MD

Background Info: The intersection of obesity and inflammatory arthritis has been a recurring theme in recent Joint Ventures episodes, and EULAR 2026 brings the first major conference presentation of full TOGETHER-PsA trial data. The phase 3b, randomised, open-label study compared ixekizumab plus tirzepatide against ixekizumab alone in 271 adults with active PsA and obesity or overweight, to be presented by Laura Coates.¹ The primary composite endpoint — ACR50 response with at least 10% weight reduction — was met by 31.7% of the combination arm versus 0.8% on ixekizumab alone, and a key secondary endpoint demonstrated superior ACR50 independent of weight loss (33.5% vs 20.4%), suggesting an effect on disease activity beyond metabolic benefit. The session also features data from the DPSA trial, a randomised controlled trial of structured dietary intervention in PsA, and a further abstract presenting real-world evidence that GLP-1 receptor agonist use is associated with lower disease activity and reduced pain in PsA independently of weight loss — a mechanistic question Arnold and Buss have examined in depth in previous episodes.

2. Personalized Medicine and Biomarkers in RMDs Sessions:

Presentations:

Tailor-Made Treatment: The Future of Personalised and Holistic RMD Management (Thursday, June 4), Chairs Peter Böhm and Ana Vieira

Basic and Clinical Abstract Session on Biomarkers in RMDs (Wednesday, June 3), Chairs Prof. Diane van der Woude, MD, PhD, and Prof. Costantino Pitzalis, MD, PhD

Background Info: Two sessions are highlighted under this theme. The Thursday session centers on translating the principle of personalized care into everyday rheumatology practice — embedding patient values, comorbidities, and circumstances into treatment decisions rather than applying a uniform algorithmic approach. The Wednesday biomarker session operationalises this, with a particular focus on abstract OP048, which examines ex vivo immune-derived molecular signatures as predictors of treatment response to JAK inhibitors versus TNF inhibitors in rheumatoid arthritis — directly addressing the clinical challenge of choosing between effective therapies for the individual patient. Other abstracts will address proteomic biomarkers in ANCA-associated vasculitis, flare prediction in RA, and prognostic markers in connective tissue disease–associated interstitial lung disease.

3. Fatigue and Quality of Life in Connective Tissue Disease Session: Non-pharmacological interventions to improve quality of life in patients with connective tissue diseases

Presentation: Wednesday, June 3

Chairs: Prof. Tanja Stamm, PhD, and Ilaria Galetti

Background Info: Fatigue is 1 of rheumatology's most common and least well-addressed complaints, affecting an estimated 40% or more of patients with connective tissue disease and frequently persisting despite adequate disease activity control. Lectures in this session will cover a structured differential diagnostic approach to pathological fatigue, the evidence for lifestyle interventions, and the limits of immunological disease control in addressing symptom burden. In lupus and primary Sjögren's disease specifically, fatigue does not correlate reliably with standard inflammatory markers, is often rated by patients as more debilitating than joint involvement, and is further complicated by overlap with fibromyalgia-like features — all of which make it both clinically pressing and methodologically difficult to study. The session is intended to be broadly relevant regardless of subspecialty.

4. Mitochondrial DNA and Interferon: Upstream Drivers of Autoimmunity Session: Mitochondria: A New Culprit in Autoimmune Disease

Presentation: Wednesday, June 3

Chair: Professor Edward Vital, MD

Background Info: This session explores a mechanistic framework that reframes the initiating events of autoimmunity upstream of adaptive immune activation. Mitochondrial DNA, which retains ancient bacterial characteristics and is not normally detected as foreign, can be released into the cytoplasm or extracellular environment when mitochondria become porous under physiological stress — including cell injury, oxidative stress, NETosis, apoptosis, or defective autophagy. The innate immune system responds to this leaked mitochondrial material as it would to a viral signal, activating the cGAS-STING pathway, TLR9, and the inflammasome, which in turn drives type I interferon production.² This pathway has long been implicated in lupus and is increasingly recognised across the rheumatic disease spectrum. Speakers include Virginia Saqué on the origin of anti-double-stranded DNA antibodies, Eric Boilard, Rami Bechara, and Serena Cala Peralta, with an additional poster examining mitochondrial alterations in Still's disease.

5. Artificial Intelligence and Pattern Recognition in Rheumatology Sessions:

Presentations: Wednesday, June 3

Clinical Case Solving With and Without AI; AI in Research; Chair Jeffrey Curtis, MD

Big Data and AI Integrity in Rheumatology Publishing; Chairs S. Louis Bridges, MD, PhD, and Prof. Josef S. Smolen, MD

Background Info: Multiple sessions at EULAR 2026 address the expanding role of AI across clinical practice, research, and administration. An interactive case-solving session will test clinicians on complex cases with and without AI support; a dedicated session chaired by Jeffrey Curtis will address AI in research methodology; and sessions on publishing integrity will examine ghost references and undisclosed AI involvement in academic literature. Notable individual presentations include poster 517 on AI-based recognition of facial features of systemic sclerosis, with potential applicability across resource settings, and an oral abstract on STEM microscopy with machine learning for antinuclear antibody pattern identification. The clinical relevance for rheumatology is framed around a tiered model of AI autonomy — from low-risk administrative tasks through to clinician-supervised functions such as letter drafting — as articulated in a recent viewpoint in Lancet Rheumatology on agentic AI in the specialty.³

