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.
Anti-CCP Titers Are Predictive of the Response to Biological Agents in Patients with Rheumatoid Arthritis.
Takahashi1, Ryo, Yanai1, Ryo, Furuya1, Hidekazu, Wakabayashi1, Kuninobu, Odai1, Tsuyoshi, Isozaki2, Takeo, Yajima1, Nobuyuki
Biological agents have changed the therapy of rheumatoid arthritis (RA) dramatically last few years. But in some cases, the effect is scarce, and there is also the risk to cause a serious infectious disease. Anti-cyclic citrullinated protein antibody (anti-CCP) is known as an important indicator for diagnosis of early RA and the positivity of anti-CCP is thought as one of the poor prognosis factors. To examine the relation between serum anti-CCP titer and patient responsiveness to biological agents in RA patients.
Anti-CCP was measured by ELISA. Disease activity and its clinical improvement were assessed using Disease Activity Scores [DAS28; erythrocyte sedimentation rate (ESR) 4] with European League Against Rheumatism (EULAR) response criteria.
In the present study, 64 patients with RA treated with biological agents (infliximab; 30, etanercept; 19, tocilizumab; 7, adalimumab; 8) were included. The mean age was 36.0±18.0 yrs, mean disease duration was 7.8±4.1 yrs, and mean baseline DAS28 was 5.42±1.47. Among the 64 RA patients, 55 patients (85.9%) were positive for anti-CCP, and the mean antibody titer was 293.1±733.4 U/ml. After 14 weeks of treatment, 26 patients showed good responses and 30 moderate responses to biologic agents based on EULAR response criteria, while 8 showed no clinical improvement.
The anti-CCP titer was 73.7±112.1 U/ml in the good responders and 230.3±261.5 U/ml in the moderate responders, which were significantly lower than in the non-responders (1335±1791.5 U/ml). In addition, 100% of patients with low (<100 U/ml) basal anti-CCP titers showed moderate-good response, and 88.0% of those with moderate (100499 U/ml) titers also showed a moderate-good response. Among those with higher (>=500 pg/ml) basal anti-CCP titers, 50% showed a moderate response and 50% no response. In addition, the anti-CCP titer was 85.9±879.1 U/ml in the group with remission at 14weeks, although significant higher titers of anti-CCP (396.8±129.2 U/ml) were seen in those had no remission.
The result suggests that anti-CCP titer might to be one of significant predictors of the efficacy of the biological agents in patients with RA.
To cite this abstract, please use the following information:
Takahashi, Ryo, Yanai, Ryo, Furuya, Hidekazu, Wakabayashi, Kuninobu, Odai, Tsuyoshi, Isozaki, Takeo, et al; Anti-CCP Titers Are Predictive of the Response to Biological Agents in Patients with Rheumatoid Arthritis. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :1277