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Rheumatology
11th Mar, 2026
The Lancet
In this at-risk population, 1-year treatment with abatacept delayed progression to rheumatoid arthritis for up to 4 years. Those at highest risk of progression have a broad autoantibody profile but are more responsive to abatacept treatment.
A December, 2025 report from England's National Audit Office (NAO) has exposed substantial deficits in care for people with frailty in the country. General practitioners (GPs) within England's National Health Service (NHS) are not providing the level of support needed by people living with frailty, says the report, which outlines a suite of recommendations aimed at a more consistent, community-focused and patient-centric approach to frailty in England.
Edoardo Cipolletta and colleagues assessed whether attaining a target serum urate concentration lower than 6 mg/dL with urate-lowering treatment could reduce cardiovascular risk in patients with newly diagnosed gout using an emulated target trial framework and primary care data from the UK Clinical Practice Research Datalink Aurum linked to hospitalisation and mortality records. 109 504 newly diagnosed patients were prescribed urate-lowering therapy. Patients who attained a serum urate concentration lower than 6 mg/dL within 12 months of a first urate-lowering therapy prescription (treat-to-target group) had a lower risk of major adverse cardiovascular events within 5 years (primary outcome; weighted hazard ratio [HR] 0·91 [95% CI 0·89–0·92]) compared with those who did not.
Andersen J, Talarico R, Marinello D, et al. Patient partnership model in rare and complex rheumatological conditions: research and beyond in European Reference Network ReCONNET. Lancet Rheumatol 2026; published online Jan 21. https://doi.org/10.1016/S2665-9913(25)00284-X—In this Personal View, the spelling of the author Rosaria Talarico's name was incorrect. This correction has been made to the online version as of Feb 23, 2026.
We read with great interest the population-based study by Leher Gumber and colleagues examining trends in mortality due to haemophagocytic lymphohistiocytosis.1 This analysis provides valuable epidemiological insight into a rare but lethal condition and highlights important temporal and geographical variations.
We thank Suhai Qian and colleagues for their interest in our investigation of rheumatoid arthritis-associated interstitial lung disease (ILD) risk factors in patients with early rheumatoid arthritis.1 We agree that additional, large prospective studies are needed in this critical rheumatoid arthritis period. Qian and colleagues suggest that findings from our sensitivity analyses cast doubt on the observed association between rheumatoid arthritis disease activity and rheumatoid arthritis-associated ILD, a previously identified ILD risk factor in established rheumatoid arthritis.
We read with interest the Article by Gregory C McDermott and colleagues, which reports an association between high disease activity and the prevalence of rheumatoid arthritis-associated interstitial lung disease (ILD) in patients with early rheumatoid arthritis.1 Their work contributes valuable data to the urgent clinical need for effective screening strategies for rheumatoid arthritis-associated ILD.
The publication of the 2023 American College of Rheumatology and European Alliance of Associations for Rheumatology antiphospholipid syndrome (APS) classification criteria marks a substantial advancement in the disease's classification and evaluative framework.1 Departing from the 2006 Sapporo criteria2 that used a broad definition of thrombotic events, the updated criteria explicitly differentiate between arterial and venous thrombosis. Moreover, they place greater emphasis on the role of traditional cardiovascular risk factors in modulating thrombotic risk, moving beyond a sole focus on the prothrombotic effects of antiphospholipid antibodies.
In The Lancet Rheumatology, Chiara Tani and colleagues1 report an interim analysis of a large real-world observational study of patients with systemic lupus erythematosus (SLE) treated with anifrolumab. Anifrolumab is a monoclonal antibody that blocks the common receptor of all type I interferons—ie, all interferons but interferon-γ (type II interferon) and the λ-interferons (type III interferons). Anifrolumab was approved for SLE treatment in 2021 by both the US Food and Drug Administration and the European Medicines Agency.
The initial APIPPRA randomised controlled trial followed anti-citrullinated protein antibody (ACPA) positive participants with arthralgias, without synovitis at study onset.1 Participants were randomly assigned to 125 mg abatacept subcutaneously weekly (n=110) or placebo (n=103) for 52 weeks, which was then discontinued. Patients were followed for a second year. The primary outcome in APIPPRA was the time to development of clinical synovitis in at least three joints or rheumatoid arthritis according to the American College of Rheumatology–European Alliance of Associations for Rheumatology (ACR–EULAR) criteria.
Fibromyalgia is one of the most challenging chronic pain conditions to treat. Historically stigmatised and its existence still doubted by some physicians, patients often experience substantial diagnostic delays. Insufficient understanding of disease mechanisms and patient heterogeneity means that no drug treatment provides substantial benefit in fibromyalgia, prompting the search for new interventions. Research into disease mechanisms forges onwards, with new discoveries providing hope for improved patient outcomes.
Neurology
Myasthenia gravis, neuromyelitis optica spectrum disorder (NMOSD), and myelin oligodendrocyte glycoprotein antibody–associated disease (MOGAD) are antibody-mediated neuroimmune disorders that frequently affect women in their reproductive years and require careful treatment planning around pregnancy. Disease exacerbations (for myasthenia gravis) and attacks (for NMOSD and MOGAD) can occur during pregnancy, are common postpartum, and can cause preventable, long-term maternal disability. Many drug labels are conservative or recommend unnecessary prolonged washouts or avoidance of breastfeeding, creating uncertainty for physicians and patients.
An estimated 60% of patients with Alzheimer's disease develop epilepsy or subclinical epileptiform activity over the course of the disease. New-onset seizures in cognitively healthy adults also increase the risk of developing dementia. Epileptic activity, including both seizures and subclinical epileptiform discharges, can hasten the onset of Alzheimer's disease and accelerate cognitive decline. Studies are investigating whether antiseizure medications could improve cognitive outcomes, particularly in patients with Alzheimer's disease with epileptic activity.
Migraine imposes a heavy burden on patients and societies. Preventive treatments aimed at reducing the occurrence of migraine attacks and their intensity have been largely underused, leaving a multitude of people with migraine to rely exclusively on acute treatments, which, when used in excess, might even worsen the clinical situation. Large, randomised trials have established the tolerability and efficacy of calcitonin gene-related peptide (CGRP)-targeting drugs, a new class of migraine-specific treatment.
Antibody therapies can remove amyloid plaques from the brain and slow cognitive decline in people with Alzheimer's disease who are mildly impaired. These drugs are now being evaluated in participants who are cognitively unimpaired but positive for a biomarker of Alzheimer's disease for their safety, tolerability, disease-modifying and cognitive preserving effects, and ability to avert the onset of cognitive impairment. If these studies are successful, and the drugs get regulatory approval, they could accelerate the evaluation and approval of related Alzheimer's disease-modifying treatments in people who are unimpaired with or without a biomarker of the disease.
What's New: Drugs
5th Apr, 2026
FDA
Center,
Research
3rd Apr, 2026
2nd Apr, 2026
Office,
Investigations
What's New: Vaccines, Blood and Biologics
