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Serum 14-3-3η level predicts response to Actemra
Patients with rheumatoid arthritis and positive tests for 14-3-3η before initiation of treatment had higher disease activity scores and were more likely to respond to Actemra compared with Humira, Xeljanz or methotrexate, according to the results of a study.
Researchers studied data from 149 Japanese patients with rheumatoid arthritis (RA) who met American College of Rheumatology 1987 criteria. Before initiating treatment, clinical examinations were performed, including disease activity assessments and serological evaluations. Serum 14-3-3η was measured and considered positive at 0.19 ng/mL or greater.
Of 149 patients, 110 had positive serological values of 14-3-3η. These patients also had significantly higher disease activity scores, erythrocyte sedimentation rate (ESR), levels of anti-citrullinated protein antibodies (ACPA) and rheumatoid factor (RF). A modest correlation was seen with C-reactive protein and 14-3-3η.
Twenty-three patients received methotrexate, 49 received Humira (adalimumab, AbbVie), 50 received Actemra (tocilizumab, Genentech) and 27 received Xeljanz (tofacitinib, Pfizer).
At 1 year, 97 patients (65%) were 14-3-3η-positive. Eighteen patients who were positive at baseline became negative, and five patients who were initially negative became positive. A significant difference was shown in the Disease Activity Score in 28 joints (DAS28)-ESR between patients who became negative or remained positive, and the mean DAS28-ESR was significantly lower in the 18 patients who became negative than in the five patients who became positive.
Among all groups, DAS28-ESR remission response rate was 55% and the European League Against Rheumatism (EULAR) response rate was 71%. After adjustments for treatment type, researchers found that patients who achieved DAS28-ESR remission with tocilizumab had lower baseline 14-3-3η levels, while no association was seen with the other treatments. – by Shirley Pulawski
Disclosure: Hirata reports the receipt of consulting and speaking fees from AbbVie, Eisai, Bristol-Myers Squibb, Chugai Pharmaceutical Co., Janssen Pharmaceuticals, Takeda Pharmaceutical Co., Pfizer and Astellas Pharma. Please see the full study for a list of all other authors’ relevant financial disclosures.