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Gavrilă B I

Gavrilă B I

Carol Davila University of Medicine and Pharmacy, Romania

Title: Could diagnostic biomarkers be used to predict the response to biologic therapy in Rheumatoid Arthritis?

Biography

Biography: Gavrilă B I

Abstract

Background: Biologic therapies have revolutionized the treatment of rheumatoid arthritis (RA). Despite these advances, 20-40% of the patients are declared nonresponders to at least one of the therapies. The patient exposure to the potential side effects and high costs requires the discovery of a biomarker that could identify those who can benefit from the pretreatment of a certain therapy. We proposed to test the predictive role for the response to biologic therapy of diagnostic biomarkers used in RA: rheumatoid factor (RF) isotypes IgM and IgA, anti-cyclic citrullinated peptide (anti-CCP) and auto-antibodies against mutated citrullinated vimentin (anti-MCV). We also followed the evolution of serum levels of these biomarkers under biologic therapy.

Methods: prospective and observational study including 64 patients followed 12 months with active RA, uncontrolled by conventional synthetic DMARDs or declared non-responders to one of the biologic DMARDs.

Results: Lower baseline titres of RF type Ig M (51.36±95.359 U/ml, p=0.01629), Ig A (22.45±61.256 U/ml, p=0.03336) and anti-CCP (60.82±26.331ng/ml, p=0.00011) had predictive value for achieving a good EULAR response at 6 months. Regarding anti-MCV baseline titres, there were no differences between groups at 6 months (p=0.45914) or at 12 months (p=0.11354). Grouping patients in 2 categories (responders/non-responders), we identified significant differences between groups only for anti-CCP and response at 6 months (responders 96.04±50.355ng/ml, non-responders 146.16±41.68ng/ml, p=0.02834). For the EULAR response at 12 months, lower baseline titres for RF type Ig M (92.93±120.22 U/ml, p=0.01032) and Ig A (49.96±98.08 U/ml, p=0.00247) had predictive value for achieving a good response at 12 months. We didn’t obtain other information grouping patients in 2 categories. Regarding the evolution of serum levels, we noticed a reduction for all four biomarkers tested, statistically significant at 6 and / or 12 months from baseline.

Conclusion: Besides from their diagnostic role, these biomarkers could be used for other purposes in Rheumatoid Arthritis.