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Predictive value of immunological and imaging biomarkers on achieving good clinical response at 6 months in rheumatoid arthritis patients treated by intravenous bDMARDs

Abstract : Purpose : To investigate the value of biological and imaging biomarkers on predicting good clinical response at 6 months, in RA patients initiating intravenous bDMARDs. Methods : Single-center retrospective study between 2008 and 2017, including 173 patients with active RA according to ACR 1987 and/or ACR-EULAR 2010 criteria, initiating IV bDMARDs. Clinical, biological and imaging (US and RX) data, were collected at treatment initiation. Conclusion • In RA patients initiating IV bDMARDs, positive RF status is a strong predictive biomarker of achieving good clinical response after 6 months of treatment. • Concerning imaging biomarkers, number of US B-mode synovitis at baseline is also predictive. • The analysis has been conducted on the pooled data of bDMARDs, due to the number of patients available. It would be interesting to confirm in further Research if the results differ between IV bDMARDs. study carried out with a financial support from Bristol-Myers-Squibb. Statistical analysis was performed independently. Corresponding authors: Giuliani Stephane (s.giuliani@chru-nancy.fr), Damien Loeuille (d.loeuille@chru-nancy.fr) Structural damage on Rx Erosive RA: n=84/110 (75.5%) Median SHSe: 36.5 (Q1 11.0-Q3 79.0) Good clinical response was defined by DAS 28 < 3.2 and/or DAS 28 decrease > 1.2 at 6 months. 155 patients entered the analysis after exclusion of those with missing clinical or biological data or when lost to follow-up. Modified Sharp/van der Heijde erosion score (SHSe ranged from 0 to 280) was calculated for 110 patients and erosive disease was defined according to EULAR 2013 criteria for erosive RA (erosions in at least 3 separate joints) Ultrasound data were collected in baseline reports for number of synovitis and tenosynovitis on greyscale (B-mode) and Power Doppler (PD) modes for 127 patients. 84 33 27 11 Distribution of RA patients by IV bDMARDs Rituximab Tocilizumab Abatacept Infliximab Results : Good responders at 6 months n=87 out of 155 (56.1%) In univariate analysis (n=155 patients), predictive biomarkers of good clinical response at 6 months were: In multivariate regression (n=101 patients), two biomarkers remain predictive: Positive RF status OR=5.1 (CI 95: 1.8-14.4) Higher number of B-mode synovitis OR=1.2 (CI 95: 1.1-1.4) Predictive value of US inflammation at baseline * p=0,0015 # p=0,0130 Positive RF Higher RF titers Positive ACPA Positive RF and ACPA p=0.0145 p=0.0002 p=0.0389 p=0.0130 Higher SHSe Higher number of B-mode synovitis Higher number of PD+ synovitis p=0.0029 p=0.0015 p=0.0130 Immunology Imaging Targeted joints for US inflammatory assessment (MTP1 excluded due to frequent OA changes) Statistical analysis could not be performed for each IV bDMARD (heterogeneous distribution) Median disease duration 11years and 9months Targeted joints in the modified Sharp/Van der Heijde Erosion score (SHSe) ACPA + n=132 (85.2%) FR + n=114 (74.5%) ♂ 27.1% ♀ 72.9% Median Age: 56y (Q1 48-Q3 62)
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https://hal.univ-lorraine.fr/hal-02982732
Contributor : Marcelo de Carvalho <>
Submitted on : Wednesday, October 28, 2020 - 7:11:45 PM
Last modification on : Friday, October 30, 2020 - 3:30:58 AM

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Giuliani Stephane, Laurent Benjamin, Marcelo de Carvalho-Bittencourt, Luc Amandine, Baumann Cédric, et al.. Predictive value of immunological and imaging biomarkers on achieving good clinical response at 6 months in rheumatoid arthritis patients treated by intravenous bDMARDs. EULAR European Congress of Rheumatology, Jun 2020, Frankfurt, Germany. ⟨hal-02982732⟩

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