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.


Seropositivity and Response to RTX: Data From the CERERRA Collaboration.

Chatzidionysiou1,  Katerina, Lie2,  Elisabeth, Nasonov3,  Evgeny L., Lukina3,  Galina, Hetland4,  Merete L., Tarp5,  Ulrik, Ancuta6,  Ioan

Karolinska Institute, Stockholm, Sweden
Hosp Santa Maria, Lisbon, Portugal
University Medical Centre Ljubjana, Ljubljana, Slovenia
Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands
Hospital Clinico Universitario, Santiago, Spain
Diakonhjemmet Hospital, Oslo, Norway
ARBITER, Institute of Rheumatology, Moscow, Russia
DANBIO, Copenhagen University Hospital at Glostrup, Copenhagen, Denmark
Aarhus University Hospital, Aarhus, Denmark
Cantacuzino Hospital, Bucharest, Romania
1Institute of Rheumatology, Department of Experimental Rheumatology, 1st Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
ROB-FIN, Helsinki University Central Hospital, Helsinki, Finland
for the SCQM registry, University Hospitals of Geneva, Geneva, Switzerland

Background/Purpose:

Predictors of response to biologic therapy in rheumatoid arthritis (RA) are needed to achieve a more individualized therapy. Seropositivity has been associated with better response to rituximab (RTX). The purpose of this study was to assess the 6-month response to the first RTX course in RA according to RF and ACPA status.

Methods:

Ten European registries submitted anonymized datasets from RA patients who had started RTX, and datasets were pooled and analysed. Chi-square test for comparison of categorical variables and t-test for continuous data were used. Predictors of response were identified by logistic regression analysis.

Results:

3266 patients were included in the cohort. 79.9% of patients were RF (+) (2041 out of 2553) and 73.2% were ACPA (+) (877 out of 1198). 718 patients were double positive (DP) and 147 double negative (DN). 2200 patients were RF (+) and/or ACPA (+). Improvements of DAS28 (DDAS28) at 6 months were significantly better for RF (+) than RF (-) patients as well as for ACPA (+) than ACPA (-), DP vs. DN and RF and/or ACPA (+) vs. DN (table 1). A significantly higher percentage of ACPA (+) and DP patients achieved EULAR Good Response at 6 months compared to ACPA (-) and DN, respectively (table 1). The completeness of data was very similar for seropositive and seronegative patients, with the percentages of missing data at 6 months being approximately 50% in all groups. A significantly higher percentage of seronegative patients received retreatment by 6 months than seropositive patients. In univariate analyses adjusted for age and gender ACPA positivity (OR=2.03, p=0.016) and DP (OR=2.43, p=0.03) but not RF positivity (OR=1.53, p=0.07) predicted EULAR good response to therapy with RTX at 6 months after the first treatment.

Table 1. Clinical outcomes at 6 months for RTX treated patients according to RF and ACPA status.

 RF (+)RF (-)p-valueACPA (+)ACPA (-)p-value
Baseline DAS285.85 ± 1.365.63 ± 1.340.02*5.8 ± 1.355.68 ± 1.32NS
DeltaDAS28 6m1.94 ± 1.51.65 ± 1.340.0051.93 ± 1.511.40 ± 1.47<0.0001
EULAR Good/Moderate/ No 6m21.5/62/16.5%17.4/63.4/19.2%0.0623.9/58.7/17.4%14.9/62.9/22.2%0.009
Remission 6m13.8%11.3%NS13.5%10.9%NS
 DPDNp-valueRF and/or ACPA (+)DNp-value
Baseline DAS285.81 ± 1.365.65 ± 1.36NS5.84 ± 1.355.65 ± 1.36NS
DeltaDAS28 6m1.95 ± 1.541.41 ± 1.510.0071.93 ± 1.491.41 ± 1.510.005
EULAR Good/Moderate/No 6m24.7/58.4/16.9%13.8/65/21.2%0.0621.4/61.9/16.7%13.8/65/21.2%0.038
Remission 6m13.9%12.5%NS13.7%12.5%NS
* Corrected for baseline DAS28.

Conclusion:

In this large observational cohort of RA patients treated with RTX, seropositive patients achieved significantly greater reductions in DAS28 at 6 months compared to seronegative patients. Baseline ACPA positivity may be a better predictor for good response to RTX than RF positivity.

To cite this abstract, please use the following information:
Chatzidionysiou, Katerina, Lie, Elisabeth, Nasonov, Evgeny L., Lukina, Galina, Hetland, Merete L., Tarp, Ulrik, et al; Seropositivity and Response to RTX: Data From the CERERRA Collaboration. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :1646
DOI:

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