Background ROC study provided data to manage rheumatoid arthritis (RA) treatment after a failure to a first TNF blocker (1). We previously reported that high circulating TNF bioactivity was associated with good clinical response (2).
Objectives To explore ability of TNF bioactivity to predict response to second TNF blocker.
Methods Here, we assessed TNF bioactivity in 130 RA patients from the group rotation to a second TNF blocker at the time of randomisation and after 6 months. Clinical and biological data were recorded at baseline and 6 month with Eular response assessed at 6 month.
TNF bioactivity was assessed with HEK-Dual TNF cells adapted from our previous work (2). Due to non-normalised distribution, non parametrical analysis were performed.
Results Baseline circulating TNF bioactivity was similar according to Eular response. However, circulating TNF bioactivity at 6 month was associated with clinical response with low TNF bioactivity in responders. A ROC analysis suggested a cut-off at 0.320 with a sensitivity at 92% and a specificity at 41%.
Conclusions After a failure of a first TNF blocker, circulating TNF bioactivity is not able to predict response to a second TNF blocker despite a lower level in responders compared to non-responders.
Gottenberg J-E, Brocq O, Perdriger A, Lassoued S, Berthelot J-M, Wendling D, et al. Non-TNF-Targeted Biologic vs a Second Anti-TNF Drug to Treat Rheumatoid Arthritis in Patients With Insufficient Response to a First Anti-TNF Drug: A Randomized Clinical Trial. JAMA. 2016 Sep 20;316(11):1172–80.
Marotte H, Maslinski W, Miossec P. Circulating tumour necrosis factor-alpha bioactivity in rheumatoid arthritis patients treated with infliximab: link to clinical response. Arthritis Res Ther. 2005;7(1):R149–155.
Disclosure of Interest None declared
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