Anti-TNF-α treatment in rheumatoid arthritis with anti-Ro/SSA antibodies. Analysis of 17 cases among a cohort of 322 treated patients

Ilaria Cavazzana, Francesca Bobbio-Pallavicini, Franco Franceschini, Chiara Bazzani, Angela Ceribelli, Elena Bravi, Stefania Zingarelli, Roberto Caporali, Roberto Cattaneo, Carlo Maurizio Montecucco

Research output: Contribution to journalArticle

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Abstract

Objective: To compare the efficacy and safety of anti-TNF-α treatment in RA patients with and without anti-Ro antibodies, in order to detect any change in their immunological or clinical profile. Methods: Autoantibodies in 322 patients being treated with anti-TNF-α drugs were studied; 17 were found to be anti-Ro positive, while 305 were anti-Ro negative. Results: Two groups, comparable in terms of sex distribution, RA duration and anti-TNF-α drug employed, showed symmetrical, erosive polyarticular RA with high disease activity. Anti-TNF-α led to significant improvement in both groups. At baseline rheumatoid factor and ANA, globally positive in 68.6% and 40%, were more frequent in anti-Ro positive sera. ANA showed a rising trend beginning in the 6th month of treatment in both groups, which was always statistically significant compared to baseline. Anti-dsDNA antibodies, measured using either CLIFT and ELISA or the Farr assay, remained stable in the first 6 months, then increased at 12th and 18th month, and subsequently declined. No difference was detected between the two groups regarding the number or cause of dropouts, but lupus-like disease was more frequent in anti-Ro positive subjects (p = 0.012). In addition, two cases of NHL were detected. Conclusion: Anti-TNF-α treatment was shown to be effective in patients with anti-Ro antibodies. Although anti-dsDNA and lupus-like disease were more frequent in anti-Ro positive patients, severe manifestations of systemic involvement were not observed. A longer follow-up is warranted to evaluate the risk of NHL in these patients.

Original languageEnglish
Pages (from-to)676-683
Number of pages8
JournalClinical and Experimental Rheumatology
Volume25
Issue number5
Publication statusPublished - Sep 2007

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Rheumatoid Arthritis
Anti-Idiotypic Antibodies
Radioimmunoprecipitation Assay
Therapeutics
Sex Distribution
Rheumatoid Factor
Pharmaceutical Preparations
Autoantibodies
Enzyme-Linked Immunosorbent Assay
SS-A antibodies
Safety
Serum

Keywords

  • Anti-Ro/SSA
  • Anti-TNF-α
  • Etanercept
  • Infliximab
  • Rheumatoid arthritis

ASJC Scopus subject areas

  • Rheumatology
  • Immunology

Cite this

Anti-TNF-α treatment in rheumatoid arthritis with anti-Ro/SSA antibodies. Analysis of 17 cases among a cohort of 322 treated patients. / Cavazzana, Ilaria; Bobbio-Pallavicini, Francesca; Franceschini, Franco; Bazzani, Chiara; Ceribelli, Angela; Bravi, Elena; Zingarelli, Stefania; Caporali, Roberto; Cattaneo, Roberto; Montecucco, Carlo Maurizio.

In: Clinical and Experimental Rheumatology, Vol. 25, No. 5, 09.2007, p. 676-683.

Research output: Contribution to journalArticle

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abstract = "Objective: To compare the efficacy and safety of anti-TNF-α treatment in RA patients with and without anti-Ro antibodies, in order to detect any change in their immunological or clinical profile. Methods: Autoantibodies in 322 patients being treated with anti-TNF-α drugs were studied; 17 were found to be anti-Ro positive, while 305 were anti-Ro negative. Results: Two groups, comparable in terms of sex distribution, RA duration and anti-TNF-α drug employed, showed symmetrical, erosive polyarticular RA with high disease activity. Anti-TNF-α led to significant improvement in both groups. At baseline rheumatoid factor and ANA, globally positive in 68.6{\%} and 40{\%}, were more frequent in anti-Ro positive sera. ANA showed a rising trend beginning in the 6th month of treatment in both groups, which was always statistically significant compared to baseline. Anti-dsDNA antibodies, measured using either CLIFT and ELISA or the Farr assay, remained stable in the first 6 months, then increased at 12th and 18th month, and subsequently declined. No difference was detected between the two groups regarding the number or cause of dropouts, but lupus-like disease was more frequent in anti-Ro positive subjects (p = 0.012). In addition, two cases of NHL were detected. Conclusion: Anti-TNF-α treatment was shown to be effective in patients with anti-Ro antibodies. Although anti-dsDNA and lupus-like disease were more frequent in anti-Ro positive patients, severe manifestations of systemic involvement were not observed. A longer follow-up is warranted to evaluate the risk of NHL in these patients.",
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AU - Franceschini, Franco

AU - Bazzani, Chiara

AU - Ceribelli, Angela

AU - Bravi, Elena

AU - Zingarelli, Stefania

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AU - Montecucco, Carlo Maurizio

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