Brief Report: Association of Rheumatoid Factor and Anti–Citrullinated Protein Antibody Positivity With Better Effectiveness of Abatacept: Results From the Pan‐European Registry Analysis. Issue 6 (26th May 2016)

• Record Type: Journal Article
• Authors: Gottenberg, J. E.; Courvoisier, D. S.; Hernandez, M. V.; Iannone, F.; Lie, E.; Canhão, H.; Pavelka, K.; Hetland, M. L.; Turesson, C.; Mariette, X.; Finckh, A.
• Is Part Of: Arthritis & rheumatology. Volume 68:Issue 6(2016)
• Page Start: 1346
• Page End: 1352
• Publication Date: 2016-05-26
• Subjects: Arthritis -- Periodicals; Rheumatism -- Periodicals; 616.72
• DOI: 10.1002/art.39595
• Languages: English
• ISSNs: 2326-5191

Abstract

Abstract : Objective: To investigate the role of rheumatoid factor (RF) status and anti–citrullinated peptide antibody (ACPA) status as predictors of abatacept (ABA) effectiveness in patients with rheumatoid arthritis (RA). Methods: We conducted a pooled analysis of data from 9 observational RA registries in Europe (ARTIS [Sweden], ATTRA [Czech Republic], BIOBADASER [Spain], DANBIO [Denmark], GISEA [Italy], NOR‐DMARD [Norway], ORA [France], Reuma.pt [Portugal], and SCQM‐RA [Switzerland]). Inclusion criteria were a diagnosis of RA, initiation of ABA treatment, and available information on RF and/or ACPA status. The primary end point was continuation of ABA treatment. Secondary end points were ABA discontinuation for ineffectiveness or adverse events and response rates at 1 year (good or moderate response according to the European League Against Rheumatism criteria with LUNDEX adjustment for treatment continuation). Hazard ratios (HRs) and 95% confidence intervals (95% CIs) for the study end points in relation to RF and ACPA status were calculated. Results: We identified 2, 942 patients with available data on RA‐associated autoantibodies; data on RF status were available for 2, 787 patients (77.0% of whom were RF positive), and data on ACPA status were available for 1, 903 patients (71.3% of whom were ACPA positive). Even after adjustment for sociodemographic and disease‐ and treatment‐related confounders, RF and ACPA positivity were each associated with a lower risk of ABA discontinuation for any reason (HR 0.79 [95% CI 0.69–0.90], P < 0.001 and HR 0.78 [95% CI 0.68–0.90], P < 0.001, respectively), compared to RF‐negative and ACPA‐negative patients. Similar associations with RF and ACPA were observed for discontinuation of ABA treatment due to ineffectiveness, with HRs of 0.72 (95% CI 0.61–0.84) and 0.74 (95% CI 0.62–0.88), respectively (both P < 0.001). Conclusion: Our results strongly suggest that positivity for RF or ACPA is associated with better effectiveness of ABA therapy.