title: High anti-CCP antibody titres predict good response to rituximab in patients with active rheumatoid arthritis.
abstract: OBJECTIVE
  Previous studies reported that anti-CCP antibody positivity predicts good response to rituximab (RTX) in rheumatoid arthritis (RA). A quantitative approach to such possibility could be a good way to detect the subset of patients most likely to respond. We investigated whether serum anti-CCP antibody titres could predict response to RTX in RA patients.
  
  
  METHODS
  We retrospectively investigated RA patients who received RTX. The primary criterion was decrease in DAS28>1.2 at 6months (M6). Secondary efficacy criteria included a good response and remission according to EULAR. Predictors of response were investigated by multivariate logistic regression analysis.
  
  
  RESULTS
  We included 114 RA patients (81.6% female, median age 53.5 [IQR 45.7-61.2] years, median disease duration 8.5 [4.0-16.0] years). Anti-CCP antibodies were present in 93 patients (81.6%), with median anti-CCP antibody titres 583 [195-1509] U/mL. In all, 44 patients (38.6%) showed decreased DAS28>1.2 at M6. On univariate analysis, high anti-CCP titres were associated with response rather than non-response to RTX (median 1122 [355-1755] vs. 386 [149-800] U/mL, P=0.0191) at M6. On multivariate regression analysis, with a cut-off of 1000 U/mL, anti-CCP antibody titres≥1000 was associated with a decrease in DAS28>1.2 (OR 5.10 [1.97-13.2], P=0.0002); a EULAR good response (4.26 [1.52-11.95], P=0.0059); and a trend for EULAR remission (2.52 [0.78-8.12], P=0.1207).
  
  
  CONCLUSIONS
  High anti-CCP antibody titres predict response to RTX in RA. This factor, easily assessed in clinical practice, can help with personalized medicine and selecting the best candidates for RTX treatment.
authors.affiliation: Université Paris Diderot, Service de Rhumatologie, Hôpital Bichat, AP-HP, Paris, France.
authors.forename: Anaïs
authors.initials: A
authors.lastname: Gardette
authors.affiliation: Université Paris Diderot, Service de Rhumatologie, Hôpital Bichat, AP-HP, Paris, France. Electronic address: sebastien.ottaviani@bch.aphp.fr.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Ottaviani
authors.affiliation: AP-HP, Hôpital Bichat-Claude-Bernard, Département d'Épidémiologie Biostatistique et Recherche Clinique, Paris, France; Université Paris Diderot, Sorbonne Paris Cité, Paris, France; INSERM, CIE801, Paris, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Tubach
authors.affiliation: AP-HP, Hôpital Bichat-Claude-Bernard, Département d'Épidémiologie Biostatistique et Recherche Clinique, Paris, France; Université Paris Diderot, Sorbonne Paris Cité, Paris, France; INSERM, CIE801, Paris, France.
authors.forename: Carine
authors.initials: C
authors.lastname: Roy
authors.affiliation: Université Paris Diderot, Service d'Immunologie, Hôpital Bichat, AP-HP, Paris, France.
authors.forename: Pascale
authors.initials: P
authors.lastname: Nicaise-Roland
authors.affiliation: Université Paris Diderot, Service de Rhumatologie, Hôpital Bichat, AP-HP, Paris, France.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Palazzo
authors.affiliation: Université Paris Diderot, Service de Rhumatologie, Hôpital Bichat, AP-HP, Paris, France.
authors.forename: Ghislaine
authors.initials: G
authors.lastname: Gill
authors.affiliation: Université Paris Diderot, Service de Rhumatologie, Hôpital Bichat, AP-HP, Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Meyer
authors.affiliation: Université Paris Diderot, Service de Rhumatologie, Hôpital Bichat, AP-HP, Paris, France; Université Paris Diderot, INSERM U699, Paris, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Dieudé
mesh_terms: D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000188:drug therapy* / Q000276:immunology; D015415:Biomarkers / Q000097:blood / Q000652:urine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010456:Peptides, Cyclic / Q000097:blood / Q000276:immunology*; D012189:Retrospective Studies; D000069283:Rituximab
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D018501:Antirheumatic Agents; D015415:Biomarkers; D010456:Peptides, Cyclic; C487763:cyclic citrullinated peptide; D000069283:Rituximab
keywords: Anti-CCP antibodies; Rheumatoid arthritis; Rituximab