High serum levels of CXCL13 predict lower response to csDMARDs in both ACPA-positive and ACPA-negative early rheumatoid arthritis
Authors' conclusion
High serum levels of CXCL13 identify a subgroup of RA patients who are more refractory to first-line treatment with MTX.
Study context
- Population
- Early RA patients undergoing treat-to-target with first-line MTX
- Participants
- 243 patients
- Exposure
- High baseline serum CXCL13 vs lower CXCL13
- Outcome
- Disease remission after 6 months and escalation to second-line therapies within year 2
- Follow-up
- 6 months; year 2
Methodological detailstreat-to-target with MTX, ACPA subgroup analyses
- Treat-to-target with MTX
- ACPA subgroup analyses
Main finding
As reported in the abstract
AOR for remission
0.17-0.49
range of adjusted odds ratios (ORs); ACPA-positive
AOR for second-line treatment
6.75
ACPA-positive
Observational data: associations, not effects.
Further findings
| Outcome | aOR (95% CI) | |
|---|---|---|
| MTX escalations in ACPA-negative patientsHigh CXCL13vs Low CXCL13 | 2.69 (1.35–5.34) | |
| 0.20.5125Adjusted odds ratio (log scale) |
MTX escalations in ACPA-negative patients
- In ACPA-negative patients with high CXCL13, remission occurred at the expense of higher doses of MTX
Prevalence of high CXCL13 · baseline
- ACPA-positive
- 53.6%
- ACPA-negative
- 31.5%
- Minimal association with disease activity and RF
Serum CXCL13 short-term variation · 2 months
- Serum CXCL13 remained stable after 2 months
Original publication
High serum levels of CXCL13 predict lower response to csDMARDs in both ACPA-positive and ACPA-negative early rheumatoid arthritis. Rheumatology (Oxford). Published 28 October 2024. doi:10.
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