Disease response in rheumatoid arthritis across four biologic therapies associates with improvement in paraoxonase-1 activity and oxylipins
Authors' conclusion
Improvement in disease activity across four classes of biologics is associated with enhanced PON1 activity, which has significant implications for cardiovascular safety.
Study context
- Population
- Adults with rheumatoid arthritis (RA) and moderate-to-high disease activity (Clinical Disease Activity Index (CDAI) >10) initiating a new biologic in the CERTAIN registry
- Participants
- 1,213 adults
- Exposure
- Four biologic therapies (tocilizumab (TCZ), abatacept, TNFi, RTX): change in PON1 activity and oxylipins vs disease response
- TCZn = 296
- Abataceptn = 374
- Tumour necrosis factor inhibitorsn = 427
- Rituximabn = 116
- Outcome
- PON1 activity (ARYL, LAC and PON assays) and its association with disease activity
- Follow-up
- 6 months
Methodological detailsregistry-based (CERTAIN), biomarker analysis
- Registry-based (CERTAIN)
- Biomarker analysis
Main finding
As reported in the abstract
- Increases in all three PON1 domains associated with significant decreases in DAS28-CRP/CDAI
- p<0.05
- Increase in lactonase (LAC) associated with ACR20/50/70 response, OR
- 1.12 (1.04, 1.22), p<0.01 (95% CI)
- Increase in arylesterase (ARYL) associated with ACR20/50/70 response, OR
- 1.13 (1.04, 1.23), p<0.01 (95% CI)
Observational data: associations, not effects.
Further findings
Oxylipins (subset with lowest and highest 6-month DAS28-CRP responses)
- Some oxylipins, including 12-hydroxyeicosatetraenoic acid, correlated with RA disease activity measures
Original publication
Disease response in rheumatoid arthritis across four biologic therapies associates with improvement in paraoxonase-1 activity and oxylipins. RMD Open. Published 26 October 2024. doi:10.
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