Hernández-Breijo Borja, Parodis Ioannis, Novella-Navarro Marta, Martínez-Feito Ana, Navarro-Compán Victoria, Díaz-Almirón Mariana, Pascual-Salcedo Dora, Balsa Alejandro, Plasencia-Rodríguez Chamaida
Immuno-Rheumatology Research Group, Hospital La Paz Institute for Health Research-IdiPAZ, 28046 Madrid, Spain.
Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, 17176 Stockholm, Sweden.
J Clin Med. 2022 Sep 2;11(17):5207. doi: 10.3390/jcm11175207.
We investigated B-cell-activating factor (BAFF) in relation to response to treatment with TNF inhibitors (TNFis) in rheumatoid arthritis (RA). This was a longitudinal study including 158 patients with RA treated with TNFis and followed up for 6 months. Clinical response at 6 months of treatment was defined according to the EULAR criteria for good responders (GRs). BAFF concentration was measured in serum samples, collected at baseline and at 6 months. Associations with EULAR response were evaluated using univariable and multivariable logistic regression models. ROC analysis was performed to determine the optimal threshold of serum BAFF concentration associated with good EULAR response to treatment. After 6 months of TNFi treatment, 24% of patients were GRs. They had a lower BMI, lower baseline DAS28 and lower baseline serum BAFF concentration than non-responders. After 6 months of TNFi treatment, autoantibody-positive patients who attained GR had significantly lower serum BAFF concentrations compared with patients who did not. Serum BAFF < 968 pg/mL at 6 months represented the concentration likely to best discriminate between GR and non-GR at 6 months of TNFi treatment. Autoantibody-seropositive patients who had serum BAFF < 968 pg/mL at 6 months demonstrated a more than four-fold increased probability to be GRs compared with patients with higher BAFF concentrations. In conclusion, serum BAFF concentrations were associated with response to TNFis in seropositive RA patients, corroborating the importance of the B-cell compartment in RA.
我们研究了类风湿关节炎（RA）患者中与肿瘤坏死因子抑制剂（TNFis）治疗反应相关的B细胞活化因子（BAFF）。这是一项纵向研究，纳入了158例接受TNFis治疗的RA患者，并随访6个月。根据欧洲抗风湿病联盟（EULAR）关于良好反应者（GRs）的标准定义治疗6个月时的临床反应。在基线和6个月时采集血清样本，测量BAFF浓度。使用单变量和多变量逻辑回归模型评估与EULAR反应的相关性。进行ROC分析以确定与EULAR治疗良好反应相关的血清BAFF浓度的最佳阈值。TNFis治疗6个月后，24%的患者为GRs。他们的体重指数较低，基线DAS28较低，基线血清BAFF浓度低于无反应者。TNFis治疗6个月后，达到GR的自身抗体阳性患者的血清BAFF浓度明显低于未达到者。TNFis治疗6个月时血清BAFF<968 pg/mL代表可能最能区分GR和非GR的浓度。6个月时血清BAFF<968 pg/mL的自身抗体血清阳性患者成为GRs的概率比BAFF浓度较高的患者增加了四倍多。总之，血清BAFF浓度与血清阳性RA患者对TNFis的反应相关，证实了B细胞区室在RA中的重要性。
