Abstract
Objective: Recently, the number of rheumatoid arthritis (RA) patients treated with anti-tumor necrosis-α (anti-TNF-α) has been rapidly increasing. At present, however, there are no available measures that can serve as an indicator of its efficacy. Anti-cyclic citullinated peptide Antibody (anti-CCP antibody) wasconsideredto be an importantprognostic factor atAmerican College of Rheumatology (ACR) recommendation in 2008. And anti-CCP antibody has the possibility to be able to become an important prognostic factor in anti-TNF-α therapy.
Methods: In view of the above, we investigated the relationship between the efficacy of infliximab (IFX) and anti-cyclic citullinated peptide antibody (anti-CCP antibody). IFX was administered to 38 patients with RA during the period from 2006 to 2010,with those having initial anti-CCP antibody levels of less than 100 U/ml referred to as Group A and those having initial anti-CCP antibody levels of 100 U/ml or more referred to as Group B. We investigated the effectiveness of IFX for clinical joint symptoms by comparing the groups in C-reactive protein (CRP), Visual analogue scale (VAS), and disease activity score in 28 joints (DAS28), matrix metalloproteinase (MMP)-3 and adherence at week 0, week 6, week 14, and week 22.
Results: The CRP levels of group A was significantly lower that that of Group B at week 0, week 6, and week 22. No other significant parametric differences were recognized between the two groups. To compare the items of interests at week 0 and week 22, Group A exhibited significant improvements in all items except MMP-3, whereas Group B made no significant improvements in the number of tender joins and swelling joints, ESR, and MMP-3. Additionally, while anti-CCP antibody levels significantly improved in IFX responders (good response＋ moderate response in EULAR criteria) between week 0 and the last observation, non-responders showed no significant reduction in anti-CCP antibody levels.
Conclusion: These results suggest that the group with initial anti-CCP levels of 100 U/ml or more may respond poorly to IFX compared to initial anti-CCP levels of less than 100 U/ml and that anti-CCP antiboy may be significantly lower in responders.
