Influence of the shared epitope on the effectiveness of biologic antirheumatic agents in European patients with rheumatoid arthritis
Authors' conclusion
In the current study, the SE was not associated with bDMARD effectiveness in patients with RA of mainly European ancestry.
Study context
- Population
- Patients with rheumatoid arthritis (RA) initiating bDMARD (abatacept, tumour necrosis factor inhibitors (TNFi), rituximab, tocilizumab) with available DNA samples, Swiss and Danish registries464 matched per bDMARD group
- Exposure
- SE positive vs SE negative, within each of four bDMARD groups
- Outcome
- Treatment retention (crude by SE status; adjusted Cox regression)
- Follow-up
- 1 year
Methodological detailspropensity-score matched 1:1, Swiss (SCQM) and Danish (DANBIO) registries, SE distribution among matched: SE negative 31%, one SE allele 48%, two alleles 21%
- Propensity-score matched 1:1
- Swiss (SCQM) and Danish (DANBIO) registries
- SE distribution among matched: SE negative 31%, one SE allele 48%, two alleles 21%
Main finding
As reported in the abstract
Treatment retention, SE positive vs SE negative (adjusted Cox)
SE positive vs SE negativeHazard ratio (95% CI)
Abatacept
0.99(0.71–1.38)
TNFi
1.01(0.66–1.54)
Rituximab
1.14(0.71–1.84)
Tocilizumab
1.48(0.92–2.40)
Observational data: associations, not effects.
Secondary outcomes
Low disease activity (LDA) and remission rates · 1, 2 years
- Unaffected by SE status for all four biologic disease-modifying antirheumatic drugs (bDMARDs)
Sensitivity analyses (number of SE alleles)
- Similar results
Original publication
Influence of the shared epitope on the effectiveness of biologic antirheumatic agents in European patients with rheumatoid arthritis. RMD Open. Published 9 July 2026. doi:10.
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