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.
OBJECTIVES
To 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.


METHODS
In 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.


RESULTS
Baseline 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.


CONCLUSIONS
In 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 NUMBER
NCT00929864.
['Sokolove|Jeremy|J|', 'Schiff|Michael|M|', 'Fleischmann|Roy|R|', 'Weinblatt|Michael E|ME|', 'Connolly|Sean E|SE|', 'Johnsen|Alyssa|A|', 'Zhu|Jin|J|', 'Maldonado|Michael A|MA|', 'Patel|Salil|S|', 'Robinson|William H|WH|']
D000069594:Abatacept D000068879:Adalimumab D000328:Adult D000368:Aged D000369:Aged, 80 and over D018501:Antirheumatic Agents D001172:Arthritis, Rheumatoid D001323:Autoantibodies D004359:Drug Therapy, Combination D005260:Female D006801:Humans D007074:Immunoglobulin G D007279:Injections, Subcutaneous D008297:Male D008727:Methotrexate D008875:Middle Aged D010456:Peptides, Cyclic D011379:Prognosis D016037:Single-Blind Method D016896:Treatment Outcome D055815:Young Adult
Rheumatoid Arthritis Ant-CCP Autoantibodies DMARDs (biologic)