The Baseline Th17 Lymphocytes Level Is a Predictive Marker of Good Response to Biologics in Rheumatoid Arthritis

Sarah Salomon¹, Caroline Guignant², Pierre Morel³, Brigitte Gubler⁴, Patrice Fardellone⁵, Jean-Pierre Marolleau⁶ and Vincent Goeb⁷, ¹Rheumatology, University Hospital of Amiens, Amiens, France, ²Immunology Laboratory, University Hospital of Amiens, Amiens, France, ³Hematology, University Hospital of Amiens, Amiens, France, ⁴Immunology, University Hospital of Amiens, Amiens, France, ⁵Department of Rheumatology, Amiens University hospital, Amiens, France, ⁶hematology, University Hospital of Amiens, Amiens, France, ⁷Rheumatology, Amiens University Hospital, Amiens, France

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords: Biologics, Biomarkers, flow cytometry, lymphocytes and rheumatoid arthritis (RA)

Session Information

Date: Tuesday, November 15, 2016

Title: T Cell Biology and Targets in Autoimmune Disease - Poster Session II

Session Type: ACR Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose: In clinical daily practice, the response to biologic drugs is unpredictable in patients with rheumatoid arthritis (RA). Thus, there is a crucial need for predictive biomarkers of response. The main objective of our study is to describe the evolution of T and B cells in patients with RA treated with biologics and to investigate whether there is a correlation between the initial rate of blood cells and the clinical response under therapy.

Methods: This was a propective single-center pilot study, descriptive and not randomized. Patients were included with RA fulfilling the ACR/EULAR 2010 criteria, with an active disease according to the DAS28 score despite treatment, and in whom initiation or switch of a biologic (TNF-blockers, tocilizumab and abatacept) except rituximab was required. A control group of patients without any autoimmune disease or immune dysfunction was also assessed. B and T lymphocytes whole blood phenotyping, as well as an analysis of the production of IL-10 were performed by multicolor flow cytometry (FCM) in both patients and controls at baseline (M0) and in patients after 1 (M1), 3 (M3) and 6 (M6) months of treatment. The primary endpoint was the rate and absolute value of B and T cells as a percentage and absolute value measured at each time of the study and compared with disease activity.

Results: Thirty-one patients and 17 controls were included. There was a significant difference between responders and non-responders at M6 according to their initial level of Th17 cells (sifgnificantly decresased in good responders, p=0.005). No significant difference but a trend (p=0.06) was observed for circulating CD24hiCD27+Bregs (higher in good responders). There was no significant difference between responders and non-responders for Treg and CD24hiCD38hi Breg cells. The rate of CD19 + B producing IL-10 obtained by PBMC culturing seemed lower in controls as compared to the patients.

Conclusion: A low initial rate of Th17 circulating cells is associated with a good response to biologics during RA. Th 17 cells may represent a predictive biomarker of response to therapy for RA patients.

Disclosure: S. Salomon, None; C. Guignant, None; P. Morel, None; B. Gubler, None; P. Fardellone, None; J. P. Marolleau, None; V. Goeb, None.

To cite this abstract in AMA style:

Salomon S, Guignant C, Morel P, Gubler B, Fardellone P, Marolleau JP, Goeb V. The Baseline Th17 Lymphocytes Level Is a Predictive Marker of Good Response to Biologics in Rheumatoid Arthritis [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/the-baseline-th17-lymphocytes-level-is-a-predictive-marker-of-good-response-to-biologics-in-rheumatoid-arthritis/. Accessed .

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