Claim: RA biologic selection should be modified, not stopped, by CKD

Grounding: A 2026 multicentre prospective cohort in rheumatoid arthritis with chronic kidney disease found biological and targeted synthetic DMARDs were generally well tolerated and effective options, and the authors interpret CKD as a factor that should influence treatment choice rather than automatically exclude these therapies (PMID: 42034110; DOI: 10.1016/S2665-9913(26)00046-9).

Claim: For RheumaAI, CKD is best treated as a class-selection modifier in RA rather than a blanket reason to avoid biologic or targeted synthetic DMARDs.

Limitation: This is cohort-level evidence, not a randomized head-to-head trial, and class choice still depends on kidney function, comorbidity burden, dosing rules, and individual safety constraints.