Background/Purpose: TNF inhibitors (TNFi) are the most common biological
agents used as disease-modifying treatment in rheumatoid arthritis (RA). Although these drugs have contributed to change the natural history of RA, approximately 30-50% of patients do not respond to this therapy. Early identification of optimal responders is crucial in the clinical setting. We aimed to study if baseline percentages of different leukocyte subsets in peripheral blood (PBMCs) can contribute to identify RA patients who will respond to TNFi.

Methods: This was a prospective bi-center pilot study including 50 RA patients under TNFi therapy. Clinical activity was assessed at baseline and 6 months of treatment by disease activity score 28 (DAS28), considering optimal responders if they reached remission at 6 months (DAS28≤2.6). PBMCs were obtained before treatment and different leukocyte subsets were evaluated by flow cytometry in a FACSCantoII instrument. All the analyses were adjusted by sex, age, concomitant methotrexate, baseline DAS28 and rheumatoid factor through a multivariate log-regression model (odds ratio; 95% CI).

Results: Optimal responders showed higher percentage of B cells (OR=1.28;95%; CI:1.06-1.54;p=0.011) and naive B cells (Bn; OR=1.50; 95%; CI:1.11-2.04;p=0.009) at baseline. We established cut-off values by ROC curves and analyzed the ability of both variables in predicting clinical response. Best results were obtained with Bn. Showing more than 2.55% of these cells associated with optimal response.

Conclusion: Our results suggest that basal Bn percentages may contribute to identify optimal responders to TNFi in RA. Although our data should be validated in larger cohorts.

« Back to 2018 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/blood-lymphocytes-subtypes-as-biomarkers-for-early-identification-of-optimal-responders-to-anti-tnf-treatment-in-rheumatoid-arthritis/