On-line First

J Rheum Dis

Published online February 3, 2025

© Korean College of Rheumatology

Change of autoantibody levels in established rheumatoid arthritis patients treated by biological disease-modifying anti-rheumatic drugs -the AIRTIGHT study-

Shohei Anno, M.D.1 , Kentaro Inui, M.D., Ph.D.2,3 , Masahiro Tada, M.D., Ph.D.4 , Yuko Sugioka, M.D., Ph.D.5 , Tadashi Okano, M.D., Ph.D.,5 , Kenji Mamoto, M.D., Ph.D.2 , Tatsuya Koike, M.D., Ph.D.6

1Departments of Orthopaedic Surgery, Yodogawa Christian Hospital, 2Departments of Orthopaedic Surgery, Osaka Metropolitan University Medical School, 3Departments of Orthopaedic Surgery, Saiseikai Nakatsu Hospital, 4Departments of Orthopaedic Surgery, Osaka City General Hospital, 5Center for Senile Degenerative Disorders (CSDD), Osaka Metropolitan University Medical School, Osaka, 6Search Institute for Bone and Arthritis Disease (SINBAD), Shirahama Foundation for Health and Welfare, Wakayama, Japan

Correspondence to : Tatsuya Koike, https://orcid.org/0000-0002-1522-8740
Search Institute for Bone and Arthritis Disease (SINBAD), Shirahama Foundation for Health and Welfare, Nishimuro-gun Shirahama-cho 1447, Wakayama 649-2211, Japan. E-mail: tatsuya@omu.ac.jp

Received: November 6, 2024; Revised: December 17, 2024; Accepted: January 12, 2025

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective: Previous studies reported that abatacept (ABT) decreased autoantibodies in early rheumatoid arthritis (RA) patients. We investigated the impact of ABT, and other biological disease-modifying anti-rheumatic drugs (bDMARDs) on autoantibody levels in established RA patients.
Methods: This prospective observational study included 50 RA patients treated with ABT and 115 RA patients treated with non-ABT bDMARDs. Serum levels of anticitrullinated peptide antibodies (ACPA), immunoglobulin (Ig) M-rheumatoid factor (IgMRF), IgG-RF, and anti-agalactosyl IgG antibody (anti-Gal (0) IgG) were measured at baseline and after 48 weeks of treatment.
Results: After propensity score matching, 25 patients with ABT and 25 patients with non-ABT were finally analyzed. Disease activity score in 28 joints using C-reactive protein significantly decreased in both ABT group (4.5 to 3.3, p<0.01) and non-ABT group (4.4 to 2.5, p<0.01) after 48 weeks treatment. In ABT group, median titers at baseline and 48 weeks were 62.7 and 57.8 U/mL for ACPA (p=0.22), 35.0 and 39.0 IU/mL for IgM-RF (p=0.21), 0.5 and 0.5 IU/mL for IgG-RF (p=0.19), and 50.4 and 53.5 AU/mL for anti-Gal (0) IgG (p=0.22), respectively. Changes of all autoantibody titer were not significant in ABT group. Non-ABT group showed significant decreases in ACPA (baseline 143.0 to 57.8 U/mL at week 48, p=0.03), IgM-RF (50.0 to 37.0 IU/mL, p<0.01), and anti-Gal (0) IgG (93.2 to 61.8 AU/mL, p<0.01) except IgG-RF (0.6 to 0.5 IU/mL, p=0.22).
Conclusion: Autoantibody-lowering effect of ABT was not strong in established RA patients in our study.

Keywords Rheumatoid arthritis, Biological products, Abatacept, Serologic test

Article

On-line First

J Rheum Dis

Published online February 3, 2025

Copyright © Korean College of Rheumatology.

Change of autoantibody levels in established rheumatoid arthritis patients treated by biological disease-modifying anti-rheumatic drugs -the AIRTIGHT study-

Shohei Anno, M.D.1 , Kentaro Inui, M.D., Ph.D.2,3 , Masahiro Tada, M.D., Ph.D.4 , Yuko Sugioka, M.D., Ph.D.5 , Tadashi Okano, M.D., Ph.D.,5 , Kenji Mamoto, M.D., Ph.D.2 , Tatsuya Koike, M.D., Ph.D.6

1Departments of Orthopaedic Surgery, Yodogawa Christian Hospital, 2Departments of Orthopaedic Surgery, Osaka Metropolitan University Medical School, 3Departments of Orthopaedic Surgery, Saiseikai Nakatsu Hospital, 4Departments of Orthopaedic Surgery, Osaka City General Hospital, 5Center for Senile Degenerative Disorders (CSDD), Osaka Metropolitan University Medical School, Osaka, 6Search Institute for Bone and Arthritis Disease (SINBAD), Shirahama Foundation for Health and Welfare, Wakayama, Japan

Correspondence to:Tatsuya Koike, https://orcid.org/0000-0002-1522-8740
Search Institute for Bone and Arthritis Disease (SINBAD), Shirahama Foundation for Health and Welfare, Nishimuro-gun Shirahama-cho 1447, Wakayama 649-2211, Japan. E-mail: tatsuya@omu.ac.jp

Received: November 6, 2024; Revised: December 17, 2024; Accepted: January 12, 2025

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective: Previous studies reported that abatacept (ABT) decreased autoantibodies in early rheumatoid arthritis (RA) patients. We investigated the impact of ABT, and other biological disease-modifying anti-rheumatic drugs (bDMARDs) on autoantibody levels in established RA patients.
Methods: This prospective observational study included 50 RA patients treated with ABT and 115 RA patients treated with non-ABT bDMARDs. Serum levels of anticitrullinated peptide antibodies (ACPA), immunoglobulin (Ig) M-rheumatoid factor (IgMRF), IgG-RF, and anti-agalactosyl IgG antibody (anti-Gal (0) IgG) were measured at baseline and after 48 weeks of treatment.
Results: After propensity score matching, 25 patients with ABT and 25 patients with non-ABT were finally analyzed. Disease activity score in 28 joints using C-reactive protein significantly decreased in both ABT group (4.5 to 3.3, p<0.01) and non-ABT group (4.4 to 2.5, p<0.01) after 48 weeks treatment. In ABT group, median titers at baseline and 48 weeks were 62.7 and 57.8 U/mL for ACPA (p=0.22), 35.0 and 39.0 IU/mL for IgM-RF (p=0.21), 0.5 and 0.5 IU/mL for IgG-RF (p=0.19), and 50.4 and 53.5 AU/mL for anti-Gal (0) IgG (p=0.22), respectively. Changes of all autoantibody titer were not significant in ABT group. Non-ABT group showed significant decreases in ACPA (baseline 143.0 to 57.8 U/mL at week 48, p=0.03), IgM-RF (50.0 to 37.0 IU/mL, p<0.01), and anti-Gal (0) IgG (93.2 to 61.8 AU/mL, p<0.01) except IgG-RF (0.6 to 0.5 IU/mL, p=0.22).
Conclusion: Autoantibody-lowering effect of ABT was not strong in established RA patients in our study.

Keywords: Rheumatoid arthritis, Biological products, Abatacept, Serologic test

JRD
Jan 01, 2025 Vol.32 No.1, pp. 1~7
COVER PICTURE
Cumulative growth of rheumatology members and specialists (1980~2024). Cumulative distribution of the number of the (A) Korean College of Rheumatology members and (B) rheumatology specialists. (J Rheum Dis 2025;32:63-65)

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