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Abstract Number: 2663

Evaluation of Anti-Cyclic Citrullinated Peptide Autoantibody Levels in Clinical Practice and Its Association with Disease Activity

E Alemao1, KK Gandhi1, C Iannaccone2, M Frits2, JS Coblyn2, N Shadick2 and Michael Weinblatt2, 1Bristol-Myers Squibb, Princeton, NJ, 2Brigham and Women's Hospital, Boston, MA

Meeting: ACR/ARHP Annual Meeting 2015

Date of first publication: September 29, 2015

Keywords: Anti-CCP antibodies and rheumatoid arthritis (RA), Disease Activity

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Session Information

Date: Tuesday, November 10, 2015

Title: Rheumatoid Arthritis - Clinical Aspects Poster Session III

Session Type: ACR Poster Session C

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

Background/Purpose: Testing for anti-citrullinated
peptide antibodies (ACPA) is included in the 2010 ACR classification criteria
for RA. ACPA concentration, beyond ACPA positivity, is indicative of more
aggressive radiographic progression. However, there is limited information on
ACPA levels in clinical practice settings and its association with disease
activity measures.   Methods: Data were analyzed from patients (pts) enrolled in a large, US RA registry established in 2003. The registry mostly
comprises pts with established RA who were evaluated semi-annually for multiple
clinical PROs and resource utilization parameters. The current analysis is
based on pts enrolled in the registry with ACPA values at the time of baseline
visit. Baseline and follow-up ACPA levels were based on a well-documented and validated ELISA from Inova Diagnostics until its discontinuation in
2011; the Euro-Diagnostica assay (distributed by IBL-America, Minneapolis, MN), which supplied the ‘capture’
antibody for the original Inova Diagnostics ELISA, has been used since. In assessments,
the correlation between the two assays was 0.984. Mean changes from baseline over the first 5 years (yrs)
of enrolling into the registry were calculated. Four categories of ACPA change
from baseline were created based on quartiles of the distribution of ACPA change
to Yr 1. Multivariate regression analyses controlling for baseline covariates
were conducted to evaluate associations between ACPA change from baseline quartiles
and disease activity measures defined by CDAI, SDAI, DAS28 (CRP) and joint
counts.

Results:   Overall, 1309 (97%) registry pts were included in
the current analysis. The mean (SD) age of the
cohort was 56.01 (14.04) yrs and 83.2% were females. Figure 1 represents the mean
of ACPA levels up to Yr 5. The mean (SD) change in ACPA in
ACPA+ pts was –0.5 (71.3) U/ml, 50.8 (93.9) U/ml, 33.1 (123.1) U/ml, 33.9
(132.0) U/ml, 40.6 (122.4) for Yr 1 through Yr 5, respectively. The ACPA mean
change to Yr 1 quartiles had the following cut-off values: Q1 >–488.1 to ≤–13.6
U/ml; Q2 >–13.6 to ≤0.0 U/ml; Q3 >0 to ≤8.8 U/ml; Q4 >8.8
U/ml. The mean reductions in disease activity based on CDAI, SDAI and joint
counts were greatest for Q1 (Figure 2). Similar patterns of change in disease
activity were observed after controlling for baseline covariates in
multivariate analysis.  

Conclusion:

We observed that ACPA titers change over
time and ACPA increase is primarily observed in ACPA+ pts with higher ACPA
values at baseline. Pts with reduction in ACPA show a numerically greater
reduction in disease activity levels.

 

74011P_Figure01.jpg

 

74011P_Figure02.jpg  


Disclosure: E. Alemao, Bristol-Myers Squibb, 3,Bristol-Myers Squibb, 1; K. Gandhi, Bristol-Myers Squibb, 1,Bristol-Myers Squibb, 3; C. Iannaccone, None; M. Frits, None; J. Coblyn, None; N. Shadick, Amgen, Questcor, Crescendo Biosciences, UCB, Bristol-Myers Squibb, 2; M. Weinblatt, Amgen, Abbvie, Bristol-Myers Squibb, Lilly, Novartis, Merck, Pfizer, Roche, Crescendo, Myriad Genetics, UCB, 5,Bristol-Myers Squibb, Myriad Genetics, UCB, 2.

To cite this abstract in AMA style:

Alemao E, Gandhi K, Iannaccone C, Frits M, Coblyn J, Shadick N, Weinblatt M. Evaluation of Anti-Cyclic Citrullinated Peptide Autoantibody Levels in Clinical Practice and Its Association with Disease Activity [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/evaluation-of-anti-cyclic-citrullinated-peptide-autoantibody-levels-in-clinical-practice-and-its-association-with-disease-activity/. Accessed .
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