Burden of Disease and Drug Response for Patients With Rheumatoid Arthritis by Shared Epitope and Anticitrullinated Protein Antibody Status
Authors' conclusion
Our results highlight important differences in disease burden by SE/ACPA status and suggest that ACPA status, rather than correlative SE status, may be the stronger predictor of abatacept response among individuals with RA.
Study context
- Population
- Adults with rheumatoid arthritis (RA) in 2 observational cohorts (FORWARD, Veterans Affairs RA [VARA])FORWARD 917
- Participants
- 3,243 adults
- Exposure
- RA classified by SE/anticitrullinated protein antibody (ACPA) status
- Outcome
- Rheumatic Disease Comorbidity Index (RDCI)
Methodological details2 observational cohorts (FORWARD, VARA), multiple linear regression, logistic regression
- 2 observational cohorts (FORWARD, VARA)
- Multiple linear regression
- Logistic regression
Main finding
As reported in the abstract
β
−0.35
95% CI −0.65 to −0.05P = 0.02
FORWARD
β
−0.35
95% CI −0.63 to −0.08P = 0.01
VARA
Observational data: associations, not effects.
Further findings
Disease burden among SE+/ACPA+ individuals, FORWARD
- Disease activity (PAS-II), lower: −0.77 [−1.10 to −0.44], P < 0.001
- Rheumatology visits, lower: −0.18 [−0.35 to 0.0], P = 0.046
- Disease-modifying antirheumatic drug (DMARD) counts, higher: 0.43 [0.02 to 0.85], P = 0.04
Response to abatacept initiation
- ACPA+ abatacept initiators more likely to experience clinically important improvements in PAS-II and DAS28
- RAPID3 not significantly associated with abatacept response
Original publication
Burden of Disease and Drug Response for Patients With Rheumatoid Arthritis by Shared Epitope and Anticitrullinated Protein Antibody Status. J Rheumatol. Published 15 October 2025. doi:10.
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