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SAT0074 Effect of Baseline Anti-Cyclic Citrullinated Peptide 2 Antibody Titre on Patient-Reported Outcomes Following Treatment with Subcutaneous Abatacept or Adalimumab
  1. J. Sokolove1,
  2. M. Schiff2,
  3. R. Fleischmann3,
  4. M.E. Weinblatt4,
  5. V. Strand1,
  6. S.E. Connolly5,
  7. M.A. Maldonado5,
  8. S. Patel5,
  9. E. Alemao5,
  10. W.H. Robinson1
  1. 1Stanford University School of Medicine, Palo Alto
  2. 2University of Colorado, Denver
  3. 3University of Texas Southwestern Medical Center, Dallas
  4. 4Brigham and Women's Hospital, Boston
  5. 5Bristol-Myers Squibb, Princeton, United States


Background The head-to-head AMPLE (Abatacept versus Adalimumab Comparison In Biologic-Naïve RA Subjects With Background Methotrexate) study demonstrated comparable efficacy for SC abatacept and adalimumab in patients with RA.1 Anti-citrullinated protein antibodies (ACPA) are a known biomarker for RA and disease progression,2,3 but their predictive value for treatment outcomes is not well understood. Such information may serve as a predictor of treatment response in RA.

Objectives To examine the effect of abatacept and adalimumab on patient-reported outcomes (PROs) in patients grouped by baseline quartiles of anti-cyclic citrullinated peptide-2 (anti-CCP2; a surrogate for ACPA) antibody titre.

Methods The AMPLE study has been described.1 In this post hoc analysis of the AMPLE study, anti-CCP2–immunoglobulin (Ig) G titres in patient samples collected at baseline were determined by anti-CCP2 ELISA.4 PROs were assessed in anti-CCP2-positive patients divided into quartiles 1–4 based on increasing baseline titres. PROs analysed included: Patient Global Assessment (PGA), pain, fatigue, and SF-36 physical (PCS) and mental component summary (MCS) scores. Mean change from baseline was calculated with adjustment by analysis of covariance, with treatment as a factor; baseline values and DAS28 (CRP) stratification were covariates.

Results There were 97 patients per quartile. Quartile limits were (AU/mL): Q1=28–235; Q2=236–609; Q3=613–1046; Q4=1060–4894. The number of patients per treatment group in each quartile were (abatacept, adalimumab): Q1=42, 55; Q2=51, 46; Q3=46, 51; Q4=46, 51. Higher anti-CCP2 antibody titre at baseline was associated with numerically better treatment response, as assessed by PGA, pain and SF-36 PCS for abatacept: mean changes from baseline were greater for Q4 than Q1–3 in patients receiving abatacept; such differences were not as pronounced with adalimumab. No consistent differences were evident in fatigue and SF-36 MCS based on quartile for abatacept; however, lower baseline anti-CCP2 titre (Q1) was associated with better responses in the adalimumab group for these PROs.

Conclusions A pattern of more robust improvement was observed for patients receiving abatacept, but not adalimumab, among the highest anti-CCP2 quartiles with respect to several PROs: PGA, pain, and SF-36 PCS scores. These findings are consistent with those on clinical parameters, where greater changes in DAS28 (CRP) and HAQ-DI scores were observed for patients in the highest anti-CCP2 titre quartile receiving abatacept but not adalimumab.


  1. Schiff M, et al. Ann Rheum Dis 2014;73:86–94.

  2. Verpoort KN, et al. Arthritis Rheum 2006;54:3799–808.

  3. van der Woude D, et al. Ann Rheum Dis 2010;69:1554–61

  4. Anti-CCP2 ELISA, Euro Diagnostica. Accessed 15 Jan 2015

Disclosure of Interest J. Sokolove Grant/research support from: Bristol-Myers Squibb, M. Schiff Grant/research support from: UCB, Consultant for: AbbVie, Amgen, Antares, Bristol-Myers Squibb, Eli Lilly, Horizon, Johnson and Johnson, Novartis, Novo Nordisk, Pfizer, Roche, UCB, Speakers bureau: AbbVie, R. Fleischmann Grant/research support from: AbbVie, Amgen, Astellas, AstraZeneca, Bristol-Myers Squibb, Celgene, Dynavax, Genzyme, Janssen, Eli Lilly, Merck, Novartis, Pfizer, Roche, sanofi-aventis, UCB, Xoma, Consultant for: AbbVie, Amgen, AstraZeneca, Bristol-Myers Squibb, Celgene, Janssen, Eli Lilly, Pfizer, Roche, sanofi-aventis, UCB, M. E. Weinblatt Grant/research support from: Bristol-Myers Squibb, Crescendo Bioscience, UCB, Consultant for: Bristol-Myers Squibb, Crescendo Bioscience, UCB, AbbVie, Roche, Janssen, Pfizer, Lilly, Amgen, V. Strand: None declared, S. E. Connolly Shareholder of: Bristol-Myers Squibb, Employee of: Bristol-Myers Squibb, M. A. Maldonado Shareholder of: Bristol-Myers Squibb, Employee of: Bristol-Myers Squibb, S. Patel Shareholder of: Bristol-Myers Squibb, Employee of: Bristol-Myers Squibb, E. Alemao Shareholder of: Bristol-Myers Squibb, Employee of: Bristol-Myers Squibb, W. H. Robinson: None declared

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