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Better response seen in patients with RA, anti-CCP2 positivity treated with Humira or Orencia
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Patients with rheumatoid arthritis who were anti-cyclic citrullinated peptide-2 antibody-positive at baseline were more likely to respond to treatment with Humira or Orencia than patients without the antibodies, but an association between concentrations at baseline and a higher response were only seen in patients treated with Orencia, according to recently published research.
Researchers studied data from 328 patients with rheumatoid arthritis (RA) who were randomized to treatment with Humira (adalimumab, AbbVie) and 318 patients randomized to treatment with Orencia (abatacept, Bristol-Meyers Squibb). Of the two groups, 245 patients in the adalimumab group and 252 patients in the abatacept group completed 2 years of follow-up.
Sera were available from 508 patients at baseline and showed 23.6% were anti-cyclic citrullinated peptide-2 antibody (CCP2)-negative and 76.4% were CCP2-positive, defined by a concentration of 25 AU/mL or greater. Patients who were CCP2-positive were grouped into equal quartiles based on serum concentration of CCP2 antibodies, Q1 to Q4, with Q4 representing patients with the highest concentration of antibodies (1,060 to 4,894 AU/mL).
At least a moderate response based on the European League Against Rheumatism criteria was seen in patients in either treatment group. Patients who were CCP2-negative showed fewer improvements in Disease Activity Score in 28 Joints (DAS28). The mean DAS28 score after 729 days for patients who received abatacept was significantly higher in the Q4 group compared to Q1-Q3 combined, while patients who received adalimumab showed similar responses to DAS28 across all quartiles.
The smallest mean changes from baseline Health Assessment Questionnaire-Disability Index (HAQ-DI) scores were seen in patients who were anti–CCP2-negative in either treatment group. The mean baseline HAQ-DI scores in patients who received adalimumab were similar across all quartiles, whereas patients who received abatacept in the Q4 group were significantly more likely to show greater changes than patients in the Q1 to Q3 abatacept treatment groups.
Remission rates in the group of patients who received abatacept were highest among the patients in Q4 at day 365 and day 729, but the percentage of patients who reached a DAS28 and C-reactive protein (DAS28-CRP) score below 2.6 was highest in patients in Q4 regardless of treatment type. Remission rates were higher at day 729 compared to day 365 overall, but remission rates were highest in the Q4 group who received abatacept. – by Shirley Pulawski
Disclosure: Sokolove reports the receipt of research funding support from Bristol-Myers Squibb. Please see the full study for a list of all other authors’ relevant financial disclosures.
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