Volume 22 Issue 2, February 2026

T helper 17 cells that lose IL-17 expression drive inflammation in a mouse model of chronic rheumatoid arthritis.

Advances in artificial intelligence (AI) are transforming patient stratification in rheumatology. In 2025, three landmark studies demonstrated how multimodal AI approaches spanning clinical, molecular and longitudinal data can uncover distinct disease subtypes and predict therapeutic response, advancing the field towards precision rheumatology.

In 2025, a new wave of ‘off-the-shelf’ B cell-depleting modalities for the treatment of autoimmune diseases emerged, encompassing allogeneic cellular therapies, in vivo chimeric antigen receptor engineering, and bispecific antibodies.

Many of the current therapies for arthritis lack a targeted approach, limiting clinical benefits. Nanoparticle-based delivery systems have enabled more precise and efficient delivery of therapeutic agents, particularly nucleic acids. Studies in 2025 emphasize the promise of these strategies for the treatment of various forms of arthritis.

New research published in 2025 sheds light on the pre-clinical period that precedes the onset of classifiable rheumatoid arthritis, from risk factors to immunological events and opportunities to prevent the transition to clinical disease.

Fibromyalgia remains a challenge for researchers and clinicians. Three studies published in 2025 shed light on mechanisms and management by implicating gut microbiota in symptom perpetuation, demonstrating the potential of home-based neuromodulation, and examining the uncertain role of low-dose naltrexone.

Advances in cellular and spatial profiling technologies have rapidly expanded the understanding of fibroblast heterogeneity within the target tissues of disease. In 2025, there has been a shift towards a consensus definition of shared cross-tissue fibroblast states and a greater understanding of their molecular drivers and disease-relevant effector functions.

Immune-checkpoint agonists are a promising therapeutic approach for autoimmune disease. This Review discusses the immune-checkpoint receptors PD-1, BTLA and TIGIT as well as the preclinical and clinical evidence for therapeutically targeting these receptors for the treatment of rheumatic diseases.

Emerging evidence suggests a paradigm shift in viewing osteoarthritis (OA) as a systemic, bidirectional disease. This Review examines the current data supporting this concept, outlines key challenges in research approaches, and proposes strategies to improve preclinical studies and clinical trial design.

In this Review, the authors summarize the potential role of emerging viruses in autoimmune rheumatic diseases (AIRDs). They describe the association between viruses and AIRD flare ups, the putative mechanisms linking AIRD to viral infections and hormone modulation of viral pathogenesis and autoimmune diseases.

In this Consensus Statement, a Group for Research and Assessment of Psoriasis and Psoriatic Arthritis task force presents consensus definitions for two distinct states, complex-to-manage PsA and treatment-refractory PsA, with the aim of standardizing terminology, improving patient stratification and guiding clinical decision-making and future research.