Association of Changes in Anticitrullinated Protein Antibody Levels With Resource Use and Disease Activity Measures in Rheumatoid Arthritis Patients a US Observational Cohort |
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| Affiliation: | 1. Bristol-Myers Squibb, Lawrenceville, NJ, USA;2. Department of Rheumatology, Brigham and Women''s Hospital, Boston, MA, USA;1. Motif BioSciences, Princeton, NJ, USA;2. Rutgers New Jersey Medical School, Trenton, NJ, USA;3. Veristat, Southborough, MA, USA;4. Duke University Medical Center, Durham, NC, USA;1. Department of Pharmacy, Peking University Third Hospital, Beijing, China;2. Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University Health Science Centre, Beijing, China;3. Department of Hematology, Peking University Third Hospital, Beijing, China;4. Department of Pharmacy, Beijing Tongren Hospital, Capital Medical University, Beijing, China;1. RTI Health Solutions, Research Triangle Park, NC, USA;2. Merck & Co, Inc, Kenilworth, NJ, USA;1. Department of Emergency and Hospital Medicine, Lehigh Valley Hospital and Health Network, Allentown, PA, USA;2. , Lehigh Valley Hospital and Health Network, Allentown, USA;3. Network Office of Research and Innovation, Lehigh Valley Hospital and Health Network, Allentown, PA, USA;4. Department of Internal Medicine, Lehigh Valley Hospital and Health Network, Allentown, PA, USA |
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| Abstract: | PurposeAnticitrullinated protein antibody (ACPA) concentration, beyond ACPA positivity, is indicative of more aggressive radiographic progression in patients with rheumatoid arthritis (RA). However, there is limited information on the association of changes in ACPA with resource use measures and/or disease activity measures. We evaluate associations between changes in levels of ACPA and outcomes, including durable medical equipment (DME) use, hospitalizations, and disease activity, in patients with established RA.MethodsPatients from the Brigham and Women's Hospital Rheumatoid Arthritis Sequential Study who had ACPA measurements at baseline and month 12 were included. Changes in ACPA levels from baseline to month 12 were categorized as a decrease (<−10%), no change (−10% to +10%), or increase (>+10%). DME use and hospitalizations were assessed twice yearly using patient questionnaires; disease activity was assessed annually. Binary multivariate logistic regression was used to analyze the association between changes in ACPA levels and DME use and hospitalizations; linear regression was used to assess the association with disease activity.FindingsOf 840 patients included in the analysis, 291 (34.6%), 266 (31.7%), and 283 (33.7%) had a decrease, no change, or increase in ACPA levels, respectively. A decrease in ACPA levels was associated with a reduction in DME use (adjusted odds ratio [aOR] = 0.64; 95% CI, 0.44–0.93; P = 0.02) and hospitalizations (aOR = 0.62; 95% CI, 0.41–0.95; P = 0.03) versus no change or increase. Adjusted mean changes in disease activity score in 28 joints (C-reactive protein), total and swollen joint counts, and pain scores were significantly greater in patients with decreased ACPA levels versus those with no change or increase (P < 0.05).ImplicationsAmong patients with RA, reductions in ACPA levels of >10% were associated with reductions in DME use, hospitalizations, and disease activity. ClinicalTrials.gov identifier: NCT01793103. |
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| Keywords: | anticitrullinated protein autoantibodies disease activity health care physical function rheumatoid arthritis |
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