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Anti-Ro/ssa antibodies are an independent factor associated with an insufficient response to tumor necrosis factor inhibitors in patients with rheumatoid arthritis
The Journal of Rheumatology, 10/04/2011
Clinical Article
Matsudaira R et al. – The presence of anti-Ro might be related to the lesser clinical response to infliximab compared to other TNF inhibitors, suggesting that the presence of anti-Ro should be considered when choosing the appropriate biologics for patients with RA.
Methods- Clinical responses of cohort of 190 patients with RA who were treated with infliximab, etanercept, or adalimumab (n = 112, 64, and 14, respectively) as first biologics were examined using Disease Activity Score in 28 joints (DAS28) at 24 weeks and the discontinuation rate at 56 weeks
- Baseline characteristics of responders and nonresponders were compared
- Clinical response was compared between anti-Ro-negative and -positive patients
- Factors associated with inefficiency of TNF inhibitors were estimated with multivariable logistic regression analysis
- Positive rate of anti-Ro was significantly higher in patients with no European League Against Rheumatism (EULAR) response at 24 weeks (OR 3.64, 95% CI 1.45–9.01, p = 0.003)
- In anti-Ro-positive patients, a moderate or good EULAR response rate was significantly lower with a sustaining higher median DAS28 (p = 0.006), and this difference was greater among infliximabtreated patients
- Discontinuation rate for TNF inhibitors due to inefficacy at 56 weeks was also higher in anti-Ro-positive patients (OR 4.68, 95% CI 1.82–11.99, p = 0.0005), and 75% of these patients received infliximab
- Presence of anti-Ro was strongly associated with no EULAR response at 24 weeks and higher discontinuation rate of TNF inhibitors by 56 weeks (OR 5.22, 95% CI 1.75–15.57, p = 0.003 and OR 10.18, 95% CI 2.18–49.56, p = 0.003)
