Nature Reviews Rheumatology, Published online: 21 January 2026; doi:10.1038/s41584-025-01348-0Although current treatments for axial spondyloarthritis can reduce inflammation, many patients continue to experience pain. This Review examines the complex interplay between pain and inflammation in axial spondyloarthritis and argues that both should be addressed as interconnected therapeutic targets to achieve meaningful pain relief.

Nature Reviews Rheumatology, Published online: 07 January 2026; doi:10.1038/s41584-025-01350-6A large European cohort clarifies COPA syndrome as a multi-organ interferonopathy defined by STING-driven interstitial lung disease (ILD). These findings refine diagnosis and treatment and establish COPA syndrome as a model for systemic autoimmune rheumatic disease-associated ILD.

Nature Reviews Rheumatology, Published online: 05 January 2026; doi:10.1038/s41584-025-01347-1Intravenous immunoglobulin (IVIG) is a cornerstone of autoimmune disease therapy, but its use is constrained by high costs and limited supply. A sialylated IgG1 Fc variant with enhanced affinity for the inhibitory Fcγ receptor FcγRIIB could offer an effective dose-sparing alternative to IVIG, potentially transforming treatments for autoimmune diseases.

Nature Reviews Rheumatology, Published online: 07 January 2026; doi:10.1038/s41584-025-01350-6A large European cohort clarifies COPA syndrome as a multi-organ interferonopathy defined by STING-driven interstitial lung disease (ILD). These findings refine diagnosis and treatment and establish COPA syndrome as a model for systemic autoimmune rheumatic disease-associated ILD.

Nature Reviews Rheumatology, Published online: 05 January 2026; doi:10.1038/s41584-025-01347-1Intravenous immunoglobulin (IVIG) is a cornerstone of autoimmune disease therapy, but its use is constrained by high costs and limited supply. A sialylated IgG1 Fc variant with enhanced affinity for the inhibitory Fcγ receptor FcγRIIB could offer an effective dose-sparing alternative to IVIG, potentially transforming treatments for autoimmune diseases.

Nature Reviews Rheumatology, Published online: 19 December 2025; doi:10.1038/s41584-025-01344-4Fibromyalgia 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.

Nature Reviews Rheumatology, Published online: 19 December 2025; doi:10.1038/s41584-025-01345-3Advances 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.

Nature Reviews Rheumatology, Published online: 18 December 2025; doi:10.1038/s41584-025-01346-2A new study reveals that the Epstein–Barr virus can reprogramme autoreactive B cells into pathogenic antigen-presenting cells in systemic lupus erythematosus, providing a mechanistic link between infection and autoimmunity.

Circulating cell-free DNA (cfDNA) and cfDNA fragmentation signatures are emerging as promising non-invasive biomarkers for various indications, most notably cancer. New analysis of cfDNA fragmentation...

The factors and mechanisms that regulate osteoclast-induced inflammatory bone loss are complex. The authors of this Review provide an overview of osteoclast regulation in the context of inflammatory b...

Childhood-onset SLE is characterized by high disease activity, severe organ damage and substantial treatment challenges. The authors of this Review provide an update on the advances in the understandi...

Nature Reviews Rheumatology, Published online: 15 December 2025; doi:10.1038/s41584-025-01342-6New 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.

Nature Reviews Rheumatology, Published online: 19 December 2025; doi:10.1038/s41584-025-01344-4Fibromyalgia 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.

Nature Reviews Rheumatology, Published online: 19 December 2025; doi:10.1038/s41584-025-01345-3Advances 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.

Nature Reviews Rheumatology, Published online: 18 December 2025; doi:10.1038/s41584-025-01346-2A new study reveals that the Epstein–Barr virus can reprogramme autoreactive B cells into pathogenic antigen-presenting cells in systemic lupus erythematosus, providing a mechanistic link between infection and autoimmunity.

Nature Reviews Rheumatology, Published online: 11 December 2025; doi:10.1038/s41584-025-01327-5Monogenic disorders involving key elements of the TNF pathway now encompass a diverse and expanding group of conditions, spanning autoinflammatory, autoimmune, immunodeficiency and neurodegenerative diseases. This Review discusses the genetic causes, clinical features and current therapeutic strategies for these disorders, emphasizing the value of accurate molecular diagnosis and targeted interventions.

Nature Reviews Rheumatology, Published online: 10 December 2025; doi:10.1038/s41584-025-01343-5In 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.

Nature Reviews Rheumatology, Published online: 15 December 2025; doi:10.1038/s41584-025-01342-6New 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.

Nature Reviews Rheumatology, Published online: 09 December 2025; doi:10.1038/s41584-025-01341-7Autologous haematopoietic stem cell transplantation revolutionized the treatment of severe systemic sclerosis as the first therapy able to induce long-term remission in this relentlessly fibrosing disease. Nevertheless, questions remain about patient selection, conditioning, and how this treatment fits into the evolving immune-modifying therapeutic landscape. The field should move beyond standardization towards precision therapy.

Nature Reviews Rheumatology, Published online: 08 December 2025; doi:10.1038/s41584-025-01333-7In 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.

Nature Reviews Rheumatology, Published online: 08 December 2025; doi:10.1038/s41584-025-01336-4Endosomal traffic orchestrates important immune functions, including receptor signalling, antigen processing and metabolic regulation, and has a pivotal role in maintaining self-tolerance. Disruption of these pathways contributes to autoimmune diseases such as systemic lupus erythematosus and rheumatoid arthritis, offering new therapeutic opportunities.