Ann Rheum Dis 63:1218-1221 doi:10.1136/ard.2003.014647
  • Extended report

Decrease of anti-cyclic citrullinated peptide antibodies and rheumatoid factor following anti-TNFα therapy (infliximab) in rheumatoid arthritis is associated with clinical improvement

  1. C Alessandri1,
  2. M Bombardieri1,
  3. N Papa2,
  4. M Cinquini3,
  5. L Magrini1,
  6. A Tincani3,
  7. G Valesini1
  1. 1Cattedra di Reumatologia, Dipartimento di Clinica e Terapia Medica Applicata, Università “La Sapienza”, Rome, Italy
  2. 2Dipartimento di Reumatologia, Istituto Ortopedico G Pini, Milan, Italy
  3. 3Servizio di Immunologia Clinica e Reumatologia, Ospedali Civili, Brescia, Italy
  1. 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.