6. Axial Imaging in Axial Spondyloarthritis Session: Mind the Spine — Imaging in Spondyloarthritis

Presentation: Wednesday, June 3

Chairs: Olivier Fogel, MD, PhD and Wilson Bautista-Molano, MD, PhD

Background Info: Eight oral abstracts will address structural lesion identification and progression in the spine and sacroiliac joints, representing a shift in axSpA research from inflammation detection toward structural damage quantification. Two abstracts will present 10-year follow-up data — one examining the impact of sex on spinal radiographic progression, the other tracking structural change in sacroiliac joints on MRI over a decade. Abstract 0104 is singled out for its direct comparison of MRI-based synthetic CT — a deep learning technique generating CT-like images from MRI data — against low-dose CT for detecting new bone formation in axSpA. The session reflects growing recognition that structural progression can continue even when inflammation appears well controlled, and that standard MRI findings of bone marrow oedema do not reliably predict or exclude ongoing structural damage. A complementary practical imaging skills workshop takes place on Friday, June 6.

7. Head-to-Head Superiority Trials in RA and PsA Sessions:

Presentations:

BE BOLD Late-Breaking Abstract (LB0001, Saturday, June 6, 12:00 PM) Presenter: Joseph Merola, MD

SUNSTAR (OP0205, Thursday, June 5) Presenter: Tristan Pascart, MD, PHD

Background Info: Only 3 oral presentations at EULAR 2026 include direct head-to-head comparisons — a number that, given the breadth of available therapies in RA and PsA, Arnold and Buss argue should be higher. BE BOLD is the first head-to-head study comparing an IL-17A/F inhibitor (bimekizumab) directly against an IL-23 inhibitor (risankizumab) in active PsA.⁴ The trial met its primary endpoint of ACR50 at week 16, with 49.1% of bimekizumab-treated patients achieving the response versus 38.4% with risankizumab (P = .0078). The mechanistic rationale centres on IL-17F production from IL-23-independent sources, which IL-23 blockade cannot suppress. SUNSTAR (OP0205) compares subcutaneous tocilizumab versus abatacept in RA patients with inadequate response to one or two prior b/tsDMARDs⁵ — a common clinical decision point for which no prior randomised head-to-head evidence has existed. Both trials represent a shift away from historical comparisons against TNF inhibitors toward direct comparison of two non-TNF mechanisms.

8. CAR-T and CAR-NK Therapies: Efficacy, Limits, and What Comes Next Sessions:

Presentations: Sunday, June 6

I Failed CAR-T — What's Next?
Russka Shumnalieva, MD, PhD, MPH and Chris Wincup, MBBS

CAR-NK Therapy Sessions

Poster Tour: Another One Bites the CAR-T Chairs: Samuel Bitoun, MD, PhD, and Elena Pontarini, PhD

Background Info: Arnold identifies this as his headline pick for EULAR 2026, citing the session on post–CAR-T failure as a marker of how the field has matured since last year's meeting. CD19 and BCMA-directed CAR-T therapies have produced landmark responses across multiple autoimmune rheumatic diseases, but relapse has been observed, and the practical question of what to do when a patient fails — or fails to sustain response to — CAR-T therapy is now being asked in a way it was not previously. Separately, growing interest in CAR-NK (natural killer cell) therapy is noted for its potential advantages over autologous CAR-T: reduced cytokine release syndrome, fewer severe inflammatory complications, and the ability to manufacture allogeneic off-the-shelf products for multiple patients. The trade-off is that CAR-T remains more potent and persistent — but with greater manufacturing complexity and toxicity. The session on post–CAR-T management, and the broader discussion of where CAR-NK fits in the therapeutic sequence, are expected to be among the most attended of the congress.

Arnold’s disclosures include Alumis, Roche, and Novartis. Buss has no relevant disclosures to report.

References

1. Merola JF, Mease P, Kivitz A, et al. Ixekizumab with tirzepatide achieved greater disease control than ixekizumab alone in adults with psoriatic arthritis and overweight or obesity: results from a randomized clinical trial. Arthritis Rheumatol. Published online March 28, 2026. doi:10.1002/art.70134

2. Venerito V, Lopalco G, Leccese P, Iannone F. The rheumatologist in the age of artificial intelligence. Lancet Rheumatol. 2023;5(12):e716-e724. doi:10.1016/S2665-9913(23)00233-3

3. McInnes I, et al. Bimekizumab efficacy and safety versus risankizumab in patients with active psoriatic arthritis: 16-week results from a head-to-head, multicentre, randomised, phase 3b study (BE BOLD). Presented at: EULAR Annual Meeting 2026; June 6, 2026; London, UK. Abstract LB0001.

4. Fautrel B, et al. Subcutaneous tocilizumab versus abatacept in rheumatoid arthritis with inadequate response to one or two prior b/tsDMARDs: results of the SUNSTAR head-to-head, multicentre, open-label, randomised superiority trial. Presented at: EULAR Annual Meeting 2026; June 5, 2026; London, UK. Abstract OP0205.