RESEARCH - B-cell activation biomarkers as predictive factors of response to rituximab in RA

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Arthritis Rheum. 2011 Jan 10. [Epub ahead of print]

B-cell activation biomarkers as predictive factors of the response to

rituximab in rheumatoid arthritis.

Sellam J, Hendel-Chavez H, Rouanet S, Abbed K, Combe B, Loët XL, Tebib

J, Sibilia J, Taoufik Y, Dougados M, Mariette X.

Rhumatologie, Hôpital Bicêtre, AP-HP, INSERM U1012, Université

Paris-Sud 11, Le Kremlin Bicêtre, France.

Abstract

BACKGROUND: This study examined whether serum B-cell markers could

predict response to rituximab (RTX), a B-cell depleting monoclonal

antibody, in patients with refractory rheumatoid arthritis (RA).

METHODS: This RTX re-treatment dose study (SMART, NCT01126541)

involved 208 patients with refractory RA. Serum B-cell biomarkers

(rheumatoid factor [RF], anti-cyclic citrullinated peptide antibodies

[anti-CCP], free light chains, IgG, IgA and IgM and B-cell activating

factor [bAFF]) were assessed before the first RTX cycle (1000 mg on

days 1 and 15). Univariate and multivariate analyses were performed to

identify factors associated with EULAR response at 24 weeks.

RESULTS: There were 149 responders (72%). Two baseline factors were

associated with EULAR response at 24 weeks in multivariate analysis

(odds ratio [OR]; 95% confidence interval): the presence of anti-CCP

antibodies or RF (OR=3.5 [1.6-7.6]) and a serum IgG concentration

above normal (OR=2.11 [1.02-4.33]), with synergy between them (OR =

6.0 [2.2-16.2]).

CONCLUSION: The presence of RF or anti-CCP antibodies and elevated IgG

are two simple pre-therapy biomarkers useful routinely to predict

response to RTX in refractory RA patients.

PMID: 21225699

http://www.ncbi.nlm.nih.gov/pubmed/21225699

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