Circulating Tfh cells are differentially modified by abatacept or TNF blockers and predict treatment response in rheumatoid arthritis
Authors' conclusion
ABT but not TNFb was able to curtail the cTfh frequency in RA. A higher baseline cTfh frequency predicts a good response to ABT but a poor response to TNFb.
Study context
- Population
- Seropositive, long-standing RA patients; plus patients with incomplete response to csDMARDs initiating TNFb or abatacept (ABT), studied at 0 and 12 months41 incomplete responders followed · or ABT 22
- Participants
- 45 / 59 / 34 / 137
- Exposure
- Abatacept vs TNF blockers vs csDMARDs vs healthy controls: circulating Tfh cell frequency
- csDMARDsn = 45
- TNFbn = 59
- ABTn = 34
- Healthy controls (HCs)n = 137reference
- Outcome
- Circulating Tfh (CD4+CXCR5+PD-1hi) cell frequency, by cytometry
Methodological detailscross-sectional comparison, longitudinal (0 and 12 months)
- Cross-sectional comparison
- Longitudinal (0 and 12 months)
Main finding
As reported in the abstract
cTfh frequency
- Increased cTfh frequency vs HCs in RA chronically receiving csDMARDs or TNFb but not ABT
- After changing from csDMARDs, cTfh frequency did not vary with TNFb but decreased to HC levels with ABT
Observational data: associations, not effects.
Further findings
- Baseline cTfh frequency predicting 12-month remission, ABT initiators · 12 months
- >0.38% · cut-off for remission · sensitivity 92% · specificity 90% · OR 25.3
- Baseline cTfh frequency predicting 12-month non-remission, TNFb initiators · 12 months
- >0.44% · cut-off for non-remission · sensitivity 67% · specificity 90% · OR 8.5
Baseline cTfh frequency predicting 12-month remission, ABT initiators
- Baseline cTfh frequency higher in 12-month remission vs remained active
Baseline cTfh frequency predicting 12-month non-remission, TNFb initiators
- Baseline cTfh frequency lower in 12-month remission vs remained active
Original publication
Circulating Tfh cells are differentially modified by abatacept or TNF blockers and predict treatment response in rheumatoid arthritis. Rheumatology (Oxford). Published 6 February 2024. doi:10.
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