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Impact of baseline anti-cyclic citrullinated peptide-2 antibody concentration on efficacy outcomes following treatment with subcutaneous abatacept or adalimumab: 2-year results from the AMPLE trial
  1. Jeremy Sokolove1,
  2. Michael Schiff2,
  3. Roy Fleischmann3,
  4. Michael E Weinblatt4,
  5. Sean E Connolly5,
  6. Alyssa Johnsen5,
  7. Jin Zhu6,
  8. Michael A Maldonado5,
  9. Salil Patel5,
  10. William H Robinson1
  1. 1VA Palo Alto Health Care System and Division of Immunology and Rheumatology, Stanford University School of Medicine, Palo Alto, California, USA
  2. 2Department of Rheumatology, University of Colorado, Denver, Colorado, USA
  3. 3Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
  4. 4Department of Rheumatology & Immunology, Brigham and Women's Hospital, Boston, Massachusetts, USA
  5. 5Immunoscience, Bristol-Myers Squibb, Princeton, New Jersey, USA
  6. 6Global Biometric Sciences, Bristol-Myers Squibb, Princeton, New Jersey, USA
  1. Correspondence to Dr Jeremy Sokolove, VA Palo Alto Health Care System, 3801 Miranda Avenue, Mail Stop 111G, Palo Alto, CA 94034, USA; sokolove{at}


Objectives To examine whether baseline anti-cyclic citrullinated peptide-2 (CCP2) antibody status and concentration correlated with clinical outcomes in patients treated with abatacept or adalimumab on background methotrexate (MTX) in the 2-year AMPLE (Abatacept versus adaliMumab comParison in bioLogic-naïvE rheumatoid arthritis subjects with background MTX) study.

Methods In this exploratory analysis, anti-CCP2 antibody concentration was measured at baseline, and antibody-positive patients were divided into equal quartiles, Q1–Q4, representing increasing antibody concentrations. Clinical outcomes analysed by baseline anti-CCP2 status and quartile included change from baseline in disease activity and disability and remission rates.

Results Baseline characteristics were generally comparable across quartiles and treatment groups. In both treatment groups, anti-CCP2 antibody-negative patients responded less well than antibody-positive patients. At year 2, improvements in disease activity and disability and remission rates were similar across Q1–Q3, but were numerically higher in Q4 in the abatacept group; in contrast, treatment effects were similar across all quartiles in the adalimumab group.

Conclusions In AMPLE, baseline anti-CCP2 positivity was associated with a better response for abatacept and adalimumab. Patients with the highest baseline anti-CCP2 antibody concentrations had better clinical response with abatacept than patients with lower concentrations, an association that was not observed with adalimumab.

Trial registration number NCT00929864.

  • Ant-CCP
  • Autoantibodies
  • Rheumatoid Arthritis
  • DMARDs (biologic)

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