Session Type: ACR Poster Session C
Session Time: 9:00AM-11:00AM
Background/Purpose: For twenty years, the Epstein-Barr Virus (EBV) has been suspected to contribute to Rheumatoid Arthritis (RA). Immunity against EBV is impaired in RA. RA patients have high titer anti-EBV antibodies . They also have defective EBV specific suppression by T cells. This contributes to a higher risk of developing lymphoma . We hypothesized that, in RA patients, immunosuppressive drugs may enhance the risk to develop LPD (lymphoproliferative disorders), as it is seen in post transplant patients . We have previously shown that Methotrexate and TNF alpha antagonists do not increase EBV load in RA [4,5]. Our purpose is to monitor EBV load in peripheral blood mononuclear cells (PBMC) of RA patients treated with 2 recent bDMARDs: Abatacept (CTLA4 Ig) a T cell activation inhibitor, and Tocilizumab, an anti IL6 receptor antibody to test whether they may enhance EBV load and lymphoma risk.
Methods: Patients :We included 90 patients with RA, 55 treated by abatacept (+/- methotrexate) and 35 treated with tocilizumab (+/-methroexate) followed at the Sainte-Marguerite Hospital Rheumatologic Department Marseille. All patients fullfilled the 1987 American College of Rheumatology criteria. All patients gave informed consent. (Patients Characteristics, Table1) Quantification of viral load – PBMC were separated on Ficoll gradient
The Raji EBV positive Burkitt lymphoma cell line, containing 50 copies of EBV per cell, was used as external standard. Real time quantitative PCR (LightCycler, Roche Diagnostics) was performed on 500 ng of DNA. A 214 bp sequence of the Internal Repeat was amplified. Two internal probes were used to improve specificity. Statistics : Generalized estimating equation were used to test whether EBV load is influenced by treatment
Results: Abatacept does not enhance EBV mean load after 3 years of treatment. No lymphoma occured. Tocilizumab was associated with a significant decreased EBV load during time (p = 0.021). None of the patients had a detectable load at 36 months. No lymphoma occured.
Conclusion: Reliable tool to monitor EBV load No obvious change of EBV mean load under treatment with tocilizumab and abatacept
To cite this abstract in AMA style:Massy E, Texier G, Muis Pistor O, Martin M, Auger I, Mattei JP, Guis S, Pham T, Roudier J, Balandraud N. EBV Load Quantification in Peripheral Blood Mononuclear Cells of Patients with Rheumatoid Arthritis Treated By Abatacept and Tocilizumab [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/ebv-load-quantification-in-peripheral-blood-mononuclear-cells-of-patients-with-rheumatoid-arthritis-treated-by-abatacept-and-tocilizumab/. Accessed December 1, 2020.
« Back to 2016 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/ebv-load-quantification-in-peripheral-blood-mononuclear-cells-of-patients-with-rheumatoid-arthritis-treated-by-abatacept-and-tocilizumab/