RT Journal Article
SR Electronic
T1 Antimodified protein antibody response pattern influences the risk for disease relapse in patients with rheumatoid arthritis tapering disease modifying antirheumatic drugs
JF Annals of the Rheumatic Diseases
JO Ann Rheum Dis
FD BMJ Publishing Group Ltd and European League Against Rheumatism
SP 399
OP 407
DO 10.1136/annrheumdis-2016-209297
VO 76
IS 2
A1 Figueiredo, Camille P
A1 Bang, Holger
A1 Cobra, Jayme Fogagnolo
A1 Englbrecht, Matthias
A1 Hueber, Axel J
A1 Haschka, Judith
A1 Manger, Bernhard
A1 Kleyer, Arnd
A1 Reiser, Michaela
A1 Finzel, Stephanie
A1 Tony, Hans-Peter
A1 Kleinert, Stefan
A1 Wendler, Joerg
A1 Schuch, Florian
A1 Ronneberger, Monika
A1 Feuchtenberger, Martin
A1 Fleck, Martin
A1 Manger, Karin
A1 Ochs, Wolfgang
A1 Schmitt-Haendle, Matthias
A1 Lorenz, Hanns-Martin
A1 Nuesslein, Hubert
A1 Alten, Rieke
A1 Henes, Joerg
A1 Krueger, Klaus
A1 Rech, Jürgen
A1 Schett, Georg
YR 2017
UL http://ard.bmj.com/content/76/2/399.abstract
AB Objective To perform a detailed analysis of the autoantibody response against post-translationally modified proteins in patients with rheumatoid arthritis (RA) in sustained remission and to explore whether its composition influences the risk for disease relapse when tapering disease modifying antirheumatic drug (DMARD) therapy.Methods Immune responses against 10 citrullinated, homocitrullinated/carbamylated and acetylated peptides, as well as unmodified vimentin (control) and cyclic citrullinated peptide 2 (CCP2) were tested in baseline serum samples from 94 patients of the RETRO study. Patients were classified according to the number of autoantibody reactivities (0–1/10, 2–5/10 and >5/10) or specificity groups (citrullination, carbamylation and acetylation; 0–3) and tested for their risk to develop relapses after DMARD tapering. Demographic and disease-specific parameters were included in multivariate logistic regression analysis for defining the role of autoantibodies in predicting relapse.Results Patients varied in their antimodified protein antibody response with the extremes from recognition of no (0/10) to all antigens (10/10). Antibodies against citrullinated vimentin (51%), acetylated ornithine (46%) and acetylated lysine (37%) were the most frequently observed subspecificities. Relapse risk significantly (p=0.011) increased from 18% (0–1/10 reactivities) to 34% (2–5/10) and 55% (>5/10). With respect to specificity groups (0–3), relapse risk significantly (p=0.021) increased from 18% (no reactivity) to 28%, 36% and finally to 52% with one, two or three antibody specificity groups, respectively.Conclusions The data suggest that the pattern of antimodified protein antibody response determines the risk of disease relapse in patients with RA tapering DMARD therapy.Trial registration number 2009-015740-42; Results.