Association of rheumatoid factor and anti-cyclic citrullinated peptide positivity, but not carriage of shared epitope or PTPN22 susceptibility variants, with anti-tumour necrosis factor response in rheumatoid arthritis

2009

Predictors of Response to Anti-TNF Therapy in Rheumatoid Arthritis

Sample size: 642 publication 10 minutes Evidence: moderate

Author Information

Author(s): Potter C, Hyrich K L, Tracey A, Lunt M, Plant D, Symmons D P M, Thomson W, Worthington J, Emery P, Morgan A W, Wilson A G, Isaacs J, Barton A

Primary Institution: Arthritis Research Campaign Epidemiology Unit, University of Manchester

Hypothesis

Do rheumatoid factor, anti-CCP antibodies, shared epitope, and PTPN22 variants predict response to anti-TNF therapy in rheumatoid arthritis patients?

Conclusion

Rheumatoid factor and anti-CCP antibodies are associated with a reduced response to anti-TNF drugs in rheumatoid arthritis patients.

Supporting Evidence

89% of patients were RF positive and 82% were anti-CCP positive.
Patients who were RF negative had a greater mean improvement in DAS28 compared to RF positive patients.
No association was found between drug response and SE or PTPN22 carriage.

Takeaway

If you have certain antibodies, you might not respond as well to a specific arthritis treatment. But there are still many factors that affect how well the treatment works.

Methodology

A UK-wide multicentre study recruited patients treated with anti-TNF drugs, measuring RF, anti-CCP, SE, and PTPN22 status to predict treatment response.