High anti-CCP antibody titres predict good response to rituximab in patients with active rheumatoid arthritis - 06/01/15
, Florence Tubach b, c, d, Carine Roy b, c, d, Pascale Nicaise-Roland e, Elisabeth Palazzo a, Ghislaine Gill a, Olivier Meyer a, Philippe Dieudé a, fBienvenue sur EM-consulte, la référence des professionnels de santé.
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Abstract |
Objective |
Previous studies reported that anti-CCP antibody positivity predicts good response to rituximab (RTX) in rheumatoid arthritis (RA). A quantitative approach to such possibility could be a good way to detect the subset of patients most likely to respond. We investigated whether serum anti-CCP antibody titres could predict response to RTX in RA patients.
Methods |
We retrospectively investigated RA patients who received RTX. The primary criterion was decrease in DAS28>1.2 at 6months (M6). Secondary efficacy criteria included a good response and remission according to EULAR. Predictors of response were investigated by multivariate logistic regression analysis.
Results |
We included 114 RA patients (81.6% female, median age 53.5 [IQR 45.7–61.2] years, median disease duration 8.5 [4.0–16.0] years). Anti-CCP antibodies were present in 93 patients (81.6%), with median anti-CCP antibody titres 583 [195–1509] U/mL. In all, 44 patients (38.6%) showed decreased DAS28>1.2 at M6. On univariate analysis, high anti-CCP titres were associated with response rather than non-response to RTX (median 1122 [355–1755] vs. 386 [149–800] U/mL, P=0.0191) at M6. On multivariate regression analysis, with a cut-off of 1000 U/mL, anti-CCP antibody titres≥1000 was associated with a decrease in DAS28>1.2 (OR 5.10 [1.97–13.2], P=0.0002); a EULAR good response (4.26 [1.52–11.95], P=0.0059); and a trend for EULAR remission (2.52 [0.78–8.12], P=0.1207).
Conclusion |
High anti-CCP antibody titres predict response to RTX in RA. This factor, easily assessed in clinical practice, can help with personalized medicine and selecting the best candidates for RTX treatment.
Le texte complet de cet article est disponible en PDF.Keywords : Anti-CCP antibodies, Rituximab, Rheumatoid arthritis
Abbreviations : RA, RTX, DMARDs, TNF, RF, anti-CCP, SJC, TJC, VAS, DAS28, ESR, CRP
Plan
Vol 81 - N° 5
P. 416-420 - octobre 2014 Retour au numéro
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