Rheumatic and musculoskeletal diseases (RMDs) have a significant impact on daily life, limiting both the ability to work and participation in daily activities. The 2026 EULAR (European Union of Rheumatology Societies) Annual Conference presented a series of abstracts examining strategies to combat fatigue, the lived experiences of carers, the cost-effectiveness of patient education, and access to rheumatology care. These were part of a conference dedicated to EULAR Health Professionals in Rheumatology (HPR). EULAR Health Professionals in Rheumatology (HPR) is a network of national organizations in HPR across Europe and serves as a platform for collaboration and information sharing between different health professionals working in rheumatology.
Fatigue is a common and bothersome symptom for people with inflammatory arthritis. Tailored physical activity and cognitive behavioral approaches are known to be helpful and recommended by EULAR, but little is known about the impact of combining the two. COMFI (COMbined Fatigue Intervention) is designed to integrate these two approaches. At the 2026 EULAR conference in London, Astrid Damgaard presented the results of a feasibility study in 29 Danish and Swedish patients with inflammatory arthritis. This study showed that COMFI can be successfully delivered in both countries. Recruitment was acceptable, adherence varied by group, and delivery fidelity was satisfactory. At 6-month follow-up, results showed a trend toward reduced fatigue, with changes meeting minimal clinically important differences observed in both countries in all fatigue measures, including fatigue severity, impact, and coping subscales. The authors concluded that this approach could be offered to people with inflammatory arthritis and fatigue. Future research should consider the unexpected limitations of individual sessions, support lines, and family involvement, but this combination support system requires further investigation in larger randomized controlled trials to assess its effectiveness and cost-effectiveness.
Being able to self-manage is important for patients with RMD, and patient education can be helpful in this regard. Results were shared from a trial designed to assess the cost-effectiveness of digital patient education over a 12-month period compared to a standard face-to-face approach in 175 patients with newly diagnosed rheumatoid arthritis. Results showed lower average healthcare costs and slightly greater QALY gains for digital approaches, favoring digital interventions in both adjusted and unadjusted models. Hospital care was the main driver of cost differences between groups, with mean hospital costs lower in the digital patient education group. Importantly, bootstrap analysis showed improved outcomes at lower costs, supporting the hypothesis that health system resources would be saved.
The secondary outcome was achieving minimally significant change in self-efficacy scores from baseline to 12 months. Therefore, although the intervention saved costs, the effects were small and inconsistent between adjusted and unadjusted analyses.
Speaking at parliament, Ryne Lounsbeck Knudsen said:While confirmation in a broader population is warranted, these findings suggest that structured digital patient education may be integrated into daily practice to support efficient resource use without compromising quality.. ”
RMD often requires sustained support from caregivers to enable daily functioning and disease management. However, despite the central role of caregivers, their experiences and needs are under-examined and often invisible in rheumatology research. The Italian team set out to change this by investigating the lived experiences of family groups and primary informal caregivers and identifying their needs for targeted supportive interventions. Valentina Bressan presented her research and described the qualitative phenomenological study and the methodology used. In total, 25 caregivers participated, most of whom were spouses and domestic partners. The onset of the disease was a major turning point, accompanied by emotional distress, feelings of helplessness, and guilt. Many people reported making difficult choices and compromises, with 26.7% citing major changes or sacrifices in their lives, and 52% reporting primarily negative emotions such as sadness, anxiety, fatigue, and emotional overload, which often limit their ability to plan for the future.
These results suggest that caregivers experience complex and multifaceted challenges that have a major impact on their health and daily life, and highlight the need for systematic recognition in the rheumatology care pathway. Developing caregiver-focused assessments and customized psychosocial and educational interventions has the potential to improve caregiver well-being, improve patient outcomes, and support more holistic, person-centered care.
The global average delay to diagnosis of axial spondyloarthritis (axSpA) is 7.4 years. A Canadian team has announced preliminary results from the FASTRAX study, a multidisciplinary model to improve access to rheumatology treatment and promote early detection. This approach uniquely utilizes trained extension scope providers and rheumatologists to rapidly screen patients with chronic low back pain. To date, 179 patients have completed the screening process at the three study sites, with a median wait time for evaluation of 28 days. Of these, 22.9% were diagnosed with axSpA, and the average time to diagnosis was 12.1 years. Overall, the number of patients required to screen across the state to identify one axSpA patient was five chronic low back pain patients, but this number varied slightly by facility. Of note, however, axSpA has historically accounted for approximately 5% of chronic low back pain patients, suggesting that approximately 20 people would need to be screened to detect one axSpA case.
Lead author Laura Passarento said:This model is effective, with referral wait times much lower than the state median, and provides rapid access to care. Although time to diagnosis remains extended, this time is expected to decrease as this model gains awareness among referring physicians and matures over time, allowing for more targeted rheumatology referrals.”
sauce:
European Union of Rheumatology Associations, EULAR
References:
- Damgaard A, et al. Feasibility of COMFI: COMbined Fatigue Intervention for people with inflammatory arthritis. Presented at EULAR 2026. OP0140-HPR. Ann Rheumdis 2026; DOI: 10.1136/annrheumdis-2026-eular.C.122.
- Raunsbæk Knudsen L, et al. Cost-effectiveness of digital patient education for patients with newly diagnosed rheumatoid arthritis: An economic evaluation from a randomized controlled trial. Presented at EULAR 2026. OP005-HPR. Ann Rheum Dis 2026; DOI: 10.1136/annrheumdis-2026-eular.C.44.
- Bressan V et al. Caregiving in inflammatory arthritis: A phenomenological study. Presented at EULAR 2026. OP0138-HPR. Ann Rheum Dis 2026; DOI: 10.1136/annrheumdis-2026-eular.C.157.
- Passalent L, et al. A multidisciplinary model to improve access to rheumatology treatment and promote early detection of axial spondyloarthritis: Preliminary results of the FASTRAX study. Presented at EULAR 2026. OP0142-HPR. Ann Rheum Dis 2026; DOI: 10.1136/annrheumdis-2026-eular.C.230.
