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.