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More from: Biologic Wars: Rheumatology Debate Series
The ORAL Surveillance JAK Inhibitor Controversy
ORAL Surveillance showed tofacitinib carried higher cardiovascular and malignancy risk than anti-TNF in high-risk RA patients - triggering a class-wide boxed warning. But was the signal overgeneralised? Sarah Mitchell and James Carter unpack the data, the controversy, and how to make the JAKi-vs-biologic decision in 2026.
Chasing Absolute Zero In Rheumatoid Arthritis
Treat-to-target transformed RA outcomes - not through new drugs but through rigorous measurement and escalation discipline. Sarah Mitchell and James Carter cover the evidence base, the disease activity tools, the window of opportunity in early RA, and when tapering biologics in sustained remission is safe.
Why Cheaper Humira Alternatives Face Resistance
Adalimumab biosimilars cut NHS spend by over 50% while treating more patients. NOR-SWITCH and subsequent trials consistently show switching from reference biologic to biosimilar is safe. Sarah Mitchell and James Carter explain the regulatory science, the nocebo effect, and how the biosimilar dividend is being reinvested into newer therapies.
- PsA biologic hierarchy differs from RA: IL-17 inhibitors (secukinumab, ixekizumab) and IL-23 inhibitors (guselkumab, risankizumab) are first-line for skin-dominant and enthesitis-predominant disease
- Avoid IL-17 inhibitors in PsA with IBD; prefer anti-TNF monoclonals or IL-23 inhibitors in that overlap
- In axSpA: IL-17 inhibitors show efficacy and potential structural modification - PREVENT showed secukinumab reduces syndesmophyte progression
- For uveitis: monoclonal anti-TNF (adalimumab, infliximab) preferred; etanercept and IL-17 inhibitors do not protect against uveitis
POD-2026-019 - 06/26
Matt Aldrich is a medical science communicator based in Boston. With a background in biomedical research and health journalism, he specialises in translating complex clinical trial data into accessible conversations for healthcare professionals.
Cite This Article
Team TLSFE. Stopping spinal fusion or protecting the gut?. The Life Science Feed. Published June 1, 2026. Updated June 1, 2026. Accessed June 1, 2026. https://thelifesciencefeed.com/rheumatology/arthritis-rheumatoid/research/stopping-spinal-fusion-or-protecting-the-gut.
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All content is researched from peer-reviewed, open-access sources — published trial data, clinical guidelines, and regulatory filings. AI tools are used solely to structure and summarise that evidence; no AI-generated conclusions appear without editor verification against the primary source.
Every article is reviewed by a named editor before publication. Source citations are listed in the References section. This content does not represent the views of any pharmaceutical company, medical device manufacturer, or healthcare provider.
References
[1] Mease PJ et al. DISCOVER-1. Lancet. 2020;395:1115-1125
[2] Baeten D et al. MEASURE-1. N Engl J Med. 2015;373:2534-2548
[3] Ramiro S et al. PREVENT. Ann Rheum Dis. 2021;80:1200-1207
[4] Smolen JS et al. EULAR PsA Recommendations. Ann Rheum Dis. 2020
