Association of rheumatoid factor, anti-citrullinated protein antibodies and shared epitope with clinical response to initial treatment in patients with early rheumatoid arthritis: data from a randomised controlled trial
Authors' conclusion
Based on this randomised controlled trial, abatacept treatment was associated with a better response than ACT in the RF and/or ACPA-positive subgroup at 24 weeks, but this was no longer seen at 48 weeks; adding SE allele-related genetic markers did not strengthen the association.
Study context
- Population
- Patients with treatment-naïve early RA randomised in the NORD-STAR trial
- Participants
- 778 patients
- Comparison
- Abatacept, certolizumab pegol or tocilizumab vs active conventional treatment, all with MTX, across rheumatoid factor (RF), ACPA and shared epitope subgroups
- Primary endpoint
- CDAI remission; differences in treatment effect across RF, ACPA and SE subgroups (interaction terms)
- Follow-up
- 24 and 48 weeks
Methodological detailssubgroup analysis, logistic generalised estimating equations, interaction terms, centralised laboratory analyses
- Subgroup analysis
- Logistic generalised estimating equations
- Interaction terms
- Centralised laboratory analyses
Primary result
As reported in the abstract
CDAI remission by RF/ACPA/SE subgroup · 24 weeks
- Abatacept better response than active conventional treatment (ACT) in RF and/or ACPA-positive subgroups at 24 weeks, but not significantly different from the negative subgroups
- By 48 weeks, abatacept better response regardless of RF/ACPA status
- No differences across RF, ACPA, SE allele, valine at position 11 or valine-arginine-alanine haplotype subgroups for any biological treatment at 48 weeks
- Adjusted for sex, country, age, BMI, DAS28-CRP and smoking
Original publication
Association of rheumatoid factor, anti-citrullinated protein antibodies and shared epitope with clinical response to initial treatment in patients with early rheumatoid arthritis: data from a randomised controlled trial. Ann Rheum Dis. Published 14 November 2024. doi:10.
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