High anti-CCP antibody titres predict good response to rituximab in patients with active rheumatoid arthritis |
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| Affiliation: | 1. Université Paris Diderot, Service de Rhumatologie, Hôpital Bichat, AP–HP, Paris, France;2. AP–HP, Hôpital Bichat-Claude-Bernard, Département d’Épidémiologie Biostatistique et Recherche Clinique, Paris, France;3. Université Paris Diderot, Sorbonne Paris Cité, Paris, France;4. INSERM, CIE801, Paris, France;5. Université Paris Diderot, Service d’Immunologie, Hôpital Bichat, AP–HP, Paris, France;6. Université Paris Diderot, INSERM U699, Paris, France;1. Rheumatology and Rehabilitation Department, Faculty of medicine Cairo University, Cairo, Egypt;2. Rheumatology and Rehabilitation Department, Faculty of medicine, Dr. Erfan and Bagedo General Hospital, Jeddah, Saudi Arabia;3. Radiology Department, Faculty of medicine, Cairo University, Cairo, Egypt;4. Radiology Department, Dr. Erfan and Bagedo General Hospital, Jeddah, Saudi Arabia;5. Rheumatology and Rehabilitation Department, Suez Canal University, Ismailia, Egypt;6. Cardiology Department, Al-Azhar university, Faculty of Medicine, Cairo, Egypt;7. Internal medicine department faculty of medicine Cairo University, Cairo, Egypt;8. Clinical and Chemical Pathology Department, Faculty of Medicine, Cairo University, Cairo, Egypt;9. Rheumatology Department, University of Twente, Enschede, The Netherlands;1. Rheumatology Unit, Department of Medicine DIMED, University of Padova, Via Giustiniani 2, 35128 Padova, Italy;2. Clinica Medica 4, University of Padova, Padova, Italy;3. Medicina I, Ospedale Ca’ Foncello, Treviso, Italy;4. Laboratory Medicine, University of Padova, Padova, Italy;1. Department of Rheumatology, Lapeyronie Hospital, Montpellier I University, UMR 5535, EA2415, Montpellier, France;2. Mohammed V-Souissi University, Faculty of Medicine, Laboratory of Biostatistics, Clinical Research and Epidemiology, Rabat, Morocco;3. UFR de médecine, université-Pierre-et-Marie-Curie–Paris-VI, 75013 Paris, France;1. Pôle de Gériatrie, Centre Antonin-Balmes, CHU de Montpellier, 39, avenue Charles-Flahault, 34395 Montpellier Cedex 5, France;2. Laboratoire Movement to Health, Euromov, Université Montpellier 1, Site de Référence MACVIA-LR, Contre les Maladies Chroniques pour un vieillissement actif en Languedoc-Roussillon, 700, avenue du Pic-Saint-Loup, 34090 Montpellier, France;3. Gérontopôle de Toulouse, Hôpital La Grave-Casselardit, CHU de Toulouse, Toulouse, France;4. UPRES EA 4638, Service de gériatrie, CHU d’Angers, Angers, France;5. EA4708 I3MTO, University of Orleans, Orleans, France;6. Service de Gériatrie, CHU de Nancy, Inserm U1116, Université de Lorraine, Nancy, France;7. Service de gériatrie, CHU de Nantes, Nantes, France;8. Service de rhumatologie et GEROM, CHU d’Angers, Angers, France;9. Médecine Générale, Paris, France;10. Service de Radiologie Ostéoarticulaire, Hôpital Lariboisière, Paris, France;11. Service de rhumatologie, hôpital Cochin, université Paris-Descartes, Paris, France;12. Service de rhumatologie, Hôpital Nord, Amiens, France;13. Service de rhumatologie, CHU de Nice-1, université Nice Sophia-Antipolis, Nice, France;14. Service de rhumatologie, 35500 Vitré, France;15. Service de rhumatologie, CHU de Lyon, Lyon, France;p. Inserm U606, Université Paris-Diderot Paris 7, hôpital Lariboisière, Paris, France;q. Service de gérontologie, hôpital Broca, université Paris Descartes, Paris, France;r. Université Paris-Sud, UMRS 1018, Villejuif, France;s. Inserm ERI 12, service de rhumatologie, CHU d’Amiens, Amiens, France;t. Service de chirurgie