a Department of Internal Medicine, Faculty of Medicine , University of Tsukuba , Ibaraki , Japan.
Mod Rheumatol. 2016 Nov;26(6):857-862. doi: 10.3109/14397595.2016.1153567. Epub 2016 Mar 22.
To compare the effectiveness of three different biologics in anti-Ro/SSA antibody-positive and antibody-negative patients with rheumatoid arthritis (RA).
The study subjects were 110 biologics naïve patients with RA who started treatment with biologics and examined for anti-Ro/SSA antibody between December 2003 and March 2014. For patients treated with intravenous infliximab (IFX), tocilizumab (TCZ), or abatacept (ABT), we compared the clinical characteristics and changes in composite disease activity index, such as DAS28, SDAI, and CDAI, for 12 months in anti-Ro/SSA antibody-positive and antibody-negative patients.
We examined 59 patients (nine were positive and 50 were negative for anti-Ro/SSA antibody) treated with IFX, 27 patients (5 positive and 22 negative) treated with TCZ, and 24 patients (13 positive and 11 negative) treated with ABT. For patients treated with IFX, parameters of disease activity did not change significantly from baseline in anti-Ro/SSA antibody-positive patients, whereas they improved in antibody-negative patients. On the other hand, treatment with TCZ and ABT significantly decreased disease activity, relative to baseline, in both anti-Ro/SSA antibody-positive and antibody-negative patients. Anti-Ro/SSA antibody-positive patients treated with IFX showed higher frequency of HACA and seroconversion of ANA, and lower serum TGF-β levels.
Positivity to anti-Ro/SSA in RA seems to confer resistance to IFX via production of HACA and ANA, and low serum TGF-β levels, but not to TCZ and ABT.
比较三种不同生物制剂在抗 Ro/SSA 抗体阳性和阴性类风湿关节炎（RA）患者中的疗效。
本研究纳入了 2003 年 12 月至 2014 年 3 月期间开始接受生物制剂治疗且检测了抗 Ro/SSA 抗体的 110 例生物制剂初治 RA 患者。对于接受静脉注射英夫利昔单抗（IFX）、托珠单抗（TCZ）或阿巴西普（ABT）治疗的患者，我们比较了抗 Ro/SSA 抗体阳性和阴性患者治疗 12 个月后的复合疾病活动指数（如 DAS28、SDAI 和 CDAI）的临床特征和变化。
我们共检测了 59 例（9 例抗 Ro/SSA 抗体阳性，50 例阴性）接受 IFX 治疗、27 例（5 例阳性，22 例阴性）接受 TCZ 治疗和 24 例（13 例阳性，11 例阴性）接受 ABT 治疗的患者。对于接受 IFX 治疗的患者，抗 Ro/SSA 抗体阳性患者的疾病活动参数从基线开始无明显变化，而抗体阴性患者则有所改善。另一方面，TCZ 和 ABT 治疗均显著降低了抗 Ro/SSA 抗体阳性和阴性患者的疾病活动度，与基线相比。接受 IFX 治疗的抗 Ro/SSA 抗体阳性患者出现更高频率的 HACA 和 ANA 血清学转换，以及更低的血清 TGF-β 水平。
RA 患者抗 Ro/SSA 抗体阳性似乎通过产生 HACA 和 ANA 以及低血清 TGF-β 水平而对 IFX 产生耐药性，但对 TCZ 和 ABT 则无耐药性。
