ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 0496

Certolizumab Pegol Shows a Higher Retention Rate Compared to JAK Inhibitors in Patients with Rheumatoid Arthritis, Regardless of Baseline Rheumatoid Factor Levels. A Multicenter Retrospective Study.

Mitndbaim Parra1, Rafaela Ortega-Castro2, Jerusalén Calvo3, Francisco Jose Cepas4, Montserrat Robustillo-Villarino5, Andres Zuniga-Vera5, Ana Martinez-Feito6, Chamaida Plasencia-Rodríguez7, Ester Costa-Moya8, Delia Taverner-Torrent8, Luis Sainz Comas9, Cesar Diaz-Torne9, Virginia Ruiz-Esquide10, Cynthia Rojas11, Lourdes Martin-de la Sierra Lopez12, Laura Jimenez-Rodriguez12, David Velasco-Sanchez12, Regina Fará Garcia13, Antonio Juan-Mas14, Marina soledad Moreno Garcia15, Ana Valeria Acosta Alfaro16, Santiago Muñoz17, Maria Martín López18, Raquel Zas19, FRANCISCO JAVIER GODOY NAVARRETE20, Isabel Anon Onate21, Fernando Ortiz-Márquez22, Natalia Mena Vázquez23, Paula Estrada-Alarcón24, Lourdes Ladehesa25, Alejandro Escudero Contreras3 and Clementina López Medina26, 11. Rheumatology Department, Reina Sofía University Hospital, Cordoba/IMIBIC/University of Cordoba., Cordoba, Spain, 2Rheumatology service/Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC)/ Reina Sofia University Hospital/ University of Cordoba, Spain, Cordoba, Andalucia, Spain, 3IMIBIC / Reina Sofia Hospital / University of Cordoba, Córdoba, Spain, 4University of Cordoba, Cordoba, Spain, 5Department of Rheumatology, Hospital Universitario de la Plana, Vila-real, Castellón, Spain, Vila-real, Castellón, Spain, 6Hospital Universitario La Paz, Madrid, Madrid, Spain, 7Hospital Universitario La Paz, MADRID, Spain, 8Hospital Sant Joan Reus, Reus, Spain, 9Hospital de la Santa Creu i Sant Pau, Barcelona, Spain, 10Hospital Clínic de Barcelona, Barcelona, Catalonia, Spain, 11Hospital Clinic, Barcelona, Spain, 12Hospital General Universitario de Ciudad Real, Ciudad Real, Spain, 13Hospital Son Llàtzer, Palma, Spain, 14Son Llazter University Hospital, Madrid, Spain, 15Hospital Universitario Miguel Servet, Zaragoza, Spain, 16Hospital Universitario Infanta Sofia; Universidad Europea de Madrid; FIIB HUIS-HUHEN, Madrid, Spain, 17Hospital Universitario Infanta Sofía;Universidad Europea de Madrid. Faculty of Medicine, Health and Sports. Department of Medicine; FIIB HUIS-HUHEN, Madrid, Spain, 18Hospital 12 de Octubre, Madrid, Spain, 19Hospital Universitario Doce de Octubre, Madrid, Spain, 20Jaen University Hospital, Spain, Jaen, Spain, 21Hospital Universitario de Jaén, Jaén, Spain, 22Department of Rheumatology, Hospital Regional Universitario de Málaga, Málaga, Spain, Malaga, Spain, 23Hospital Regional Universitario de Malaga, Malaga, Spain, Málaga, Spain, 24Hospital de San Juan Despí Moisès Broggi, Barcelona, Spain, 25IMIBIC-Reina Sofia Hospital-University of Cordoba, Cordoba, Spain, Cordoba, Spain, 26Department of Medicine, Hospital Universitario Reina Sofia, University of Cordoba, IMIBIC, Cordoba, Spain

Meeting: ACR Convergence 2025

Keywords: , ,

Session Information

Date: Sunday, October 26, 2025

Title: (0470–0505) Rheumatoid Arthritis – Treatment Poster I

Session Type: Poster Session A

Session Time: 10:30AM-12:30PM

Background/Purpose: Rheumatoid factor (RF) is an antibody directed against the Fc fragment of IgG that plays a key role in the development of rheumatoid arthritis (RA). Elevated RF levels have been associated with greater disease severity and higher cardiovascular risk. In this context, patients with high RF levels may present a higher inflammatory burden and a lower response to JAK inhibitors (JAKi), possibly due in part to the use of these drugs at low doses. However, previous studies have shown that certolizumab pegol (CZP) offers comparable efficacy in patients with both high and low RF levels.The objectives of this study were: a) to compare, in RA patients with high RF levels, the efficacy of CZP vs. JAKi after 12 months of treatment and b) to compare the drug retention rate between both groups after 3 years of follow-up.

