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Abstract Number: 2648

Predictive Role of Biomarkers for the Response to Biologic Therapy in Rheumatoid Arthritis. Old, New and How Future Looks like?

Bogdan Ion Gavrila1, Claudia Ciofu2, Victor Stoica3, Cornel Ursaciuc4, Dan Ciotaru4, Mihaela Surcel5, Adriana Munteanu4 and Eugenia Panaitescu6, 1Internal Medicine and Rheumatology, Department of Internal Medicine and Rheumatology Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania, Bucharest, Romania, 2Department of Internal Medicine and Rheumatology Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania, Bucharest, Romania, 3Carol Davila University of Medicine and Pharmacy, Internal Medicine and Rheumatology Department, Cantacuzino Clinical Hospital, Bucharest, Romania, 4INCD ,,Victor Babeș’’, Bucharest, Romania, Bucharest, Romania, 5INCD ,,Victor Babeș’’, Bucharest, Romania, bucharest, Romania, 6Carol Davila University of Medicine and Pharmacy ,Medical Informatics and Biostatistics, Bucharest, Romania

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords: Biologic agents, biomarkers and rheumatoid arthritis (RA)

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Session Information

Date: Tuesday, November 15, 2016

Title: Rheumatoid Arthritis – Small Molecules, Biologics and Gene Therapy - Poster III

Session Type: ACR Poster Session C

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

Background/Purpose: discovery of biomarkers that can identify pretreatment patients who will respond to biologic DMARDs therapy is one of the major interests in RA. We proposed to test the possible predictive role of RF isotypes IgM and Ig A, anti-CCP, anti-mutated citrullinated vimentin (anti-MCV), 14-3-3 eta protein and COMP on a group of patients treated with anti-TNF α agents.We have also assessed the status of these biomarkers and response to biologic therapy.

Methods: prospective and observational study including 64 patients followed 12 months with active RA, uncontrolled by conventional synthetic DMARDs or declared nonresponders to one of the biologic DMARDs and required switch to another biologic DMARDs. Clinical assessment was performed at 0, 6 and 12 months according to ACR criteria approved by OMERACT and evaluation of treatment response according to EULAR criteria (good /moderate /nonresponder).

Results: mean age was 57.55 ± 9.427 years, of the 64 patients included in the study 59 (92.2%) were women and 5 (7.9%) men. At 6 months, 7 patients were declared nonresponders, 38 achieved a moderate response and 19 good response. Following baseline immunological parameters titres and the response at 6 months, general tests have identified significant differences between groups.Tests for identifying differences between the groups showed that lower titres of both RF isotypes , anti-CCP, 14-3-3 eta protein and COMP had predictive value on achieving a good EULAR response at 6 months. Grouping patients in 2 categories (responders/nonresponders), just 14-3-3 eta protein and anti-CCP maintained their predictive value for the response at 6 months.

 

Nonresponder

Moderate response

Good response

Comparison of responses ( p value )

Nonresponder

Responder

Comparison of responses ( p value )
N

7

38

19

7

57

RF type Ig M 132.35± 99.602   157.22±131.47   51.36±95.359   0.01629 132.35± 99.602   121.93±129.92   0.57168
RF type Ig A 122.81±99.876   102.08±128.33   22.45±61.256   0.03336 122.81±99.87 75.54±116.282 0.30787
Anti- MCV 74.04±47.951 80.06±149.543 33.77±113.069 0.45914 74.04±47.951 64.63±139.174 0.86037
14-3-3 eta protein 0.99±0.888   0.28±0.469   0.51±0.580   0.04518 0.99±0.888   0.36±0.515   0.04042
Anti-CCP 146.16±41.688   113.65±50.448   60.82±26.331   0.00011 146.16±41.68 96.04±50.355 0.02834
COMP 1042.2±181.71   1032.8±188.67 746.04±130.09 0.00000 1042.2± 181.717

 

937.27±218.10

 

0.22727

After 12 months, 1 patient was declared nonresponder, 11 achieved moderate response and 14 good response. For this visit, lower baseline titres for RF type Ig M (92.93±120.22U/ml, p=0.01032) and Ig A (49.96±98.08 U/ml,p=0.00247) had predictive value for achieving a good response at 12 months . We didn’t obtain other informations grouping patients in 2 categories . Regarding the status of biomarkers and treatment response, the only differences were obtained for COMP (p = 0.0001) at 6 months for good response and RF type IgA (p=0.0041) for good response at 12 months. Using multivariate logistic regression methods we obtained a statistical model for predicting the response at 6 months including normal values for 14-3-3 eta protein, anti-CCP and COMP. The model is a good approximation for the situation analyzed (Hosmer and Lemeshow according test λ² = 5.795, p = 0.670 ≥0.05) with a predictive response accuracy of 89.1%.

Conclusion: because until now has not been discovered a single biomarker capable of distinguishing pretreatment responders versus nonresponder, in the future a version using multiple biomarkers could increase accuracy for identifying pretreatment these patients.


Disclosure: B. I. Gavrila, None; C. Ciofu, None; V. Stoica, None; C. Ursaciuc, None; D. Ciotaru, None; M. Surcel, None; A. Munteanu, None; E. Panaitescu, None.

To cite this abstract in AMA style:

Gavrila BI, Ciofu C, Stoica V, Ursaciuc C, Ciotaru D, Surcel M, Munteanu A, Panaitescu E. Predictive Role of Biomarkers for the Response to Biologic Therapy in Rheumatoid Arthritis. Old, New and How Future Looks like? [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/predictive-role-of-biomarkers-for-the-response-to-biologic-therapy-in-rheumatoid-arthritis-old-new-and-how-future-looks-like/. Accessed .
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