What is your approach to refractory erosive osteoarthritis?

Indeed, JAKi seem to have a more broadly-acting antiinflammatory/immunosuppressive activity than some of our other DMARDs and biologics particularly. I have had a patient or two with EOA who have failed JAKs, but in almost all of those patients they initially had a good response, just with subsequent waning. Of course, these drugs are best used relatively early when the inflammatory component is highest and less chronic damage has occurred.

The concern these days of course is the increased CV an...

Entirely anecdotal, but the only medication class that I've had success with in erosive OA are JAK inhibitors. Usually, start with upadacitinib 15 daily.