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Changes in anti-cyclic citrullinated peptide antibodies and rheumatoid factor isotypes serum levels in patients with rheumatoid arthritis following treatment with different biological drugs

1, 2, 3, 4, 5, 6, 7, 8

 

  1. Interdisciplinary Department of Medicine, Rheumatology Unit, University of Bari, Italy. florenzo.iannone@uniba.it
  2. Patologia Clinica, A.O. Universitaria Consorziale Policlinico, Bari, Italy.
  3. Interdisciplinary Department of Medicine, Rheumatology Unit, University of Bari, Italy.
  4. Interdisciplinary Department of Medicine, Rheumatology Unit, University of Bari, Italy.
  5. Department of Rheumatology, Policlinico Le Scotte, University of Siena, Italy.
  6. Allergologia e Immunologia Clinica, A.O. S. Maria degli Angeli, Pordenone, Italy.
  7. Department of Rheumatology, Policlinico Le Scotte, University of Siena, Italy.
  8. Interdisciplinary Department of Medicine, Rheumatology Unit, University of Bari, Italy.

CER8620
2016 Vol.34, N°3
PI 0424, PF 0429
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PMID: 26885600 [PubMed]

Received: 20/05/2015
Accepted : 26/10/2015
In Press: 09/02/2016
Published: 30/05/2016

Abstract

OBJECTIVES:
Anti-cyclic citrullinated peptide antibodies (anti-CCP) are a serological marker of rheumatoid arthritis (RA), and also have a prognostic value for more aggressive disease. Whether anti-CCP levels may change during treatment according to clinical response is matter of debate. Likewise, it is unknown whether different biological drugs have peculiar effects on anti-CCP levels. This study aimed to investigate changes in anti-CCP serum levels in RA patients on biological drugs with different mechanism of action.
METHODS:
We studied 71 patients with active RA tested positive for anti-CCP who started a first biological drug (54 anti-TNF-α drug, 9 rituximab, 8 tocilizumab). In 14 patients stopping anti-TNF-α treatment for ineffectiveness, rituximab was started. Anti-CCP and rheumatoid factor (RF) isotypes (IgM, IgA, IgG) levels were measured at entry, 12 months and again at 12 months after swapping to rituximab.
RESULTS:
After 1 year of therapy of the first biological drug, patients taking anti-TNF-α drugs showed a significant reduction of the anti-CCP levels (p=0.002), and all RF isotypes (p=0.003). Also patients treated with rituximab or tolicizumab had a significant decrease in anti-CCP (p=0.01) and RF isotype levels (p=0.01). Anti-CCP levels did not correlated with DAS28 over time. In patients switching to rituximab after failure of TNF-α blockers, anti-CCP levels did not change at 12 months (p=0.06), despite of the reduction of DAS28 (p=0.02) and RFs levels (p=0.02).
CONCLUSIONS:
Our study showed that anti-CCP levels may change during RA course, regardless of the biological drug used and the clinical response.

Rheumatology Article