Positivity for anti-cyclic citrullinated peptide is associated with a better response to abatacept: data from the ‘Orencia and Rheumatoid Arthritis’ registry

Gottenberg JE et al. – Real life efficacy of abatacept (ABA) in the Orencia and Rheumatoid Arthritis (ORA) registry was similar as that reported in clinical trials. Anti–CCP positivity was associated with a better response to ABA, independently from disease activity.

Methods

• The Orencia and Rheumatoid Arthritis” (ORA) prospective registry, promoted by the French Society of Rheumatology, has included 1003 patients with RA.

Results

• 773 patients had already fulfilled the 6–month follow–up visit. Only 21.3% of patients would have fulfilled inclusion criteria used in pivotal controlled trials.
• The European League Against Rheumatism (EULAR) response, was observed in 330 (59.1%) of the 558 assessed patients (good response: 20.4%, moderate response: 38.7%) and was similar in patients who did and in patients who did not fulfill inclusion criteria of controlled trials.
• Among EULAR responders, initial 28–joint disease activity score (5.4 (4.7–6.5) in responders vs 4.9 (4.0–6.0) in non responders, p< 0.0001), the proportion of rheumatoid factor (75.6% vs 66.7%, p= 0.03) and the proportion of anti–cyclic citrullinated peptide antibody (anti–CCP)–positivity (75.9% vs 62.2%, p= 0.001) were significantly higher.
• In multivariate analysis adjusted on initial 28–joint disease activity score and CRP, anti–CCP positivity was associated with EULAR response (OR=1.9;95% CI=1.2 to 2.9, p=0.007), but not rheumatoid factor (OR=1.0;95% CI=0.6 to 1.6, p=0.9).
• Anti–CCP positivity was also significantly associated with a higher ABA retention rate at 6 months.

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