Date: Sunday, November 8, 2015
Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
In a recent meta-analysis, neither rheumatoid
factor (RF) nor anti-cyclic citrullinated peptide (anti-CCP) antibody status
were associated with clinical response to treatment with anti-TNF agents.1
In contrast, anti-CCP positivity may be associated with increased abatacept
efficacy in patients (pts) with prior biologic failure2,3 and in
biologic-naïve pts.4 In this analysis, the efficacy of abatacept
after 6 months’ follow-up in biologic-naïve pts enrolled in the ACTION study was
compared in RF/anti-CCP-positive versus -negative pts.
prospective, observational study evaluating retention and effectiveness of IV abatacept
in pts with RA. Baseline characteristics and clinical outcomes were evaluated
at 6 months and compared for anti-CCP/RF-positive and -negative pts who were
biologic naïve using analysis of variance on ranks for quantitative variables
and Fisher exact tests for qualitative variables. EULAR response was based on
DAS28 (ESR or CRP) and derived from individual core components, as were mean CDAI
and Boolean remission.
status was reported in 577 (86%) pts (412 [71%] positive) and anti-CCP antibody
status in 552 (82%) pts (364 [66%] positive); 308/511 (60%) pts were double
positive and 127/511 (25%) pts were double negative. Clinical outcomes at 6
months were more beneficial for pts who were RF or anti-CCP positive versus
negative, including EULAR good or moderate response versus no response (Figure);
mean (95% CI) CDAI (calculated) (RF: 10.8 [9.8, 11.8] vs 15.3 [13.4, 17.2]; p<0.001;
anti-CCP: 10.9 [9.8, 12.0] vs 14.3 [12.4, 16.2]; p=0.002) and Boolean remission
(RF: 13.3% vs 4.0%; p=0.008; anti-CCP: 12.5% vs 6.3%; p=0.096). Similarly, significant
differences in clinical outcomes were observed for pts who were RF/anti-CCP single
positive or double positive versus double negative, respectively, including
EULAR good or moderate response versus no response (Figure); mean (95% CI) CDAI
(calculated) (11.1 [10.2, 12.1] and 10.5 [9.3, 11.6] vs 14.5 [12.3, 16.7];
p=0.003 and p=0.001, respectively) and Boolean remission (12.3% and 13.8% vs
3.8%; p=0.025 and p=0.013, respectively).
superior efficacy of abatacept in biologic-naïve pts who are RF and/or anti-CCP
positive versus negative, even when using stringent remission criteria. The
association between autoantibody status and clinical outcomes with abatacept
may be linked to the mechanism of action.
et al. PLoS One 2014;9:e89442.
Gottenberg JE, et al. Ann Rheum Dis 2012;71:1815–9.
T, et al. Arthritis Rheum 2013;65(Suppl.10):465.
To cite this abstract in AMA style:Alten R, Nüßlein H, Galeazzi M, Lorenz HM, Mariette X, Cantagrel A, Chartier M, Desachy G, Poncet C, Rauch C, Le Bars M. Baseline Autoantibodies Preferentially Impact Abatacept Efficacy in Patients with RA Who Are Biologic Naïve: 6-Month Results from a Real-World, International, Prospective Study [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/baseline-autoantibodies-preferentially-impact-abatacept-efficacy-in-patients-with-ra-who-are-biologic-naive-6-month-results-from-a-real-world-international-prospective-study/. Accessed May 21, 2019.
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