DOCSLIB.ORG

Treatment Outcomes in Patients with Seropositive Versus Seronegative Rheumatoid Arthritis in Phase III Randomised Clinical Trials of Tofacitinib

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Treatment Outcomes in Patients with Seropositive Versus Seronegative Rheumatoid Arthritis in Phase III Randomised Clinical Trials of Tofacitinib Rheumatoid arthritis RMD Open: first published as 10.1136/rmdopen-2018-000742 on 23 February 2019. Downloaded from ORIGINAL ARTICLE Treatment outcomes in patients with seropositive versus seronegative rheumatoid arthritis in Phase III randomised clinical trials of tofacitinib Paul Bird,1 Stephen Hall,2 Peter Nash,3 Carol A Connell,4 Kenneth Kwok,5 David Witcombe,6 Krishan Thirunavukkarasu6 To cite: Bird P, Hall S, Nash P, ABSTRACT et al. Treatment outcomes Objectives Tofacitinib is an oral JAK inhibitor for the Key messages in patients with seropositive treatment of rheumatoid arthritis (RA). We examined versus seronegative response to tofacitinib 5 or 10 mg two times a day in What is already known about this subject? rheumatoid arthritis in Phase patients with seropositive vs seronegative RA. ► The efficacy and safety of tofacitinib in patients with III randomised clinical trials rheumatoid arthritis (RA) have been demonstrated Methods Data were pooled from five Phase III studies of of tofacitinib. RMD Open previously in Phase II and Phase III clinical trials of conventional synthetic disease-modifying antirheumatic drug 2019;5:e000742. doi:10.1136/ up to 24 months’ duration and in long-term exten- rmdopen-2018-000742 (csDMARD)- or biological DMARD-inadequate responders sion studies with up to 114 months of observation. (ORAL Step [NCT00960440]; ORAL Scan [NCT00847613]; ► Elevated levels of rheumatoid factor (RF) and/or ORAL Solo [NCT00814307]; ORAL Sync [NCT00856544]; ► Prepublication history and anticyclic citrullinated peptide (CCP) antibodies (se- additional material for this ORAL Standard [NCT00853385]). ‘Serotype’ subgroups were: ropositivity) are common in patients with RA and paper are available online. To anticyclic citrullinated peptide (CCP) and rheumatoid factor may indicate greater disease severity, a higher risk view these files, please visit (RF) positive (anti-CCP+/RF+); anti-CCP+/RF negative (-); of disease progression and may influence responses the journal online (http:// dx. doi. anti-CCP-/RF+; anti-CCP-/RF-. At month 3, ACR20/50/70 org/ 10. 1136/ rmdopen- 2018- to treatments for RA. response rates, Disease Activity Score (DAS28-4[ESR])- 000742). defined remission (DAS28-4[ESR]<2.6) and low disease What does this study add? In a posthoc, pooled analysis of five Phase III studies, http://rmdopen.bmj.com/ Received 14 June 2018 activity (LDA; DAS28-4[ESR]≤3.2), changes from baseline ► Revised 13 November 2018 (CFB) in Health Assessment Questionnaire-Disability Index tofacitinib 5 or 10 mg two times a day significantly Accepted 3 December 2018 (HAQ-DI), Short Form-36 Health Survey (SF-36) physical improved ACR20/50/70 response rates, DAS28- 4(ESR) low disease activity (LDA) rates and change functioning and Functional Assessment of Chronic Illness from baseline in Health Assessment Questionnaire- Therapy-Fatigue (FACIT-F) were evaluated. Safety endpoints Disability Index and Functional Assessment of were compared. Chronic Illness Therapy-Fatigue vs placebo in pa- Results Baseline demographics/characteristics were © Author(s) (or their tients with seropositive or seronegative RA. similar across subgroups. Tofacitinib significantly employer(s)) 2019. Re-use ► Patients who were anti-CCP+/RF+ were more likely improved ACR20/50/70 response rates, DAS28-4(ESR) permitted under CC BY-NC. No to achieve ACR20/50/70 responses with tofacitinib on September 24, 2021 by guest. Protected copyright. commercial re-use. See rights LDA rates and CFB in HAQ-DI and FACIT-F vs placebo than anti-CCP-/RF- patients (ACR20/50: both tofac- and permissions. Published across subgroups. More anti-CCP+/RF+ than anti-CCP-/ by BMJ. itinib doses; ACR70: tofacitinib 10 mg two times a RF- patients had ACR20/50/70 responses (ACR20/50: 1University of New South Wales, day); anti-CCP+/RF+ or anti-CCP+/RF- patients re- both tofacitinib doses; ACR70: 10 mg two times a day). Sydney, New South Wales, ceiving tofacitinib 10 mg two times a day were more Australia SF-36 physical functioning improved in anti-CCP+/ likely to achieve DAS28-4(ESR) remission or LDA 2Cabrini Health and Monash RF+, anti-CCP+/RF- and anti-CCP-/RF+ patients (both than anti-CCP-/RF- patients. University, Melbourne, Victoria, tofacitinib doses) and anti-CCP-/RF- patients (10 mg two Australia times a day) vs placebo. More anti-CCP+/RF+ and anti- How might this impact on clinical practice? 3 University of Queensland, CCP+/RF- than anti-CCP-/RF- patients achieved DAS28- ► This study adds to the collective evidence on the relationship between seropositivity and the efficacy Brisbane, Queensland, Australia 4(ESR) remission and LDA with tofacitinib 10 mg two 4Pfizer Inc, Groton, Connecticut, of tofacitinib, which may help to inform future ther- times a day. Frequency of adverse events (AEs), serious USA apeutic strategies. 