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Abatacept, a soluble fusion protein consisting of the extracellular domain of cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) and the Fc portion of human IgG1, has been approved for the treatment of rheumatoid arthritis (RA). It acts by binding to cluster of differenciation (CD)80/86 (B7-1/B7-2) on antigen-presenting cells (APCs) and blocking the B7:CD28 interaction. Meanwhile, HLA-DRB1 shared epitope (SE) has been proposed to be associated with the production of anticyclic citrullinated peptide antibody (ACPA) via major histocompatibility complex-based antigen presentation.1 2 Moreover, the efficacy of abatacept is associated with positivity and titer for ACPA.3 4 Therefore, we hypothesised that the efficacy of abatacept may be associated with patients’ HLA-DRB1 SE positivity. To test this idea, we have retrospectively underwent exploratory analysis of the association between the clinical efficacy of abatacept and HLA-DRB1 genotype. HLA-DRB1 genotype could be identified in 72 patients. The study was approved by the ethics review board of Matsuyama Red Cross Hospital, Japan and was conducted as …
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