1277 -  Anti-CCP Titers Are Predictive of the Response to Biological Agents in Patients with Rheumatoid Arthritis

Monday, November 7, 2011: 9:00 AM-6:00 PM
Hall F2 - Poster Hall (McCormick Place West)
Ryo Takahashi1, Ryo Yanai1, Hidekazu Furuya1, Kuninobu Wakabayashi1, Tsuyoshi Odai1, Takeo Isozaki2, Nobuyuki Yajima1, Yusuke Miwa3 and Tsuyoshi Kasama1, 1Showa University School of Med, Shinagawa-ku Tokyo, Japan, 2University of Michigan Medical School, Ann Arbor, MI, 3Division of Rheumatology, Tokto, Japan
Presentation Number: 1277

Background/Purpose: Biological agents have changed the therapy of rheumatoid arthritis (RA) dramatically last few years. But in some cases, the effect is scarce, and there is also the risk to cause a serious infectious disease. Anti-cyclic citrullinated protein antibody (anti-CCP) is known as an important indicator for diagnosis of early RA and the positivity of anti-CCP is thought as one of the poor prognosis factors. To examine the relation between serum anti-CCP titer and patient responsiveness to biological agents in RA patients.

Method: Anti-CCP was measured by ELISA. Disease activity and its clinical improvement were assessed using Disease Activity Scores [DAS28; erythrocyte sedimentation rate (ESR) 4] with European League Against Rheumatism (EULAR) response criteria.

Result: In the present study, 64 patients with RA treated with biological agents (infliximab; 30, etanercept; 19, tocilizumab; 7, adalimumab; 8) were included. The mean age was 36.0±18.0 yrs, mean disease duration was 7.8±4.1 yrs, and mean baseline DAS28 was 5.42±1.47. Among the 64 RA patients, 55 patients (85.9%) were positive for anti-CCP, and the mean antibody titer was 293.1±733.4 U/ml. After 14 weeks of treatment, 26 patients showed good responses and 30 moderate responses to biologic agents based on EULAR response criteria, while 8 showed no clinical improvement.

The anti-CCP titer was 73.7±112.1 U/ml in the good responders and 230.3±261.5 U/ml in the moderate responders, which were significantly lower than in the non-responders (1335±1791.5 U/ml). In addition, 100% of patients with low (<100 U/ml) basal anti-CCP titers showed moderate-good response, and 88.0 % of those with moderate (100-499 U/ml) titers also showed a moderate-good response. Among those with higher (≥500 pg/ml) basal anti-CCP titers, 50% showed a moderate response and 50% no response. In addition, the anti-CCP titer was 85.9±879.1 U/ml in the group with remission at 14weeks, although significant higher titers of anti-CCP (396.8±129.2 U/ml) were seen in those had no remission.

Conclusion: The result suggests that anti-CCP titer might to be one of significant predictors of the efficacy of the biological agents in patients with RA. 

Keywords: anti-CCP antibodies

Disclosure: R. Takahashi, None; R. Yanai, None; H. Furuya, None; K. Wakabayashi, None; T. Odai, None; T. Isozaki, None; N. Yajima, None; Y. Miwa, None; T. Kasama, None.