5Pfizer Inc, New York City, New AEs and discontinuations due to AEs were similar across York, USA subgroups. 6PfizerA ustralia, Sydney, New Conclusion Generally, tofacitinib efficacy South Wales, Australia (ACR20/50/70 responses) and safety were similar INTRODUCTION across subgroups. DAS28-4(ESR) remission rates and Rheumatoid arthritis (RA) is a chronic and Correspondence to SF-36 physical functioning appeared lower in anti-CCP- debilitating autoimmune disease that has a Dr David Witcombe; patients. david. witcombe@ pfizer. com major effect on health status and quality of Bird P, et al. RMD Open 2019;5:e000742. doi:10.1136/rmdopen-2018-000742 1 RMD Open RMD Open: first published as 10.1136/rmdopen-2018-000742 on 23 February 2019. Downloaded from life.1 2 RA is characterised by inflammation of the artic- structural damage early in the course of the disease than ular synovium leading to deformity, progressive disability detection of individual markers.20 and ultimately destruction of joints. Tofacitinib is an oral Janus kinase (JAK) inhibitor for The current guidelines of both the European League the treatment of RA. The efficacy and safety of tofacitinib against Rheumatism and the American College of Rheu- 5 and 10 mg two times a day administered as monotherapy matology (ACR) recommend a ‘treat-to-target’ approach, or in combination with csDMARDs, mainly MTX, in with the primary goals of treating patients with RA identi- patients with moderately to severely active RA, have been fied as the attainment of remission or low disease activity demonstrated in Phase II21–27 and Phase III randomised (LDA) if remission is not achievable.3 4 The use of the controlled trials of up to 24 months’ duration28–33 and conventional synthetic (cs) disease-modifying antirheu- in long-term extension studies with up to 114 months of matic drug (DMARD) methotrexate (MTX) in conjunc- observation.34–36 tion with glucocorticoids (GC), either as monotherapy or This posthoc subgroup analysis used pooled data from in combination with other csDMARDs, is recommended five Phase III studies of tofacitinib to examine treatment as first-line therapy, with the aim of target attainment by response in patients with seropositive vs seronegative RA. 6 months. If this treatment fails, or if unfavourable prog- nostic markers such as early erosions, autoantibodies or METHODS high disease activity are present, the addition of other Clinical trials csDMARDs, biologic DMARDs or targeted synthetic DMARDs is recommended.3 4 However, clinical outcomes Subgroup data were pooled across five Phase III of current treatments remain variable. randomised, placebo-controlled, double-blind studies of Conflicting efficacy results have been observed for 6 to 24 months’ duration. Tofacitinib was administered at 5 or 10 mg two times a day, either as monotherapy (ORAL tumour necrosis factor inhibitors (TNFi) in different 29 studies. Previously, a randomised double-blind study of Solo, ClinicalTrials. gov number: NCT00814307) or in etanercept in combination with MTX resulted in 85% of combination with csDMARDs, mainly MTX (ORAL Sync: NCT00856544;30 ORAL Standard: NCT00853385;33 ORAL patients achieving a 20% improvement in RA according 32 28 to ACR criteria (ACR20 response).5 However, an Scan: NCT00847613 and ORAL Step: NCT00960440 ) earlier study investigating the same treatment regimen in patients with moderately to severely active RA and reported an ACR20 response rate of 71%.6 Furthermore, an inadequate response to ≥1 csDMARD or biologic contrasting results have also been observed in different DMARD. One Phase III study (ORAL Standard) included studies of infliximab. While one study from 2000 found an active comparator of adalimumab (40 mg subcutane- ACR20 responses in 42% of patients following treat- ously once every 2 weeks). Patients were permitted stable ment with infliximab in combination with MTX,7 other, background doses of low-dose oral GCs and non-steroidal anti-inflammatory drugs. more recent studies with the same treatments resulted http://rmdopen.bmj.com/ 8 9 10 in ACR20 responses in 62.4%, 60% and 58.6% of Serotype subgroups patients. Therefore, gaining a better understanding of The seropositivity status of each patient was recorded at the underlying differences in patient characteristics that baseline. For this analysis, patients were categorised as: give rise to variation in response to treatment would be anti-CCP and RF positive (anti-CCP+/RF+); anti-CCP+/ of benefit and would allow the identification of patient RF negative (-); anti-CCP-/RF+; anti-CCP-/RF-. subpopulations most likely to respond to specific treat- ment modalities. Efficacy endpoints and patient-reported outcomes Elevated levels of rheumatoid
Load more

Recommended publications
  • Autoimmune Pancreatitis: an Autoimmune Or Immunoinflammatory Disease?
