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Brief Report: Association of Rheumatoid Factor and Anti–Citrullinated Protein Antibody Positivity With Better Effectiveness of Abatacept: Results From the Pan‐European Registry Analysis
Author(s) -
Gottenberg J. E.,
Courvoisier D. S.,
Hernandez M. V.,
Ian F.,
Lie E.,
Canhão H.,
Pavelka K.,
Hetland M. L.,
Turesson C.,
Mariette X.,
Finckh A.
Publication year - 2016
Publication title -
arthritis and rheumatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.106
H-Index - 314
eISSN - 2326-5205
pISSN - 2326-5191
DOI - 10.1002/art.39595
Subject(s) - medicine , abatacept , rheumatoid arthritis , hazard ratio , rheumatoid factor , discontinuation , confidence interval , rheumatism , rituximab , lymphoma
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.