Distinct impact of RF and ACPA titer on the effectiveness and persistency of biologics and JAK inhibitors: The ANSWER cohort study.

IF 1.8 4区医学 Q3 RHEUMATOLOGY

Modern Rheumatology Pub Date : 2025-03-19 DOI:10.1093/mr/roaf029

Yuki Etani, Yasutaka Okita, Yuichi Maeda, Kohei Tsujimoto, Makoto Hirao, Akira Onishi, Hideo Onizawa, Takaichi Okano, Keisuke Nishimura, Ayaka Yoshikawa, Hideyuki Shiba, Hideki Amuro, Yonsu Son, Motomu Hashimoto, Tadashi Okano, Ryota Hara, Wataru Yamamoto, Shotaro Tachibana, Shinya Hayashi, Takaaki Noguchi, Atsushi Kumanogoh, Seiji Okada, Ken Nakata, Kosuke Ebina

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引用次数: 0

Abstract

Objective: We aimed to identify the impact of rheumatoid factor (RF) or anti-cyclic citrullinated peptide antibody (ACPA) titers on the retention of biological disease-modifying antirheumatic drugs (bDMARDs) and Janus kinase inhibitors (JAKi) in patients with rheumatoid arthritis.

Methods: We retrospectively analyzed 5312 courses of bDMARDs or JAKi from the ANSWER cohort. To calculate hazard ratios (HRs) for treatment discontinuation, we used multivariate Cox proportional hazards modeling, adjusted for potential confounders.

Results: HRs for discontinuation due to ineffectiveness were calculated based on RF classification, revealing that anti-interleukin-6 receptor antibodies (aIL-6R) exhibited the highest retention rates regardless of RF titer. In the RF-positive group, tumor necrosis factor inhibitors (TNFi) showed lower retention rates, whereas cytotoxic T lymphocyte-associated antigen-4-Ig (CTLA4-Ig) and JAKi followed aIL-6R in the retention rates. When classified based on ACPA, aIL-6R also exhibited the highest retention rates across all ACPA groups. TNFi showed lower retention rates compared with other agents in the ACPA-positive group, whereas CTLA4-Ig showed lower retention rates in the ACPA-negative group compared with other agents.

Conclusion: Considering effectiveness, aIL-6R showed the highest retention rates regardless of seropositivity. Although CTLA4-Ig and JAKi followed aIL-6R in RF or ACPA-positive cases, CTLA4-Ig showed the lowest retention rates in ACPA-negative cases.

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来源期刊

Modern Rheumatology RHEUMATOLOGY-

CiteScore

4.90

自引率

9.10%

发文量

146

审稿时长

1.5 months

期刊介绍： Modern Rheumatology publishes original papers in English on research pertinent to rheumatology and associated areas such as pathology, physiology, clinical immunology, microbiology, biochemistry, experimental animal models, pharmacology, and orthopedic surgery. Occasional reviews of topics which may be of wide interest to the readership will be accepted. In addition, concise papers of special scientific importance that represent definitive and original studies will be considered. Modern Rheumatology is currently indexed in Science Citation Index Expanded (SciSearch), Journal Citation Reports/Science Edition, PubMed/Medline, SCOPUS, EMBASE, Chemical Abstracts Service (CAS), Google Scholar, EBSCO, CSA, Academic OneFile, Current Abstracts, Elsevier Biobase, Gale, Health Reference Center Academic, OCLC, SCImago, Summon by Serial Solutions