Baseline ANA and Anti-Ro60/SSA Antibody as Potential Predictors for Immunogenicity and Poor EULAR Response in Adalimumab-Treated RA Patients

Abstract

What Is Known and Objective. Given that autoantibodies are relatively abundant and easily measured, the detection of antibody biomarkers would be ideal for predicting therapeutic responses. Although anti-Ro60/SSA (anti-TROVE2) antibody has been identified as a useful predictor for the development of immunogenicity and therapeutic failure to adalimumab in RA patients, autoantibodies with similar predictive potentials are not yet sufficiently validated. Methods. We aimed to investigate the baseline autoantibodies, including rheumatoid factor (RF)-IgM, anti-citrullinated peptide antibodies (ACPA), antinuclear antibody (ANA), anti-Ro60/SSA antibody, and anti-La/SSB antibody, for their relationships with drug immunogenicity and therapeutic responses in RA patients assessed at week 48 of adalimumab therapy. We also compared adalimumab drug survival between participants with or without these autoantibodies. Results and Discussion. Our results showed that poor EULAR responders had significantly higher positive rates of baseline ANA, anti-Ro60/SSA antibody, and anti-La/SSB antibody than moderate or good responders. However, no significant differences in circulating levels of RF-IgM or ACPA were observed among groups with different responses. The multivariate logistic regression analysis revealed that ANA and anti-Ro60/SSA antibodies were significant predictors of developing immunogenicity to adalimumab (both p < 0.001). The presence of ANA, anti-Ro60/SSA, and anti-SSB antibodies could significantly predict poor EULAR response in adalimumab-treated RA patients (odds ratio, 4.98, 5.60, and 8.08, respectively, all p < 0.01). In Kaplan–Meier analysis, the adalimumab drug survival rate was significantly lower in RA patients with positivity for ANA, anti-Ro60/SSA, anti-SSB, and anti-drug antibodies than in the seronegative group. What Is New and Conclusion. Our results suggest that baseline ANA and anti-Ro60/SSA antibodies are potential predictive markers of drug immunogenicity and poor EULAR response in adalimumab-treated RA patients.