<abstract xmlns="http://www.w3.org/1999/xhtml"> Introduction: Rheumatoid factor (RF) and anti-citrullinated protein antibodies (ACPA) are poor prognostic factors in rheumatoid arthritis (RA). The therapeutic implication of antinuclear antibody (ANA) positivity in RA is still debated. The study aims to evaluate ANA positivity as a prognostic factor for the therapeutic response to biologics in RA. Methods: observational study; data were gathered from the Romanian Registry of Rheumatic Diseases which comprises all biological-treated RA patients in Romania. We included only RA patients who were tested for ANA before initiating biologics. Results: A number of 740 RA patients were included (72.4% treated with TNF-α blockers, 27.6% with rituximab). Compared to ANA-negative patients, ANA-positive patients (26.9%) had: a higher disease activity score (DAS28) prior to biologics, at the time of treatment switch and after the observation period; lower drug persistence (p &lt; 0.001 for all tests). Multiple linear regressions showed that ANA positivity is a significant predictor of the current value of DAS28, independently of the presence of RF and/or ACPA (p &lt; 0.05). Conclusion: ANA positivity in RA patients before starting biologics may be a poor prognosis factor for efficacy and drug persistence. Further studies are needed to confirm these observations.</abstract>

Introduction: Rheumatoid factor (RF) and anti-citrullinated protein antibodies (ACPA) are poor prognostic factors in rheumatoid arthritis (RA). The therapeutic implication of antinuclear antibody (ANA) positivity in RA is still debated. The study aims to evaluate ANA positivity as a prognostic factor for the therapeutic response to biologics in RA. Methods: observational study; data were gathered from the Romanian Registry of Rheumatic Diseases which comprises all biological-treated RA patients in Romania. We included only RA patients who were tested for ANA before initiating biologics. Results: A number of 740 RA patients were included (72.4% treated with TNF-α blockers, 27.6% with rituximab). Compared to ANA-negative patients, ANA-positive patients (26.9%) had: a higher disease activity score (DAS28) prior to biologics, at the time of treatment switch and after the observation period; lower drug persistence (p < 0.001 for all tests). Multiple linear regressions showed that ANA positivity is a significant predictor of the current value of DAS28, independently of the presence of RF and/or ACPA (p < 0.05). Conclusion: ANA positivity in RA patients before starting biologics may be a poor prognosis factor for efficacy and drug persistence. Further studies are needed to confirm these observations.

Pre-treatment antinuclear antibody positivity, therapeutic efficacy and persistence of biologics in rheumatoid arthritis

“Dr. Ion Stoia” Clinical Center of Rheumatic Diseases, Bucharest, Romania

“Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania

“Ion Stoia” Clinical Hospital, Rheumatology, 5th Thomas Masaryk, Bucharest, Romania

County Emergency Hospital Cluj-Napoca, Romania; “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania

Rheumatology Department of Mures County Hospital, Romania; University of Medicine and Pharmacy of Targu Mures, Romania

Rheumatology Department of Clinical Hospital Colentina, Bucharest, Romania

Internal Medicine and Rheumatology Department of “Sfânta Maria” Clinical Hospital, Bucharest, Romania

Revista Romana de Medicina de Laborator

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Introduction: Rheumatoid factor (RF) and anti-citrullinated protein antibodies (ACPA) are poor prognostic factors in rheumatoid arthritis (RA). The therapeutic...

Pre-treatment antinuclear antibody positivity, therapeutic efficacy and persistence of biologics in rheumatoid arthritis

Published Online: Jun 28, 2016

Page range: 212 - 222

Received: Oct 15, 2015

Accepted: Apr 03, 2016

DOI: https://doi.org/10.1515/rrlm-2016-0018

Keywords
rheumatoid arthritis;antinuclear antibodies;biological therapy

© by Claudiu Costinel Popescu

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Pre-treatment antinuclear antibody positivity, therapeutic efficacy and persistence of biologics in rheumatoid arthritis

Published Online: Jun 28, 2016

Page range: 212 - 222

Received: Oct 15, 2015

Accepted: Apr 03, 2016

DOI: https://doi.org/10.1515/rrlm-2016-0018

Keywordsrheumatoid arthritis;antinuclear antibodies;biological therapy

© by Claudiu Costinel Popescu

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Keywords
rheumatoid arthritis;antinuclear antibodies;biological therapy