Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.
Baseline Serum Interferon Beta/Alpha Ratio Predicts Response to Tumor Necrosis Factor Alpha Inhibition in Rheumatoid Arthritis.
Aggrawal1, Rachna, Franek1, Beverly S., Kern2, Marlena, Gregersen2, Peter K., Niewold1, Timothy B.
Response to tumor necrosis factor alpha (TNF-a) inhibition is heterogenous in rheumatoid arthritis (RA). Previous studies have suggested that circulating type I interferon (IFN) levels may predict treatment response to TNF-a inhibitors and other biological agents in RA. Prediction of likely responders prior to initiating therapy would represent a major advance in biological treatment strategies for RA.
We studied sera from 32 RA patients from the ABCoN Consortium pre-treatment and 46 weeks after beginning treatment with TNF-a inhibitors, selecting patients who either had a good response or no response at 14 weeks by EULAR criteria. 27 of the 32 subjects were of European ancestry. Total serum type I IFN activity as well as IFN-a vs. IFN-b activity were measured using a functional reporter cell assay. Data were available regarding baseline and follow up disease activity score (DAS), EULAR response criteria at 14 weeks, anti-CCP antibody titer, and type of TNF-a inhibitor used.
An increased ratio of IFN-b/IFN-a >1.3 in the pre-treatment serum sample was associated with lack of response by EULAR criteria at 14 weeks (p=0.009). Similarly, higher IFN-b/IFN-a ratio was positively correlated with higher DAS score at 14 weeks (Spearman's rho= 0.57, p=0.0075). Anti-CCP antibody titer and type of TNF-a inhibitor did not influence this relationship. In follow up sera at 46 weeks, the EULAR non-responders were more likely to have increased total type I IFN activity than good responders (p=0.008), and this increase was characterized by a shift toward increased IFN-a as compared to good responders (p=0.039).
Increased pre-treatment serum IFN-b/IFN-a ratio was strongly associated with non-response to TNF-a inhibition by EULAR criteria at 14 weeks. A previous study of IFN-b/IFN-a ratio and response to TNF-a inhibiton in Hispanic-American RA patients reported an association, although in a different direction than our predominantly European ancestry population. This may represent a population-specific difference, and both studies support the potential utility of serum type I IFN in predicting outcome of TNF-a inhibition in RA.
To cite this abstract, please use the following information:
Aggrawal, Rachna, Franek, Beverly S., Kern, Marlena, Gregersen, Peter K., Niewold, Timothy B.; Baseline Serum Interferon Beta/Alpha Ratio Predicts Response to Tumor Necrosis Factor Alpha Inhibition in Rheumatoid Arthritis. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :456