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Arthritis Rheumatol. 2016 Jun;68(6):1346-52. doi: 10.1002/art.39595.

Brief Report: Association of Rheumatoid Factor and Anti-Citrullinated Protein Antibody Positivity With Better Effectiveness of Abatacept: Results From the Pan-European Registry Analysis.

Author information

1
Strasbourg University Hospital and University of Strasbourg, CNRS, Institut de Biologie Moléculaire et Cellulaire, Immunopathologie, et Chimie Thérapeutique, Strasbourg, France.
2
University of Geneva and University Hospital of Geneva, Geneva, Switzerland.
3
Hospital Clinic of Barcelona and IDIBAPS, Barcelona, Spain.
4
University of Bari and University Hospital, Bari, Italy.
5
Diakonhjemmet Hospital, Oslo, Norway.
6
University of Lisbon and Santa Maria Hospital, Lisbon, Portugal.
7
Institute of Rheumatology and University Hospital, Prague, Czech Republic.
8
DANBIO Registry and University of Copenhagen, Copenhagen, Denmark, and Rigshospitalet, Glostrup, Denmark.
9
Lund University and Skåne University Hospital, Malmö, Sweden.
10
Université Paris-Sud, Hôpitaux Universitaires Paris-Sud, Hôpital Bicêtre, AP-HP, and INSERM U1184, Le Kremlin Bicêtre, France.

Abstract

OBJECTIVE:

To investigate the role of rheumatoid factor (RF) status and anti-citrullinated peptide antibody (ACPA) status as predictors of abatacept (ABA) effectiveness in patients with rheumatoid arthritis (RA).

METHODS:

We conducted a pooled analysis of data from 9 observational RA registries in Europe (ARTIS [Sweden], ATTRA [Czech Republic], BIOBADASER [Spain], DANBIO [Denmark], GISEA [Italy], NOR-DMARD [Norway], ORA [France], Reuma.pt [Portugal], and SCQM-RA [Switzerland]). Inclusion criteria were a diagnosis of RA, initiation of ABA treatment, and available information on RF and/or ACPA status. The primary end point was continuation of ABA treatment. Secondary end points were ABA discontinuation for ineffectiveness or adverse events and response rates at 1 year (good or moderate response according to the European League Against Rheumatism criteria with LUNDEX adjustment for treatment continuation). Hazard ratios (HRs) and 95% confidence intervals (95% CIs) for the study end points in relation to RF and ACPA status were calculated.

RESULTS:

We identified 2,942 patients with available data on RA-associated autoantibodies; data on RF status were available for 2,787 patients (77.0% of whom were RF positive), and data on ACPA status were available for 1,903 patients (71.3% of whom were ACPA positive). Even after adjustment for sociodemographic and disease- and treatment-related confounders, RF and ACPA positivity were each associated with a lower risk of ABA discontinuation for any reason (HR 0.79 [95% CI 0.69-0.90], P < 0.001 and HR 0.78 [95% CI 0.68-0.90], P < 0.001, respectively), compared to RF-negative and ACPA-negative patients. Similar associations with RF and ACPA were observed for discontinuation of ABA treatment due to ineffectiveness, with HRs of 0.72 (95% CI 0.61-0.84) and 0.74 (95% CI 0.62-0.88), respectively (both P < 0.001).

CONCLUSION:

Our results strongly suggest that positivity for RF or ACPA is associated with better effectiveness of ABA therapy.

PMID:
26815727
DOI:
10.1002/art.39595
[Indexed for MEDLINE]
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