High anti-CCP antibody titres predict good response to rituximab in patients with active rheumatoid arthritis
High anti-CCP antibody titres predict good response to rituximab in patients with active rheumatoid arthritis
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DOI：
10.1016/j.jbspin.2014.06.001
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发表时间：
2014-10-01
期刊：
影响因子：
4.2
通讯作者：
Dieude, Philippe
中科院分区：
文献类型：
--
作者：
Gardette, Anais;Ottaviani, Sebastien;Dieude, Philippe
目的：既往研究表明，抗CCP抗体阳性预示着类风湿关节炎(RA)对利妥昔单抗(RTX)有良好的疗效。对这种可能性的量化方法可能是检测最有可能做出反应的患者子集的好方法。我们调查了血清中抗CCP抗体滴度是否可以预测类风湿关节炎患者对RTX的反应。主要标准是6个月时(M6)的DAS28>；1.2评分下降。根据EULAR，次要疗效标准包括良好反应和缓解。结果：114例RA患者(女性占81.6%，中位年龄53.5[IQR45.7-61.2]年，中位病程8.5[4.0-16.0]年)。抗CCP抗体阳性93例(81.6%)，抗体滴度中位数为583[195~1509]U/mL。总共有44名患者(38.6%)在M6时DA528和GT；1.2降低。在单变量分析中，在M6，抗CCP滴度高与对RTX有反应而不是无反应有关(中位数1122[355-1755]比386[149-800]U/mL，13=0.0191)。在多元回归分析中，以1000U/mL为界值时，抗CCP抗体滴度与DA528和GT1.2的下降(OR5.10[1.97~13.2]，P=0.0002)、EULAR良好应答(4.26[1.52~11.95]，P=0.0059)和EULAR缓解的趋势(2.52[0.78~8.12]，13=0.1207)相关。这一因素在临床实践中很容易评估，可以帮助个性化药物和选择RTX治疗的最佳候选者。(C)2014年法国兴业银行。爱思唯尔·马森公司出版。版权所有。
Objective: Previous 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.Methods: We 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.Results: We 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 DA528 > 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, 13= 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 DA528 > 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], 13= 0.1207).Conclusion: High 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. (C) 2014 Societe francaise de rhumatologie. Published by Elsevier Masson SAS. All rights reserved.