Methods: Longitudinal, retrospective, multicenter study including RA patients treated with CZP or JAKi (tofacitinib, baricitinib, upadacitinib, or filgotinib) between 2010 and 2024. Baseline RF levels and disease activity (DAS28) were collected at baseline, 6 months, and 12 months, along with treatment start and discontinuation dates. Propensity score (PS) matching was used to match CZP and JAKi groups based on age, prior use of b/tsDMARDs, and concomitant methotrexate use. Change in DAS28 was compared between groups using Student’s t-test. Log-rank tests and Kaplan-Meier curves were used to evaluate treatment retention rates in both groups according to RF levels, considering RF ≥200 IU/mL as “very high” levels.

Results: A total of 364 patients (234 CZP and 126 JAKi) with available RF titers were included. After PS matching, both groups (126 patients each) were comparable in age, sex, disease duration, baseline DAS28, concomitant methotrexate use, and prior b/tsDMARD use.In patients with RF ≥200 IU/mL, those treated with CZP showed a greater reduction in DAS28 compared to JAKi (-2.12±1.29 vs. -1.41±1.38, p=0.098), although this did not reach statistical significance. In patients with RF < 200 IU/mL, the change in DAS28 was similar between groups (-1.66±1.38 vs. -1.89±1.41, p=0.339).In patients with RF ≥200 IU/mL, the 3-year drug retention rate was significantly higher in CZP vs. JAKi (survival probability 57.6% [95%CI 43.0–77.2] vs. 7.1% [95%CI 1.9%–27.2], p < 0.001). Similarly, in patients with RF < 200 IU/mL, CZP also showed a higher retention rate (survival probability 54.8% [95%CI 45.6%–66.0%] vs. 22.5% [95%CI 15.5%–32.4%], p < 0.001).

Conclusion: In patients with high RF levels (≥200 IU/mL), CZP showed a trend toward greater clinical efficacy after 12 months compared to JAKi. In addition, CZP demonstrated a higher drug retention rate than JAKi in both high and low RF subgroups, suggesting greater persistence of CZP regardless of RF levels in the general RA patient population.

Supporting image 1Figure 1. Three-year drug retention rate in patients with (A) RF ≥200 IU/mL and (B) RF < 200 IU/mL.

Disclosures: M. Parra: None; R. Ortega-Castro: None; J. Calvo: None; F. Cepas: None; M. Robustillo-Villarino: None; A. Zuniga-Vera: None; A. Martinez-Feito: None; C. Plasencia-Rodríguez: AbbVie/Abbott, 5, 6, Eli Lilly, 6, Novartis, 6, Pfizer, 5, 6, UCB, 6; E. Costa-Moya: None; D. Taverner-Torrent: None; L. Sainz Comas: None; C. Diaz-Torne: None; V. Ruiz-Esquide: None; C. Rojas: None; L. Martin-de la Sierra Lopez: None; L. Jimenez-Rodriguez: None; D. Velasco-Sanchez: None; R. Fará Garcia: None; A. Juan-Mas: None; M. Moreno Garcia: None; A. Acosta Alfaro: None; S. Muñoz: Janssen, 1, 2, 5, 6, 7; M. Martín López: None; R. Zas: None; F. GODOY NAVARRETE: None; I. Anon Onate: None; F. Ortiz-Márquez: None; N. Mena Vázquez: None; P. Estrada-Alarcón: None; L. Ladehesa: None; A. Escudero Contreras: None; C. López Medina: None.

To cite this abstract in AMA style:

Parra M, Ortega-Castro R, Calvo J, Cepas F, Robustillo-Villarino M, Zuniga-Vera A, Martinez-Feito A, Plasencia-Rodríguez C, Costa-Moya E, Taverner-Torrent D, Sainz Comas L, Diaz-Torne C, Ruiz-Esquide V, Rojas C, Martin-de la Sierra Lopez L, Jimenez-Rodriguez L, Velasco-Sanchez D, Fará Garcia R, Juan-Mas A, Moreno Garcia M, Acosta Alfaro A, Muñoz S, Martín López M, Zas R, GODOY NAVARRETE F, Anon Onate I, Ortiz-Márquez F, Mena Vázquez N, Estrada-Alarcón P, Ladehesa L, Escudero Contreras A, López Medina C. Certolizumab Pegol Shows a Higher Retention Rate Compared to JAK Inhibitors in Patients with Rheumatoid Arthritis, Regardless of Baseline Rheumatoid Factor Levels. A Multicenter Retrospective Study. [abstract]. Arthritis Rheumatol. 2025; 77 (suppl 9). https://acrabstracts.org/abstract/certolizumab-pegol-shows-a-higher-retention-rate-compared-to-jak-inhibitors-in-patients-with-rheumatoid-arthritis-regardless-of-baseline-rheumatoid-factor-levels-a-multicenter-retrospective-study/. Accessed .

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