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ANA-positive patients with RA may have poorer response to TNF-alpha inhibitors

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Anti-nuclear antibody-positive patients with rheumatoid arthritis may have a poorer response to tumor necrosis factor-alpha inhibitors and may be more likely to switch medications than patients without the antibodies, according to research presented at the European League Against Rheumatism Annual European Congress of Rheumatology.

Of 74 patients with rheumatoid arthritis (RA), 20 were antinuclear antibody (ANA)-positive at baseline, with a minimum titer of 1:100, and had similar clinical characteristics compared with ANA-negative participants. Patients met the American College of Rheumatology criteria and started receiving tumor necrosis factor-alpha (TNF-a) inhibitors between 2002 and 2013. Ninety percent of the patients were women, and the patients’ mean age was 54.56 years.

Disease activity (DAS28) was scored at baseline and at 6, 12, 18 and 24 months, and European League Against Rheumatism (EULAR) criteria were used to assess clinical response to treatment. Treatment classifications were defined as good, moderate and no response. Log rank analysis was sued to determine the duration of treatment between groups, and Kaplan-Meier survival analysis was used to evaluate the persistence of use.

At 6 months, among the patients who were ANA-positive at baseline, 8.3% had a good response, 33.3% had a moderate response and 58.4% had no response compared with a good response in 11.9%, moderate response in 69.1% and no response in 19% among ANA-negative patients.

Although statistical significance was not achieved, ANA-positive patients tended to have a higher rate of switching medication (45% vs. 27.5%), according to the researchers. – by Shirley Pulawski

Reference:

Fonseca R, et al. Paper #AB1167. Presented at: European League Against Rheumatism Annual European Congress of Rheumatology; June 10-13, 2015; Rome.

Disclosure: The researchers report no relevant financial disclosures.