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Rheumatoid factor positivity rather than anti-CCP positivity, a lower disability and a lower number of anti-TNF agents failed are associated with response to rituximab in rheumatoid arthritis.
Rheumatology (Oxford) 2009; 48(12):1557-9R

Abstract

OBJECTIVES

We explored clinical factors associated with a major response to rituximab (RTX) (e.g. ACR >/=50, and European League against Rheumatism (EULAR) moderate to good response) in patients with active long-standing RA and inadequate response to anti-TNF agents or traditional DMARDs.

METHODS

RTX was used in 110 RA patients in six different Italian centres. The mean disease activity score on 28 joints (DAS28) was 6.4 +/- 0.99 and the mean HAQ was 1.63 +/- 0.68 at baseline. Thirty-two patients (29.1%) underwent RTX after the failure of DMARD therapy, 37 (33.6%) had failed or were intolerant to at least two anti-TNF agents, and 41 (37.3%) had failed or were intolerant to one anti-TNF agent. Univariate and multivariate analyses were performed.

RESULTS

The number of previous anti-TNF agents (P = 0.043), HAQ (P = 0.023), RF positivity (P < 0.0001) and anti-cyclic citrullinated peptide (anti-CCP) positivity (P = 0.003) were associated with ACR response >or=50 between month +4 and month +6 after starting RTX by univariate analysis. Multivariate analysis confirmed that a lower HAQ, a lower number of anti-TNF agents failed before RTX and RF positivity, but not anti-CCP positivity, were the selected variables associated with an ACR response >or=50, with an accuracy of 84% of the model. Only RF positivity correlated with EULAR moderate to good response both in the univariate and in the multivariate analysis, with an accuracy of 79% of the model.

CONCLUSION

RF-positive rather than anti-CCP-positive RA patients with lower baseline disability and a lower number of previously failed TNF blockers may be the best candidates to RTX.

Authors+Show Affiliations

Clinica di Reumatologia, DPMSC, Azienda Ospedaliero-Universitaria S Maria della Misericordia, University of Udine, Udine, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

19789202

Citation

Quartuccio, Luca, et al. "Rheumatoid Factor Positivity Rather Than anti-CCP Positivity, a Lower Disability and a Lower Number of anti-TNF Agents Failed Are Associated With Response to Rituximab in Rheumatoid Arthritis." Rheumatology (Oxford, England), vol. 48, no. 12, 2009, pp. 1557-9.
Quartuccio L, Fabris M, Salvin S, et al. Rheumatoid factor positivity rather than anti-CCP positivity, a lower disability and a lower number of anti-TNF agents failed are associated with response to rituximab in rheumatoid arthritis. Rheumatology (Oxford). 2009;48(12):1557-9.
Quartuccio, L., Fabris, M., Salvin, S., Atzeni, F., Saracco, M., Benucci, M., ... De Vita, S. (2009). Rheumatoid factor positivity rather than anti-CCP positivity, a lower disability and a lower number of anti-TNF agents failed are associated with response to rituximab in rheumatoid arthritis. Rheumatology (Oxford, England), 48(12), pp. 1557-9. doi:10.1093/rheumatology/kep314.
Quartuccio L, et al. Rheumatoid Factor Positivity Rather Than anti-CCP Positivity, a Lower Disability and a Lower Number of anti-TNF Agents Failed Are Associated With Response to Rituximab in Rheumatoid Arthritis. Rheumatology (Oxford). 2009;48(12):1557-9. PubMed PMID: 19789202.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Rheumatoid factor positivity rather than anti-CCP positivity, a lower disability and a lower number of anti-TNF agents failed are associated with response to rituximab in rheumatoid arthritis. AU - Quartuccio,Luca, AU - Fabris,Martina, AU - Salvin,Sara, AU - Atzeni,Fabiola, AU - Saracco,Marta, AU - Benucci,Maurizio, AU - Cimmino,Marco, AU - Morassi,Pia, AU - Masolini,Paola, AU - Pellerito,Raffaele, AU - Cutolo,Maurizio, AU - Puttini,Piercarlo Sarzi, AU - De Vita,Salvatore, Y1 - 2009/09/29/ PY - 2009/10/1/entrez PY - 2009/10/1/pubmed PY - 2010/3/27/medline SP - 1557 EP - 9 JF - Rheumatology (Oxford, England) JO - Rheumatology (Oxford) VL - 48 IS - 12 N2 - OBJECTIVES: We explored clinical factors associated with a major response to rituximab (RTX) (e.g. ACR >/=50, and European League against Rheumatism (EULAR) moderate to good response) in patients with active long-standing RA and inadequate response to anti-TNF agents or traditional DMARDs. METHODS: RTX was used in 110 RA patients in six different Italian centres. The mean disease activity score on 28 joints (DAS28) was 6.4 +/- 0.99 and the mean HAQ was 1.63 +/- 0.68 at baseline. Thirty-two patients (29.1%) underwent RTX after the failure of DMARD therapy, 37 (33.6%) had failed or were intolerant to at least two anti-TNF agents, and 41 (37.3%) had failed or were intolerant to one anti-TNF agent. Univariate and multivariate analyses were performed. RESULTS: The number of previous anti-TNF agents (P = 0.043), HAQ (P = 0.023), RF positivity (P < 0.0001) and anti-cyclic citrullinated peptide (anti-CCP) positivity (P = 0.003) were associated with ACR response >or=50 between month +4 and month +6 after starting RTX by univariate analysis. Multivariate analysis confirmed that a lower HAQ, a lower number of anti-TNF agents failed before RTX and RF positivity, but not anti-CCP positivity, were the selected variables associated with an ACR response >or=50, with an accuracy of 84% of the model. Only RF positivity correlated with EULAR moderate to good response both in the univariate and in the multivariate analysis, with an accuracy of 79% of the model. CONCLUSION: RF-positive rather than anti-CCP-positive RA patients with lower baseline disability and a lower number of previously failed TNF blockers may be the best candidates to RTX. SN - 1462-0332 UR - https://www.unboundmedicine.com/medline/citation/19789202/Rheumatoid_factor_positivity_rather_than_anti_CCP_positivity_a_lower_disability_and_a_lower_number_of_anti_TNF_agents_failed_are_associated_with_response_to_rituximab_in_rheumatoid_arthritis_ L2 - https://academic.oup.com/rheumatology/article-lookup/doi/10.1093/rheumatology/kep314 DB - PRIME DP - Unbound Medicine ER -