PBS restrictions on rituximab for rheumatoid arthritis were removed in January
2026 — previously reserved for patients who had failed TNF inhibitors and other
bDMARDs. The ANZMUSC/Australian Rheumatology Association/Cochrane Musculoskeletal
Living Guideline (livingguidelines.org) is now the primary Australian-specific
pharmacological recommendation source for RA/axSpA/PsA/JIA, continuously updated
rather than a static document. See
Rheumatoid Arthritis.
Australia’s first national RA Clinical Care Standard (Australian Rheumatology
Association, November 2023) reframes RA care as a systems-level quality target — 12
quality statements around timely diagnosis, treat-to-target monitoring and
comorbidity screening. See Rheumatoid Arthritis.
Avacopan is now a recommended steroid-sparing induction agent for ANCA-associated
vasculitis (GPA/MPA), per the BSR’s 2025 guideline. Rituximab is now preferred for
relapsing disease and maintenance. GPA now also has a formal 2022 ACR/EULAR weighted
classification criteria (≥5 points required, e.g. cytoplasmic/PR3-ANCA +5, pulmonary
nodules/cavitation +2), replacing informal pattern-recognition. See
Wegener’s Granulomatosis / GPA.
Anifrolumab is now the preferred first-line biologic for cutaneous SLE, per the
BSR’s 2026 Lupus guideline, which also sets out a treat-to-target (LLDAS/remission)
care model and a structured annual review. See SLE.
The BSR’s 2025 axial spondyloarthritis guideline sets out a full b/tsDMARD
algorithm — TNF inhibitor first-line, then TNFi/IL-17 inhibitor/JAK inhibitor
second-line, tailored to extra-articular manifestations (IL-17 inhibitors can worsen
coexisting IBD). See Ankylosing Spondylitis.
csDMARD monitoring has been simplified: the BSR’s 2025 csDMARDs guideline
recommends FIB-4 + elastography over routine liver biopsy for methotrexate liver
monitoring, confirms cardiovascular disease and malignancy are not contraindications
to csDMARD therapy, and advises against routinely stopping csDMARDs perioperatively.
See Rheumatoid Arthritis.
Pain in inflammatory arthritis should be managed with DMARDs and short-term
bridging steroids, not analgesics/NSAIDs alone — per the BSR’s 2026 pain-management
guideline, which also puts non-pharmacological measures (exercise, OT, sleep,
psychological support) on equal footing with drug therapy. See
Rheumatoid Arthritis.
Daratumumab + CyBorD is now the standard-of-care first-line regimen for newly
diagnosed AL amyloidosis (FDA approval 2021, following the ANDROMEDA trial). See
Amyloidosis.
Sarcoidosis now has a formal three-part diagnostic definition and baseline
screening protocol (ATS/ERS/JRS/ALAT 2020), plus a simpler standardised 20mg/day
prednisolone starting dose (2021 ERS treatment guideline), replacing the old
weight-based regimen. See Pulmonary Sarcoidosis.
Sjögren disease now has formal 2016 ACR/EULAR classification criteria (BSR 2023
guideline), with ultrasound as an alternative to lip biopsy, and an explicit emphasis
on early lymphoma recognition — Sjögren carries the highest lymphoma risk of any
rheumatic disease. See Sjögren Disease.
The first joint BAD/BSR Behçet’s living guideline (2025) makes 87 recommendations
across 9 domains (general management, skin, joints, GI, eyes, neurology, vascular,
psychological, pregnancy). See Behçet’s Syndrome.
Spinal muscular atrophy has been transformed by disease-modifying therapy —
nusinersen (PBS 2018), onasemnogene abeparvovec/Zolgensma (TGA 2021, PBS 2022) and
risdiplam (PBS 2021) mean Type 1 SMA is no longer a near-uniformly fatal infant
diagnosis for many patients, provided treatment starts early. See
Spinal Muscular Atrophy.