December 2025 to March 2026
Author: Elvis Hysa
Complete PET/CT extinction and subsequent risk of aortic dilation in patients with giant cell arteritis-related large vessel vasculitis treated with tocilizumab
Dumont et al. evaluated tocilizumab (TCZ) combined with glucocorticoids (GC) in 91 patients with giant cell arteritis-related large vessel vasculitis. Complete metabolic extinction, defined as grade 0 or 1 18FDG-PET/CT uptake across 8 vascular territories, was achieved in 76% of patients. This response allowed GC discontinuation in 88% of responders. Metabolic extinction strongly protected against structural damage: aortic dilation occurred in 1% of patients with extinction versus 18% without (p=0.006). Although 14% relapsed after TCZ discontinuation, achieving grade 0-1 metabolic response effectively facilitates GC tapering and significantly prevents subsequent aortic dilation.
A phase III, randomised, double- blind, multi- dose, placebo- and naproxen- controlled study to evaluate the efficacy and safety of fasinumab in patients with pain due to osteoarthritis of the knee or hip
DiMartino et al. evaluated fasinumab, an anti-nerve growth factor (NGF) monoclonal antibody, in patients with moderate-to-severe knee/hip osteoarthritis (OA) inadequately controlled by standard therapies. In thisphase III trial, 3307 patients were randomised to subcutaneous fasinumab 1 mg every4 weeks (Q4W), 1 mg every 8 weeks, naproxen 500 mg twice daily, or placebo. At week 16, fasinumab 1 mg Q4W achieved significantly greater reductions in WOMAC pain and physical function scores versus both placebo and naproxen (all p<0.005). However, adjudicated arthropathies, radiographic joint damage including rapidly progressive OA, were higher with fasinumab (9.7% Q4W vs 1.1% placebo), limiting clinical development.
Comparative effectiveness and predictors of remission between adalimumab and ixekizumab in patients with psoriatic arthritis: findings from the ‘AIRE’ multicentre study
Paci et al. compared the real-world effectiveness of adalimumab (ADA) and ixekizumab (IXE) in 437 patients with psoriatic arthritis (PsA) across seven Italian tertiary centres over 12 months. Disease Activity in Psoriatic Arthritis (DAPSA) scores improved significantly in both groups, with no between-treatment differences in joint outcomes or remission rates at 12 months assessed by DAPSA or Minimal Disease Activity (MDA). IXE demonstrated faster early skin response at 3 months. Predictors of remission included male sex, better functional status, fewer prior biologic disease-modifying antirheumatic drugs (bDMARDs), and higher baseline Psoriasis Area and Severity Index (PASI). No unexpected safety signals emerged.
Patterns of spinal new bone formation in patients with axial spondyloarthritis, psoriatic arthritis, rheumatoid arthritis and healthy controls: a low-dose CT study
Willesen et al. characterised patterns of spinalnew bone formation (NBF) using low-dose computed tomography (ldCT; mean effective dose 1.60 mSv) in 69 participants: 30 with axial spondyloarthritis (axSpA), 19 with psoriatic arthritis (PsA), 10 with rheumatoid arthritis (RA) and 10 healthycontrols. AxSpA exhibited the highest burden of marginal syndesmophytes, predominantly in the thoracic spine and at anterior vertebral corners. PsA and RA were characterised mainly by osteophytes, without a consistent distinguishing NBF pattern. Inter-reader reliability was excellent (intraclass correlation coefficient >0.9) for any NBF type in most groups, supporting ldCT feasibility for multiplanar structural damage assessment.
[¹⁸F]FAPI PET/CT-based scoring systems for patient assessment in IgG4-related disease
Chen et al. developed a novel positron emission tomography (PET)/CT-based scoring system using ¹⁸F-fibroblast activation protein inhibitor ([¹⁸F]FAPI) to assess disease activity in IgG4-related disease (IgG4-RD). Among 85 patients with IgG4-RD, organ-specific uptake thresholds were established using 10 healthy controls, achieving sensitivity, specificity and accuracyof 86.2%, 83.3% and 85.9%, respectively, for detecting IgG4-RD involvement. The newly developed [¹⁸F]FAPI PET/CT Activity Score of IgG4-RD (FPAS-IgG4) significantly distinguished active from inactive disease (5.2±3.0 vs 1.7±1.3; p<0.0001). At a cut-off of >2, FPAS-IgG4 yielded 93.2% sensitivity and 73.1% specificity, independently predicting active IgG4-RD on multivariable analysis.
Elvis Hysa
Elvis is a Rheumatologist and PhD Candidate at the Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, University of Genova, Italy.
His research focuses primarily on clinical and translational studies in polymyalgia rheumatica (PMR) and giant cell arteritis (GCA), imaging aspects of systemic sclerosis and other autoimmune connective tissue diseases (particularly capillaroscopy and skin ultrasound), and rheumatic-immune related adverse events in oncologic patients following immune checkpoint inhibitor therapy.
He is a member of the EMEUNET Newsletter Sub-Committee and is actively involved in international task forces on imaging and treatment-related aspects in PMR and GCA.