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Abstract Number: 1229

Blood Lymphocyte Subsets for Early Identification of Non-Remission to TNF Inhibitors in Rheumatoid Arthritis

Eulalia Rodriguez-Martín1, Israel Nieto-Gañán1, Borja Hernández-Breijo2, Cristina Sobrino3, Carlota García-Hoz1, Javier Bachiller-Corral4, Ana Martínez-Feito5, Victoria Navarro-Compán6, Paloma Lapuente-Suanzes1, Gema Bonilla7, Dora Pascual-Salcedo8, Garbiñe Roy1, Teresa Jurado2, Pilar Nozal2, Mónica Vázquez4, Alejandro Balsa7, Luisa M Villar1 and Chamaida Plasencia7, 1Hospital Universitario Ramón y Cajal-IRYCIS, Madrid, Spain, 2Hospital Universitario La Paz-Idipaz, Madrid, Spain, 3Hospital Ramón y Cajal-IRYCIS, Madrid, Spain, 4Rheumatology, Hospital Universitario Ramón y Cajal, Madrid, Spain, 5Hospital Unversitario La Paz- idipaz, Madrid, Spain, 6Hospital Universitario La Paz IdiPaz, Madrid, Pais Vasco, Spain, 7Rheumatology, La Paz University Hospital-IdiPAZ, Madrid, Spain, 8Hospital Universitario La Paz- Idipaz, Madrid, Spain

Meeting: ACR Convergence 2020

Keywords: Anti-TNF Drugs, B-Lymphocyte, Biomarkers, Disease Activity, rheumatoid arthritis

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Session Information

Date: Sunday, November 8, 2020

Session Title: RA – Treatments Poster III: PROs, Biomarkers, Systemic Inflammation & Radiographs

Session Type: Poster Session C

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

Background/Purpose: TNF inhibitors (TNFis) are widely used for the treatment of rheumatoid arthritis (RA), although the response rates to this therapy in patients with RA remains heterogeneous and less than 50% achieve remission (REM). 
Our aim was to analyze baseline peripheral blood leukocytes profiles in order to search for biomarkers identifying patients who will most likely not achieve REM under TNFi treatment.

Methods: A prospective bi-center pilot study including 98 RA patients treated with TNFis and followed-up during 6 months. Patients were classified according to DAS28 as follows: those who achieved REM (DAS28≤2.6) and those who did not (DAS28 >2.6) at 6 months after starting TNFis.  These rates were also assessed by simplified disease activity index (SDAI ≤3.3 and SDAI >3.3, respectively).  Peripheral blood immune cells were studied by flow cytometry before treatment initiation.

Results: At 6 months, 61% or 80% of patients did not achieve REM by DAS28 or SDAI, respectively. Basal leukocyte profiles differed between REM versus non-REM patients. Non-REM patients showed lower percentages of total and naïve B cells at baseline than REM subjects. A B lymphocyte/CD4+ lymphocyte ratio (BL/CD4 ratio) < 0.2 clearly associated with a higher probability of non-REM status based on DAS28 at 6 months (OR=9.2, p=0.006). These data were confirmed when patient response was evaluated by SDAI index.

Conclusion: Our results strongly suggest that BL/ CD4 ratio could be considered as a useful biomarker for the early identification of non-remitters to TNFi in clinical practice.


Disclosure: E. Rodriguez-Martín, None; I. Nieto-Gañán, None; B. Hernández-Breijo, None; C. Sobrino, None; C. García-Hoz, None; J. Bachiller-Corral, None; A. Martínez-Feito, None; V. Navarro-Compán, Novartis Pharma, 1, 5, 8, AbbVie Inc., 5, 8, Eli Lilly and Company, 5, 8, Pfizer Inc., 5, UCB, 5, 8; P. Lapuente-Suanzes, None; G. Bonilla, None; D. Pascual-Salcedo, None; G. Roy, None; T. Jurado, None; P. Nozal, None; M. Vázquez, None; A. Balsa, BMS, 9; L. Villar, None; C. Plasencia, None.

To cite this abstract in AMA style:

Rodriguez-Martín E, Nieto-Gañán I, Hernández-Breijo B, Sobrino C, García-Hoz C, Bachiller-Corral J, Martínez-Feito A, Navarro-Compán V, Lapuente-Suanzes P, Bonilla G, Pascual-Salcedo D, Roy G, Jurado T, Nozal P, Vázquez M, Balsa A, Villar L, Plasencia C. Blood Lymphocyte Subsets for Early Identification of Non-Remission to TNF Inhibitors in Rheumatoid Arthritis [abstract]. Arthritis Rheumatol. 2020; 72 (suppl 10). https://acrabstracts.org/abstract/blood-lymphocyte-subsets-for-early-identification-of-non-remission-to-tnf-inhibitors-in-rheumatoid-arthritis/. Accessed February 24, 2021.
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