Session Type: Abstract Submissions (ACR)
Background/Purpose: There is some rheumatoid arthritis (RA) patients with poor responses to certain biologics which requires switching to another biologics. However, there is no solid evidence to support such switching of biologics. We examined cytokine profiles for these patients to identify effective switching of biologics.
Methods: IORRA cohort is a hospital-based large observational cohort of Japanese RA patients.Clinical information and laboratory data are collected biannually. The patients who had switched biologics were chosen from the cohort. Serum levels of various cytokines (TNF alpha, IL-6, IL-17A, IL-1 beta, IL-8, MCP-1, TNF R1, TNF R2) before switching biologics were measured by using multiplex cytokine array system. Multiple regression model were used to examine following variables (objective variable: delta DAS28, explaining variable: previous DAS28, various cytokines) in several switching patterns. Statistical significant was established at p< 0.05.
Results: Eighty seven patients were identified as first TNF alpha antibody failure (infliximab: 50, etanercept: 21, adalimumab: 16). Thirty patients switched from one anti-TNF alpha antibody to another anti-TNF alpha agent, 36 switched to an anti-IL-6 antibody. Delta DAS28 (Post DAS28-Pre DAS28) set up in accordance with regression coefficient is shown Figure 1. Constant term, IL-17A and IL-1 beta was identified as significant regression coefficients in switching from one anti-TNF antibody to another anti-TNF alpha agent group. Pre DAS28 was only extracted as significant regression coefficients in switching from one anti-TNF antibody to an anti-IL-6 antibody group. Pre DAS28, TNF alpha, IL-8, MCP-1, TNFR1 and TNFR2 were chosen in concordance with EULAR good and moderate response cases in this group. It was impossible to examine the patients switching from etanercept because of the small number.
Conclusion: Our results suggest that cytokine profile maybe an effective way of predicting of possible switching from one biologic to another. Inefficient biologics switching may expose patients to further unnecessary joint destruction and cost.
Daiichi Sankyo, Mitsubishi Tanabe Pharma, Abbott Japan, Eisai, Takeda Pharmaceutical, Janssen Pharmaceutical, Hoffmann-La Roche, and Pfizer,
Abbott Japan, Asahikasei Kuraray Medical, Asahikasei Pharma, Astellas Pharma, AstraZeneca, MSD, Chugai Pharmaceutical, Daiichi Fine Chemical, Daiichi Sankyo, Dainippon Sumitomo Pharma, Eisai, GlaxoSmithKline, Janssen Pharmaceutical, Japan Tobacco, Kaken P,
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/multiple-cytokine-profiling-predicts-the-effectiveness-of-switching-biologics-in-rheumatoid-arthritis/