orthopédique, hôpital Saint-Antoine, Paris, France;u. Centre de médecine gériatrique, CHR d’Orléans, Orléans, France;v. Inserm UMR U 991, Service de rhumatologie, CHU de Rennes, Rennes, France;w. Service de gérontologie, hôpital Broca, Paris, France;x. Centre de Rhumatologie, CHU Purpan, Toulouse, France;y. Service de gynécologie médicale et médecine du couple, hôpital Jeanne-de-Flandre, CHRU de Lille, Lille, France;z. Centre de référence des maladies rares du calcium et du phosphore, CIC Inserm 204, CHU de Rouen, Rouen, France;11. Service de rhumatologie, hôpital Côte-de-Nacre, Caen, France;12. Service de rhumatologie, hôpital Lariboisière, Paris, France;13. Service de Gériatrie, CHU de Lille, Lille, France;14. Service de rhumatologie, Angers, France;15. Laboratoire d’Explorations Fonctionnelles, Inserm U845, Hôpital Necker-Enfants–Malades, Paris, France;16. Service de chirurgie orthopédique des adultes de l’Institut Calot-de-Berck, Berck-sur-Mer, France;17. Centre de ménopause, hôpital Paule-de-Viguier, Toulouse, France;18. Service d’endocrinologie, CHU de Nancy, Vandoeuvre-lès-Nancy, France;19. Inserm U1059, Service de Rhumatologie, CHU de Saint-Étienne, 42055 Saint-Étienne Cedex 2, France;1. Division of Musculoskeletal and Dermal Sciences, Arthritis Research UK Centre for Genetics and Genomics, Centre for Musculoskeletal Research, Manchester Academic Health Science Centre, The University of Manchester, Room 2.607, Stopford Building, Oxford Road, Manchester M13 9PT, UK;2. NIHR Manchester Biomedical Research Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester M139WU, UK;1. Clinical immunology and osteoarticular diseases therapeutic Unit, Lapeyronie University Hospital, 371, avenue du doyen-Gaston-Giraud, 34295 Montpellier, France;2. Department of Radiology, Lapeyronie Hospital, 34295 Montpellier, France |
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| Abstract: | ObjectivePrevious studies reported that anti-CCP antibody positivity predicts good response to rituximab (RTX) in rheumatoid arthritis (RA). A quantitative approach to such possibility could be a good way to detect the subset of patients most likely to respond. We investigated whether serum anti-CCP antibody titres could predict response to RTX in RA patients.MethodsWe retrospectively investigated RA patients who received RTX. The primary criterion was decrease in DAS28 > 1.2 at 6 months (M6). Secondary efficacy criteria included a good response and remission according to EULAR. Predictors of response were investigated by multivariate logistic regression analysis.ResultsWe included 114 RA patients (81.6% female, median age 53.5 [IQR 45.7–61.2] years, median disease duration 8.5 [4.0–16.0] years). Anti-CCP antibodies were present in 93 patients (81.6%), with median anti-CCP antibody titres 583 [195–1509] U/mL. In all, 44 patients (38.6%) showed decreased DAS28 > 1.2 at M6. On univariate analysis, high anti-CCP titres were associated with response rather than non-response to RTX (median 1122 [355–1755] vs. 386 [149–800] U/mL, P = 0.0191) at M6. On multivariate regression analysis, with a cut-off of 1000 U/mL, anti-CCP antibody titres ≥ 1000 was associated with a decrease in DAS28 > 1.2 (OR 5.10 [1.97–13.2], P = 0.0002); a EULAR good response (4.26 [1.52–11.95], P = 0.0059); and a trend for EULAR remission (2.52 [0.78–8.12], P = 0.1207).ConclusionHigh anti-CCP antibody titres predict response to RTX in RA. This factor, easily assessed in clinical practice, can help with personalized medicine and selecting the best candidates for RTX treatment. |
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