    10 The Open Autoimmunity Journal, 2011, 3, 10-16 Open Access Autoimmune Pancreatitis: An Autoimmune or Immunoinflammatory Disease? Yvonne Hsieh, Sudhanshu Agrawal, Leman Yel and Sudhir Gupta* Division of Basic and Clinical Immunology, University of California, Irvine, CA 92697, USA Abstract: Autoimmune pancreatitis (AIP) has been widely presumed to be an autoimmune disease that is characterized by elevated IgG and/or IgG4, the presence of autoantibodies, and an infiltration of lymphocytes and plasma cells with fi- brosis. However, no detailed immunological studies have been published. To define immunological changes in AIP in de- tail, and to review evidence for autoimmunity which may be antigen specific and may play a role in the pathogenesis of AIP, and therefore, to determine whether AIP is an autoimmune disease. A detailed immunological investigation for both innate and adaptive immune responses was performed in a patient with AIP. Review of literature was performed from Pub med, and Medline search. Immunological analysis of patient with AIP revealed increased production of proinflammatory IL-6, and IL-17, and increased NK cell activity. No organ-specific or non-specific antibodies were detected. There was no correlation between serum IgG4 with disease activity or response to steroid therapy. Review of literature revealed lack of auto-antigen-specific T and B cell responses in AIP, and autoantibodies are present only in a subset of patients, and are not specific to pancreatic tissue antigens. Therefore, we propose the term Immunoinflammatory pancreatitis rather than an autoimmune pancreatitis. Keywords: NK cells, IL-6, IL-17, autoantibodies, IgG4. INTRODUCTION collectively has been suggested to increase the sensitivity of detection of the disease [6].
    [Show full text]
  • 73 Rheumatoid Factor in Patients with Systemic Lupus Erythematosus
    Abstracts Lupus Sci Med: first published as 10.1136/lupus-2019-lsm.73 on 1 April 2019. Downloaded from Conclusions LIT responds appropriately in both directions of the following: LI, anti 2GP1 IgG/IgM, Anti aCL IgG/ to changes in physician (T2T) as well as patient relevant IgM. (DA and health status) outcomes among Spanish SLE Statistical Analysis: Epiinfo version 7.2.0.1. patients. Results We reviewed 147 clinical histories, 107 with RF Funding Source(s): None ordered. Female 93/107 (86.9%), mean age 41.6 years (SD ±13.8). Disease duration 98 months (SD ±80.6). Tobacco exposure 10/107 (9.35%). RF (+) 22/107 (20.5%), RF median titer 228.8 IU/ml (31–2825 IU/ml). – 73 RHEUMATOID FACTOR IN PATIENTS WITH SYSTEMIC RF level in patients with GMN was 142 IU/ml (39 191), – LUPUS ERYTHEMATOSUS without GMN 258 IU/ml (31 2825) p=0.46. RF level in patients with anti Ro (+) was 248 IU/ml (31– Diana G Garate*, Demelza D Yucra, Ruth Balcazar, Hamaui Adriana, Diana Dubinsky. 2825), Ro (-) 52.5 IU/ml (31–74) p=0.37. Sanatorio Guemes RF (-) subgroup showed statistically significant association 10.1136/lupus-2019-lsm.73 with female sex, discoid lesions and aPL presence. RF(+) was associated with Ab Ro, La and patients with RA. (Table 1). Background Rheumatoid factor (RF) in SLE is found in Not found significant association with: rash, photosensivity, around 25% of patients. Authors associate it with cutaneous oral ulcer, joint pain, arthritis, serositis, neurologic and hema- involvement, Sicca, anti Ro (+) and a protective role in glo- tological involvement.
