Impact of baseline anti-cyclic citrullinated peptide-2 antibody concentration on efficacy outcomes following treatment with subcutaneous abatacept or adalimumab: 2-year results from the AMPLE trial

• Published in: Annals of the rheumatic diseases Vol. 75; no. 4; pp. 709 - 714
• Main Authors: Sokolove, Jeremy, Schiff, Michael, Fleischmann, Roy, Weinblatt, Michael E, Connolly, Sean E, Johnsen, Alyssa, Zhu, Jin, Maldonado, Michael A, Patel, Salil, Robinson, William H
• Format: Journal Article
• Language: English
• Published: England Elsevier Limited 01.04.2016; BMJ Publishing Group
• Series: Concise report
• Subjects: Abatacept - therapeutic use; Adalimumab - therapeutic use; Adult; Aged; Aged, 80 and over; Antirheumatic Agents - therapeutic use; Arthritis, Rheumatoid - drug therapy; Arthritis, Rheumatoid - immunology; Autoantibodies - immunology; Clinical and Epidemiological Research; Drug Therapy, Combination; Female; Humans; Immunoglobulin G - immunology; Injections, Subcutaneous; Male; Methotrexate - therapeutic use; Middle Aged; Patients; Peptides, Cyclic - immunology; Prognosis; Single-Blind Method; Treatment Outcome; Young Adult; Ant-CCP; DMARDs (biologic); Autoantibodies; Rheumatoid Arthritis
• ISSN: 0003-4967; 1468-2060; 1468-2060
• DOI: 10.1136/annrheumdis-2015-207942

ObjectivesTo examine whether baseline anti-cyclic citrullinated peptide-2 (CCP2) antibody status and concentration correlated with clinical outcomes in patients treated with abatacept or adalimumab on background methotrexate (MTX) in the 2-year AMPLE (Abatacept versus adaliMumab comParison in bioLogic-naïvE rheumatoid arthritis subjects with background MTX) study.MethodsIn this exploratory analysis, anti-CCP2 antibody concentration was measured at baseline, and antibody-positive patients were divided into equal quartiles, Q1–Q4, representing increasing antibody concentrations. Clinical outcomes analysed by baseline anti-CCP2 status and quartile included change from baseline in disease activity and disability and remission rates.ResultsBaseline characteristics were generally comparable across quartiles and treatment groups. In both treatment groups, anti-CCP2 antibody-negative patients responded less well than antibody-positive patients. At year 2, improvements in disease activity and disability and remission rates were similar across Q1–Q3, but were numerically higher in Q4 in the abatacept group; in contrast, treatment effects were similar across all quartiles in the adalimumab group.ConclusionsIn AMPLE, baseline anti-CCP2 positivity was associated with a better response for abatacept and adalimumab. Patients with the highest baseline anti-CCP2 antibody concentrations had better clinical response with abatacept than patients with lower concentrations, an association that was not observed with adalimumab.Trial registration numberNCT00929864.