Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences , Nagasaki, Japan.
Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group , Kyushu, Japan.
Scand J Rheumatol. 2021 Jan;50(1):15-19. doi: 10.1080/03009742.2020.1772361. Epub 2020 Sep 3.
: To determine whether the positivity of baseline anti-Ro/Sjögren's syndrome antigen A (SSA) antibodies influences the response to abatacept, we compared therapeutic responses between anti-Ro/SSA antibody-negative and -positive patients with rheumatoid arthritis (RA) using a multicentre RA ultrasonography prospective cohort. : We reviewed Japanese patients with RA who started abatacept as the first biological disease-modifying anti-rheumatic drug between June 2013 and April 2018. We assessed 28-joint Disease Activity Score-erythrocyte sedimentation rate (DAS28-ESR) change between baseline and 6 or 12 months after treatment in RA patients treated with abatacept, and European League Against Rheumatism (EULAR) response at 6 and 12 months. The Global OMERACT-EULAR Synovitis Score (GLOESS) was calculated at baseline and at 6 and 12 months. : Overall, 51 patients were enrolled and divided into anti-Ro/SSA antibody-negative and -positive groups of 35 and 16, respectively. Median age at baseline was significantly higher in the anti-Ro/SSA antibody-negative group (p = 0.04). The retention rate and percentage of EULAR good responders at 12 months were significantly higher in the anti-Ro/SSA antibody-negative group (both p = 0.02). Anti-Ro/SSA antibody-negative patients exhibited larger decreases in both DAS28-ESR and DAS28-C-reactive protein at 12 months than anti-Ro/SSA antibody-positive patients (p = 0.02 and 0.04, respectively). GLOESS decreased significantly at 6 months in anti-Ro/SSA antibody-negative patients (p = 0.03). Multivariate analyses showed that anti-Ro/SSA antibody positivity was an independent factor associated with change in the DAS28-ESR at 6 months (p < 0.05). : Anti-Ro/SSA antibody positivity predicts a poor response to abatacept and low retention rate.
为了确定基线抗 Ro/Sjögren 综合征抗原 A(SSA)抗体的阳性是否影响阿巴西普的反应,我们使用多中心 RA 超声前瞻性队列比较了抗 Ro/SSA 抗体阴性和阳性的类风湿关节炎(RA)患者的治疗反应。
我们回顾了 2013 年 6 月至 2018 年 4 月期间开始使用阿巴西普作为首种生物改善病情抗风湿药物的日本 RA 患者。我们评估了 RA 患者接受阿巴西普治疗后基线与治疗后 6 或 12 个月时 28 关节疾病活动评分-红细胞沉降率(DAS28-ESR)的变化,以及 6 和 12 个月时的欧洲抗风湿病联盟(EULAR)反应。基线和 6 及 12 个月时计算了全球 OMERACT-EULAR 滑膜炎评分(GLOESS)。
总体而言,共纳入 51 例患者,分为抗 Ro/SSA 抗体阴性组和阳性组,分别为 35 例和 16 例。抗 Ro/SSA 抗体阴性组的基线中位年龄显著较高(p=0.04)。抗 Ro/SSA 抗体阴性组的 12 个月时的保留率和 EULAR 良好反应者百分比显著较高(均 p=0.02)。抗 Ro/SSA 抗体阴性患者在 12 个月时 DAS28-ESR 和 DAS28-C 反应蛋白的降低均显著大于抗 Ro/SSA 抗体阳性患者(分别为 p=0.02 和 0.04)。抗 Ro/SSA 抗体阴性患者在 6 个月时 GLOESS 显著降低(p=0.03)。多变量分析显示,抗 Ro/SSA 抗体阳性是与 6 个月时 DAS28-ESR 变化相关的独立因素(p<0.05)。
抗 Ro/SSA 抗体阳性预测阿巴西普反应不良和保留率低。