ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1390

Prediction of Clinical Response to Abatacept in Rheumatoid Arthritis Patients Through the Determination of Anti-Carbamylated Proteins Antibodies Levels

Silvia Piantoni1, Michele Boldini 1, Rajesh Kumar 1, Emirena Garrafa 1, Chiara Bazzani 2, Micaela Fredi 3, Ilaria Cavazzana 1, Angela Tincani 3 and Franco Franceschini 3, 1ASST Spedali Civili and University of Brescia, Brescia, Italy, 2Rheumatology and Clinical Immunology, Spedali Civili, Brescia, Italy, Brescia, Italy, 3Rheumatology and Clinical Immunology, Spedali Civili and Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy, Brescia, Italy

Meeting: 2019 ACR/ARP Annual Meeting

Keywords: , ,

Session Information

Date: Monday, November 11, 2019

Title: RA – Treatments Poster II: Established Treatments

Session Type: Poster Session (Monday)

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

Background/Purpose:

Carbamylation is a non-enzymatic irreversible post-translational modification of proteins. The presence of anti-carbamylated protein antibodies (anti-CarP) has been observed in rheumatoid arthritis (RA). In particular, it was recently demonstrated that the 16% of anti-citrullinated proteins antibodies (ACPA) negative RA patients had a positivity for anti-CarP, showing a more severe disease course than that of seronegative RA.  This study was focused to verify whether anti-CarP antibodies can be used as a predictive factor of clinical response to abatacept (ABA, CTLA4-Ig).

Methods:

Sixty rheumatoid arthritis patients (F/M=49/11; media (±standard deviation) of age= 57 (±12.1) years; CRP (C Reactive Protein)-DAS28= 4.59 (±0.99); ACPA positive (n (%))=51 (85); RF positive=35 (58)), treated with ABA were enrolled. A home-made ELISA for anti-CarP immunoglobulin G (IgG) and a commercial anti-CCP3.1 kit (Inova Diagnostic) for ACPA IgG were applied to determine serum levels every six months of therapy. Rheumatoid Factor (RF) IgG (Siemens) was also tested.

Results: At baseline, we found that 30% of our patients were positive for anti-CarP antibodies. Anti-CarP positive patients (n=18) were younger (p=0.01) with a longer disease duration(p=0.05) and with higher levels of CRP (p< 0.05), when compared to anti-CarP negative patients (n=42). Considering the entire cohort, a significant reduction of anti-CarP titre after twelve-months of treatment was shown (p< 0.01). A significant reduction of CRP-DAS28 in the first six months of therapy was found in the subgroup of anti-CarP positive patients in comparison with the negative ones (p=0.03). No significant results were found by dividing the cohort using the positivity to ACPA and/or RF.

Conclusion:

The precocious onset and a longer disease duration in anti-CarP positive patients might suggest them as a specific risk factors for RA in this subgroup of patients. The link between the anti-CarP positivity at baseline and the reduction of disease activity during the first six months of treatment let us to hypothesize that anti-CarP antibodies, but not ACPA and/or RF, could be a predictive factor of a good clinical response to ABA.

Shi J, PNAS USA 2011; Shi J, ARD 2014; Trouw LA, Autoimmun Rev 2012.

 

Disclosure: S. Piantoni, None; M. Boldini, None; R. Kumar, None; E. Garrafa, None; C. Bazzani, None; M. Fredi, None; I. Cavazzana, None; A. Tincani, None; F. Franceschini, None.

To cite this abstract in AMA style:

Piantoni S, Boldini M, Kumar R, Garrafa E, Bazzani C, Fredi M, Cavazzana I, Tincani A, Franceschini F. Prediction of Clinical Response to Abatacept in Rheumatoid Arthritis Patients Through the Determination of Anti-Carbamylated Proteins Antibodies Levels [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/prediction-of-clinical-response-to-abatacept-in-rheumatoid-arthritis-patients-through-the-determination-of-anti-carbamylated-proteins-antibodies-levels/. Accessed .

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