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Selective Biologic Responses in Seropositive RA

Aug 20, 2020 11:25 pm

The Journal of Rheuatology reports a pooled analysis of patients from 16 observational RA registries that examined the association between seropositivity (RF or ACPA) with biologic DMARDs responses; they showed better clinical responses when seropositive RA patients receive abatacept (ABA) or rituximab (RTX).

The study included 27 583 RA patients. Overall, seropositivity was associated with different drug discontinuation rates across bDMARDs (P for interaction <0.001).

When comparing seropositive with seronegative patients the adjusted hazard ratios for drug discontinuation were:

  • TNF inhibitors: 1.01 (95% CI 0.95, 1.07)
  • Tociilizumab (TCZ): 0.89 (0.78, 1.02)]
  • ABA 0.80 (0.72, 0.88)
  • RTX: 0.70 (0.59, 0.84)

Better remission and low disease activity rates were similarly better in seropositive patients treated with ABA, and a largest difference with RTX (Lundex remission difference +5.9%, low disease activity difference +11.6%)..

Responses to TNFi and TCZ were not significantly different between seropositive and seronegative RA patients.

The author has received compensation as an advisor or consultant on this subject

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