AB0422 Serum Drug Level and Anti-Citrullinated Peptide Antibodies as Biomarkers That Predict Eular Response in Rheumatoid Arthritis - A New Step to Personalized Medicine

Clinical response in patients with rheumatoid arthritis (RA) treated with biologic agents can be influenced by their pharmacokinetics and immunogenicity. The present study evaluated the concordance between serum drug and antidrug levels as well as the clinical response in RA patients treated with biological agents who experience their first disease exacerbation while being on a stable biologic treatment. 154 RA patients treated with rituximab (RTX), infliximab (IFX), adalimumab (ADL), or etanercept (ETN) were included. DAS28, SDAI, and EULAR response were assessed at baseline and reevaluated at precise time intervals. At the time of their first sign of inadequate response, patients were tested for both serum drug level and antidrug antibodies level. At the next reevaluation, patients retreated with RTX that had detectable drug level had a better EULAR response (P=0.038) with lower DAS28 and SDAI scores (P=0.01andP=0.03). The same tendency was observed in patients treated with IFX and ETN regarding EULAR response (P=0.002andP=0.023), DAS28 score (P=0.002andP=0.003), and SDAI score (P=0.001andP=0.026). Detectable biologic drug levels correlated with a better clinical response in patients experiencing their first RA inadequate response while being on a stable biologic treatment with RTX, IFX, and ETN.

Download Full-text

Anticyclic Citrullinated Peptide Antibodies in Patients with Rheumatic Diseases other than Rheumatoid Arthritis: Clinical or Pathogenic Significance?

The Journal of Rheumatology ◽

10.3899/jrheum.141486 ◽

2015 ◽

Vol 42 (6) ◽

pp. 1063-1064 ◽

Cited By ~ 1

Author(s):

SARA CATERBI ◽

ONELIA BISTONI ◽

ALESSIA ALUNNO ◽

ELENA BARTOLONI ◽

ROBERTO GERLI

Keyword(s):

Rheumatoid Arthritis ◽

Rheumatic Diseases ◽

Citrullinated Peptide ◽

Anticyclic Citrullinated Peptide Antibodies ◽

Peptide Antibodies

Download Full-text

Circulating anti-citrullinated peptide antibodies, cytokines and genotype as biomarkers of response to disease-modifying antirheumatic drug therapy in early rheumatoid arthritis

BMC Musculoskeletal Disorders ◽

10.1186/s12891-015-0587-1 ◽

2015 ◽

Vol 16 (1) ◽

Cited By ~ 20

Author(s):

Mahmood M. T. M. Ally ◽

Bridget Hodkinson ◽

Pieter W. A. Meyer ◽

Eustasius Musenge ◽

Gregory R. Tintinger ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Drug Therapy ◽

Early Rheumatoid Arthritis ◽

Antirheumatic Drug ◽

Disease Modifying ◽

Antirheumatic Drug Therapy ◽

Citrullinated Peptide ◽

Disease Modifying Antirheumatic Drug ◽

Peptide Antibodies

Download Full-text

Markers of the early stage of rheumatoid arthritis

Diagnostyka Laboratoryjna ◽

10.5604/01.3001.0008.2523 ◽

2016 ◽

Vol 51 (4) ◽

pp. 305-314

Author(s):

Beata Polińska ◽

Joanna Matowicka-Karna ◽

Halina Kemona

Keyword(s):

Rheumatoid Arthritis ◽

Human Population ◽

Early Stage ◽

Clinical Signs ◽

High Sensitivity ◽

Unknown Etiology ◽

Serological Tests ◽

Citrullinated Peptide ◽

Peptide Antibodies

Rheumatoid arthritis (RA) is a chronic, autoimmune connective tissue disease of unknown etiology. RA affects about 1% of the human population, women suffer three times more often than men, with the peak incidence between the age of 40 to 50. The up-to-date criteria from 2010 for the diagnosis of RA include: occurrence and duration of clinical signs, indicators of inflammation and serological tests. Neopterin, a protein released by macrophages, is a sensitive indicator of inflammation and the severity of RA. Regarding the serological tests, anti-cyclic citrullinated peptide antibodies represent a well-known marker with the specificity for RA of about 98%. The antibodies may be present in the serum of patients even a few years before the first clinical signs of the disease, heralding erosive changes in the joints and more severe course of RA. The literature also contains reports about autoantibodies anti-CarP and anti-Sa/ anti-MCV, which may occur in people with pain and swelling of joints and precede full-blown development of RA as well as reflect disease activity. Serological diagnosis of RA may be supported by some genetic tests based on PCR for detecting mutations e.g. C1858T in the PNPN22 gene. In turn, the quantitative analysis of different classes of miRNAs seems justified in order to better classify patients showing symptoms of RA. Further studies are needed that take into account the role of different markers in the development of RA, and confirm the high sensitivity and specificity of these markers in the diagnosis of the disease.

Download Full-text