A large Canadian early arthritis cohort study found that more than half (52%) of patients with newly diagnosed rheumatoid arthritis (RA) reported experiencing major stressful life events in the year before diagnosis. These patients presented with significantly worse disability, depression, pain, fatigue, sleep disturbance, and overall well-being at the time of diagnosis compared with those without recent stressors. Importantly, the negative impact on patient-reported outcomes persisted at 1 year, even though objective measures of disease activity (SDAI) improved similarly across groups. The findings suggest that major life stressors may independently influence RA symptom burden and functional status beyond joint inflammation alone, highlighting the importance of addressing psychosocial factors early in the disease course.

A large international cross-sectional study of 1,003 patients with antiphospholipid syndrome (APS) from 17 centres across 11 countries revealed a high burden of traditional cardiovascular risk factors and persistently poor control of these risk factors in real-world practice. Hypertension, hyperlipidaemia, obesity, and smoking were common, yet target attainment for blood pressure, lipids, BMI, and smoking cessation remained suboptimal across the cohort. Patients with primary APS showed worse achievement of cardiovascular risk factor targets compared with those with SLE-related APS, particularly for blood pressure control and smoking cessation, despite similar or lower prevalence of some risk factors. Older age and a history of arterial thrombosis were associated with even lower likelihood of reaching multiple risk factor goals. These findings underscore the urgent need for greater awareness and more aggressive cardiovascular risk management in APS, especially in patients with primary disease where cardiovascular risk is frequently under-recognised.

Belimumab, the first biologic approved for systemic lupus erythematosus (SLE) in 2011, has well-documented benefits including reduced disease activity, lower glucocorticoid requirements, fewer flares, and higher rates of low disease activity and remission. While these overall effects are established, real-world clinical practice often focuses on controlling specific organ manifestations. Lupus arthritis, one of the most frequent and burdensome features of SLE, causes significant pain, functional impairment, and risk of permanent joint damage. This background sets the stage for evaluating how effectively belimumab addresses articular disease in everyday SLE care.

In a preliminary analysis of eight patients with refractory systemic lupus erythematosus (SLE), CD19 CAR T cell therapy led to striking improvements in quality of life alongside deep clinical remission. One year after treatment, physical health scores rose dramatically from 22% to 76%, while mental health scores improved from 25% to 63%, bringing overall quality of life to levels comparable with healthy individuals. At the same time, annual direct healthcare costs fell by more than 90%, decreasing from approximately €29,700 to €3,100 per patient. These early findings suggest that CAR T cell therapy not only offers sustained drug-free remission but also delivers meaningful gains in daily functioning and substantial reductions in the socioeconomic burden of active SLE.

In real-world practice, patients with refractory Behçet’s disease (BD) who fail or cannot tolerate TNF-α inhibitors may benefit from targeted biologics directed against other inflammatory pathways. Data from the International AIDA Network Registry on 65 such patients showed that anakinra was the most commonly used agent and provided partial or complete responses in a majority of those with musculoskeletal and ocular involvement. Canakinumab demonstrated effectiveness even in some anakinra non-responders, while tocilizumab performed particularly well in ocular and neurological disease. IL-17 inhibitors (secukinumab and ixekizumab) were useful for mucocutaneous-articular phenotypes, especially when axial spondyloarthritis was present, and both ustekinumab and rituximab showed benefit in selected refractory cases. No new major safety signals were observed. These findings support individualized use of IL-1, IL-6, IL-17, and IL-12/23 pathway inhibitors as valuable alternatives in difficult-to-treat Behçet’s disease.