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Shared epitope positivity is related to efficacy of abatacept in rheumatoid arthritis
  1. Kensuke Oryoji1,
  2. Kenji Yoshida1,
  3. Yusuke Kashiwado2,
  4. Keiko Tanaka3,4,
  5. Shin-ichi Mizuki1,
  6. Hiroshi Tsukamoto2,
  7. Kazuo Kamada1,
  8. Koichi Akashi2
  1. 1 Center for Rheumatic Diseases, Matsuyama Red Cross Hospital, Matsuyama, Ehime, Japan
  2. 2 Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Fukuoka, Japan
  3. 3 Department of Epidemiology and Preventive Medicine, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
  4. 4 Epidemiology and Medical Statistics Unit, Translational Research Center, Ehime University Hospital, Toon, Ehime, Japan
  1. Correspondence to Dr Kensuke Oryoji, Center for Rheumatic diseases, Matsuyama Red Cross Hospital, Matsuyama, Ehime 7908524, Japan; oryoji{at}

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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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  • Handling editor Tore K Kvien.

  • Contributors KO contributed to the study design, overall review, writing of the manuscript, and the other authors were involved in performance of the study coordination. KY, YK, KK and SM enrolled and managed patients in the clinic. All authors read and approved the final manuscript.

  • Competing interests KO and SM have received speaking fees from Abbvie, Chugai, Tanabe-Mitsubishi, Astellas, Eisai, Janssen, Pfizer, UCB and Ono.

  • Patient consent Obtained.

  • Ethics approval Matsuyama Red Cross Hospital.

  • Provenance and peer review Not commissioned; externally peer reviewed.