AB0409 B CELLS PROFILE AS A BIOMARKER FOR EARLY IDENTIFICATION OF OPTIMAL RESPONDERS TO TNF INHIBITORS IN RHEUMATOID ARTHRITIS. (June 2019) - Sobrino, Cristina
Abstract : Background: The most common biological agents used as disease-modifying treatment in rheumatoid arthritis (RA) are TNF inhibitors (TNFi). Although these new strategies to treat RA have improved the course of the disease, approximately 30-50% of patients do not respond to this therapy. Early identification of optimal responders is crucial in the clinical setting. Objectives: The aim of this study was to investigate if baseline percentages of different leukocyte subsets in peripheral blood (PBMCs) can contribute to identify RA patients who will respond to TNFi. Methods: This was a prospective bi-center pilot study including 100 RA patients under TNFi therapy. Clinical activity was assessed at baseline and 6 months of treatment by disease activity score 28 (DAS28), considering optimal responders if they reached remission at 6 months (DAS28≤2.6). PBMCs were obtained before treatment and different leukocyte subsets were evaluated by flow cytometry (FACSCantoII instrument). The association between the percentage of PBMCs at baseline and clinical response at 6 months was evaluated through logistic regression models (odds ratio; 95% CI). All the analyses were adjusted by sex, age, disease duration, concomitant methotrexate, baseline DAS28 and seropositivity (ACPA and/or RF). Results: Demographic characteristics are shown in Table 1 . After 6m of TNFi treatment, 40% of the patients achieved clinical remission. A significant association between higher percentage of total B cells (OR=1.19; 95%; CI:1.05-1.35; p=0.007) and naive B cells (Bn; OR=1, 32; 95%; IC:1.08-1.61; p=0.007) at baseline and clinical response was found. The other PBMC subsets (monocytes, NK cells, CD4+ and CD8+ T cells subtypes) did not show statistical differences (Figure 1 ). Conclusion: Our results suggest that basal B cells profile may contribute to identify optimal responders to TNFi in RA. (Funding: ISCIII (PI16/01092, PI16/00474). Disclosure of Interests: Cristina Sobrino: None declared, Borja Hernández-Breijo: None declared, Carlota García-Hoz: None declared, Israel Nieto-Gañán: None declared, Victoria Navarro-Compán: None declared, ANA MARTÍNEZ-FEITO: None declared, Javier Bachiller-Corral: None declared, Gemma Bonilla: None declared, Paloma Lapuente-Suanzes: None declared, Cristina Pijoan Moratalla: None declared, DORA PASCUAL-SALCEDO Grant/research support from: Pfizer, Speakers bureau: Pfizer, Abbvie, Takeda, Alejandro Balsa Grant/research support from: Abbvie, Pfizer, Novartis, BMS, Nordic, Sanofi, Consultant for: Abbvie, Pfizer, Novartis, BMS, Nordic, Sanofi, Sandoz, Lilly, Paid instructor for: Pfizer, Speakers bureau: Pfizer, Novartis, UCB, Nordic, Sanofi, Sandoz, Lilly, Garbiñe Roy: None declared, Mónica Vázquez: None declared, Luisa María Villar: None declared, Chamaida Plasencia Speakers bureau: Pfizer, MSD, Eulalia Rodríguez-Martín: None declared