New research presented at the European League Against Rheumatism Annual Congress (EULAR 2016) June 8-11 in London could help with the development of personalized treatments for rheumatoid arthritis (RA).
Specific antibodies found in the blood of some people with RA, including anti-CPP, predicted how patients would respond to certain medications. Anti-CPP stands for anti-cyclic citrullinated peptide antibody. The presence of this antibody is sometimes used to confirm that a person has RA.
Having the anti-CCP antibody predicted that an individual with RA would respond to abatacept, but not a type of drug known as a tumor necrosis factor-inhibitor (TNFi).
“These findings are exciting as anti-CCP antibodies are a marker of disease severity and detectable early in the course of the disease. A better understanding of the relationship between anti-CCP antibodies and treatment response has the potential to advance patient care,” said Dr. Leslie R. Harrold of the University of Massachusetts in Worcester, and Corrona LLC of Southborough, Massachusetts.
“Specifically, patients with RA can spend years trying different treatments until their disease is properly controlled. Therefore, identifying subsets of patients likely to respond to a specific drug or class of drugs is so critical,” Harrold added.
The researchers analyzed anti-CCP and rheumatoid factor (RF) antibodies and how they affect RA treatment. The trial included 566 RA patients who took abatacept. Patients taking abatacept who had both antibodies tended to have a greater response to treatment when they were compared to people with neither blood antibody. Even those individuals who had only one of the antibodies responded better to abatacept.
In contrast, the 1,715 people with RA who were taking a TNF inhibitor had no difference in their response to treatment based on having either the anti-CCP or RF antibody.
“Our findings have shown that the effects of TNF inhibitors are not dependent on the ACPA antibody status,” Harrold said. “However, the outcomes of patients receiving the T-cell co-stimulation modulator abatacept were dependent on [anti-CPP antibody] status with better responses observed in those who were positive for anti- CCP antibodies, compared to those who didn’t have these antibodies.”
The study has important implications for future RA testing. A blood test could be used as part of personalized medicine to determine who will best respond to specific medications such as abatacept.