title: Baseline autoantibodies preferentially impact abatacept efficacy in patients with rheumatoid arthritis who are biologic naïve: 6-month results from a real-world, international, prospective study.
abstract: OBJECTIVE
  To determine the impact of baseline rheumatoid factor (RF) and anticyclic citrullinated peptide (anti-CCP) status on the clinical efficacy of intravenous abatacept in biologic-naïve patients with rheumatoid arthritis (RA) enrolled in the real-world ACTION study.
  
  
  METHODS
  Clinical outcomes (European League Against Rheumatism (EULAR) response, mean Clinical Disease Activity Index (CDAI) and Boolean remission) at 6 months were compared by baseline RF and anti-CCP status.
  
  
  RESULTS
  Of 672 biologic-naïve patients, RF status was reported in 577 (86%) (412 (71%) positive) and anti-CCP status in 552 (82%) (364 (66%) positive); of 511 patients for whom data were available, 308/511 (60%) were double positive and 127/511 (25%) were double negative. Clinical outcomes were improved with RF-positive or anti-CCP-positive versus RF-negative/anti-CCP-negative status-good or moderate EULAR response: RF: 84.6 vs 72.9%, p=0.012; anti-CCP: 85.2 vs 74.2%, p=0.015; mean CDAI (calculated): RF: 10.8 vs 15.3, p<0.001; anti-CCP: 10.9 vs 14.3, p=0.002; and Boolean remission: RF: 13.3 vs 4.0%, p=0.008; anti-CCP: 12.5 vs 6.3%, p=0.096. Clinical outcomes were also improved with single or double RF-positive/anti-CCP-positive versus double-negative status.
  
  
  CONCLUSIONS
  In biologic-naïve patients with RA, RF-positive and/or anti-CCP-positive status is associated with greater efficacy of intravenous abatacept than seronegative status.
  
  
  BACKGROUND
  NCT02109666.
authors.affiliation: Department of Internal Medicine, Rheumatology, Clinical Immunology, Osteology , Schlosspark-Klinik University Medicine , Berlin , Germany.
authors.forename: Rieke
authors.identifier: 0000-0002-3395-4412
authors.initials: R
authors.lastname: Alten
authors.affiliation: Department of Internal Medicine and Rheumatology , University of Erlangen , Nuremberg , Germany.
authors.forename: Hubert G
authors.initials: HG
authors.lastname: Nüßlein
authors.affiliation: Department of Rheumatology , Université Paris-Sud, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, INSERM U1184 , Le Kremlin Bicêtre, Paris , France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Mariette
authors.affiliation: Department of Medical Sciences, Surgery, and Neuroscience , University of Siena , Siena , Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Galeazzi
authors.affiliation: Division of Rheumatology , University Hospital , Heidelberg , Germany.
authors.forename: Hanns-Martin
authors.initials: HM
authors.lastname: Lorenz
authors.affiliation: Department of Rheumatology , Purpan Hospital , Toulouse , France.
authors.forename: Alain
authors.initials: A
authors.lastname: Cantagrel
authors.affiliation: Medical Data Operations , Bristol-Myers Squibb , Rueil-Malmaison , France.
authors.forename: Melanie
authors.initials: M
authors.lastname: Chartier
authors.affiliation: Department of Biostatistics , DOCS International , Nanterre , France.
authors.forename: Coralie
authors.initials: C
authors.lastname: Poncet
authors.affiliation: Department of Immunoscience , Bristol-Myers Squibb , Munich , Germany.
authors.forename: Christiane
authors.initials: C
authors.lastname: Rauch
authors.affiliation: Medical Affairs, Europe , Bristol-Myers Squibb , Rueil-Malmaison , France.
authors.forename: Manuela
authors.initials: M
authors.lastname: Le Bars
keywords: Ant-CCP; Rheumatoid Arthritis; Rheumatoid Factor