Article Text

Download PDFPDF
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;


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
  • anti-CCP antibodies
  • rheumatoid factor
  • rheumatoid arthritis
  • infliximab

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.