Decrease of anti-cyclic citrullinated peptide antibodies and rheumatoid factor following anti-TNFα therapy (infliximab) in rheumatoid arthritis is associated with clinical improvement
- 1Cattedra di Reumatologia, Dipartimento di Clinica e Terapia Medica Applicata, Università “La Sapienza”, Rome, Italy
- 2Dipartimento di Reumatologia, Istituto Ortopedico G Pini, Milan, Italy
- 3Servizio di Immunologia Clinica e Reumatologia, Ospedali Civili, Brescia, Italy
- Correspondence to:
Professor G Valesini
Dipartimento di Clinica e Terapia Medica Applicata, Cattedra di Reumatologia, Università “La Sapienza”, V’le del Policlinico 155, 00161 Rome, Italy;
- Accepted 19 November 2003
Objective: To investigate the effect of infliximab treatment on anti-cyclic citrullinated peptide antibodies (anti-CCP) and rheumatoid factor (RF) in patients with rheumatoid arthritis.
Methods: 43 patients with rheumatoid arthritis not responding to disease modifying anti-rheumatic drugs (DMARD) received intravenous infliximab at a dose of 3 mg/kg at baseline and after two and six weeks, and subsequently bimonthly, in combination with methotrexate. Serum samples were collected at baseline and at week 24. A commercial enzyme linked immunosorbent assay was used to test for anti-CCP antibodies; RF were detected using a quantitative nephelometric assay.
Results: At baseline, 38 of the 43 patients (88%) were positive for anti-CCP antibodies, and 41 (95%) were positive for RF. The serum titre of anti-CCP and RF decreased significantly after six months of treatment (p = 0.0001 and p<0.0001, respectively). When the patients were grouped on the basis of their clinical response to infliximab, a significant decrease in serum anti-CCP antibodies and RF was observed only in patients who had clinical improvement (ACR 20 and ACR 50).
Conclusions: Anti-TNFα treatment in rheumatoid arthritis results in a decrease in the serum titres of RF and anti-CCP antibodies in patients showing clinical improvement, suggesting that these measurements may be a useful adjunct in assessing treatment efficacy.
- ACR, American College of Rheumatology
- CCP, cyclic citrullinated peptide
- DMARD, disease modifying antirheumatic drug
- HCV, hepatitis C virus
- RF, rheumatoid factor