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J Rheumatol. 2018 Jan;45(1):32-39. doi: 10.3899/jrheum.170007. Epub 2017 Nov 1.

Effect of Anticitrullinated Protein Antibody Status on Response to Abatacept or Antitumor Necrosis Factor-α Therapy in Patients with Rheumatoid Arthritis: A US National Observational Study.

Author information

1
From the University of Massachusetts Medical School, Worcester; Corrona LLC, Southborough, Massachusetts; Bristol-Myers Squibb, Princeton, New Jersey; Albany Medical College and The Center for Rheumatology, Albany, New York. Leslie.Harrold@umassmed.edu.
2
L.R. Harrold, MD, MPH, University of Massachusetts Medical School, and Corrona LLC; H.J. Litman, PhD, Corrona LLC; S.E. Connolly, PhD, Bristol-Myers Squibb; S. Kelly, MD, Bristol-Myers Squibb; W. Hua, MS, Corrona LLC; E. Alemao, MS, RPh, Bristol-Myers Squibb; L. Rosenblatt, MD, MPH, Bristol-Myers Squibb; S. Rebello, MPH, Corrona LLC; J.M. Kremer, MD, Corrona LLC, and Albany Medical College and The Center for Rheumatology. Leslie.Harrold@umassmed.edu.
3
From the University of Massachusetts Medical School, Worcester; Corrona LLC, Southborough, Massachusetts; Bristol-Myers Squibb, Princeton, New Jersey; Albany Medical College and The Center for Rheumatology, Albany, New York.
4
L.R. Harrold, MD, MPH, University of Massachusetts Medical School, and Corrona LLC; H.J. Litman, PhD, Corrona LLC; S.E. Connolly, PhD, Bristol-Myers Squibb; S. Kelly, MD, Bristol-Myers Squibb; W. Hua, MS, Corrona LLC; E. Alemao, MS, RPh, Bristol-Myers Squibb; L. Rosenblatt, MD, MPH, Bristol-Myers Squibb; S. Rebello, MPH, Corrona LLC; J.M. Kremer, MD, Corrona LLC, and Albany Medical College and The Center for Rheumatology.

Abstract

OBJECTIVE:

Assess whether baseline anticyclic citrullinated peptide antibodies (anti-CCP) status is associated with treatment response in patients with rheumatoid arthritis (RA) initiating abatacept (ABA) or a tumor necrosis factor-α inhibitor (TNFi).

METHODS:

Using the Corrona RA registry, patients were identified who initiated ABA or a TNFi (June 2004-January 2015), had a followup visit 6 months (± 3 mos) after initiation, and anti-CCP measured at or prior to initiation. Primary outcome was mean change in Clinical Disease Activity Index (CDAI) from initiation to 6 months. Treatment response was evaluated based on a typical patient profile (female, aged 57 yrs, body mass index of 30 kg/m2, baseline CDAI of 20, 1 prior biologic, and no comorbidities other than RA). Secondary outcomes included remission and low disease activity.

RESULTS:

There were 566 ABA initiators [anti-CCP+ (≥ 20 units/ml): n = 362; anti-CCP- (< 20 units/ml): n = 204] and 1715 TNFi initiators (anti-CCP+: n = 1113; anti-CCP-: n = 602). Differences between treatment groups included baseline disease duration, CDAI, and prior biologic use. At 6 months, anti-CCP+ ABA initiators were associated with significantly greater CDAI response versus anti-CCP- ABA initiators; no significant difference was observed for TNFi initiators. When considering a typical RA patient profile, CDAI response was greater in anti-CCP+ versus anti-CCP- ABA initiators; anti-CCP+ versus anti-CCP- TNFi initiators were similar. Secondary outcome responses were also greater in anti-CCP+ versus anti-CCP- ABA initiators; TNFi initiators did not differ by anti-CCP status.

CONCLUSION:

In a US-based clinical practice setting, anti-CCP status was associated with a differential treatment response to ABA, but not TNFi.

KEYWORDS:

ANTI-TUMOR NECROSIS FACTOR; ANTICYCLIC CITRULLINATED ANTIBODIES; DISEASE-MODIFYING ANTIRHEUMATIC DRUGS; RHEUMATOID ARTHRITIS

PMID:
29093151
DOI:
10.3899/jrheum.170007
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