    [Show full text]
  • Rheumatoid Factor: a Novel Determiner in Cancer History
    cancers Commentary Rheumatoid Factor: A Novel Determiner in Cancer History Alessio Ugolini 1,2 and Marianna Nuti 1,* 1 Department of Experimental Medicine, “Sapienza” University of Rome, Viale Regina Elena 324, 00161 Rome, Italy; alessio.ugolini@moffitt.org 2 Department of Immunology, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA * Correspondence: [email protected] Simple Summary: Rheumatoid factors are autoantibodies that characterize different autoimmune diseases, in particular rheumatoid arthritis, but that can also be found in the sera of the general healthy population. They have been mainly studied in the context of autoimmune diseases, but some evidence have suggested an association between their presence and the predisposition to develop cancer as well as a facilitation of cancer growth and progression in oncologic patients. In this review, for the first time we thus analyze and discuss the possible roles that these autoantibodies can assume in tumor history, from determiners of a heightened susceptibility of developing cancer to drivers of a reduced response to immunotherapies. Abstract: The possible interplay between autoimmunity and cancer is a topic that still needs to be deeply explored. Rheumatoid factors are autoantibodies that are able to bind the constant regions (Fc) of immunoglobulins class G (IgGs). In physiological conditions, their production is a transient event aimed at contributing to the elimination of pathogens as well as limiting a redundant immune response by facilitating the clearance of antibodies and immune complexes. Their production can become persistent in case of different chronic infections or diseases, being for instance a fundamental marker for the diagnosis and prognosis of rheumatoid arthritis.
    [Show full text]
  • Antisynthetase Syndrome and Rheumatoid Arthritis: a Rare Overlapping Disease
    Case Report Annals of Clinical Case Reports Published: 15 Jul, 2020 Antisynthetase Syndrome and Rheumatoid Arthritis: A Rare Overlapping Disease Makhlouf Yasmine*, Miladi Saoussen, Fazaa Alia, Sallemi Mariem, Ouenniche Kmar, Leila Souebni, Kassab Selma, Chekili Selma, Zakraoui Leith, Ben Abdelghani Kawther and Laatar Ahmed Department of Rheumatology, Mongi Slim Hospital, Tunisia Abstract The association between Antisynthetase Syndrome (ASS) and rheumatoid arthritis is extremely rare. In this case report, we are describing a 16 years long standing history of seropositive RA before its uncommon association to an ASS. A 55-year-old female patient presented at the first visit with symmetric polyarthritis and active synovitis affecting both hands and ankles. Laboratory investigations showed positive rheumatoid factors, positive anti-CCP antibodies and negative ANA. The X-rays were consistent with typical erosive in hands. Thus, the patient fulfilled the ACR 1987 criteria of RA in 2000 at the age of 37. Methotrexate was firstly prescribed. However, it was ineffective after 4 years. Then, the patient did well with Leflunomide until January 2017, when she developed exertional dyspnea. High-resolution CT of the lung revealed Nonspecific Interstitial Pneumonia (NSIP). Autoantibodies against extractable nuclear antigens were screened and showed positive results for anti-Jo1 autoantibodies. She was diagnosed with ASS complicating the course of RA. Keywords: Antisynthetase syndrome; Rheumatoid arthritis; Overlap syndrome; Nonspecific interstitial pneumonia Key Points • Antisynthetase Syndrome should be considered as a clinical manifestation of overlap syndromes, particularly in active RA patients with pulmonary signs and anti-Jo-1 antibody. OPEN ACCESS • An early diagnosis of antisynthetase syndrome in an overlap syndrome is important, as *Correspondence: treatment may need adjustment.
    [Show full text]
  • What Should I Do with a Positive ANA Or RF?
    What should I do with a positive ANA or RF? ACP Puerto Rico Chapter Meeting March 13-14, 2020 Elena Myasoedova, MD, PhD Associate Professor of Medicine Mayo Clinic Rochester, Minnesota [email protected] ©2017 MFMER | slide-1 Disclosures • None ©2017 MFMER | slide-2 Why is this important? • Patients are frequently tested for RF or ANA without specific indication • Patients are referred to Rheumatology clinic on the basis of positive RF/ ANA • Patients and primary care providers are often uncertain regarding the meaning of abnormal test ©2017 MFMER | slide-3 Learning objectives • Understand the circumstances when ordering RF or ANA is helpful • Learn how to interpret a positive RF or ANA • Understand the indications for referral to Rheumatology in patients with positive RF or ANA ©2017 MFMER | slide-4 Laboratory Case 1 • You are asked to evaluate a 74 year old woman who was found to have a positive RF of 84 IU/ml by her orthopedic surgeon. The test was obtained to evaluate multiple chronic joint pains in her hands and knees. She is otherwise well and takes OTC naproxen for her pains. Her ESR is 24 mm/ hour • Your examination reveals nodular osteoarthritis of the fingers, bilateral genu varus deformities of the knees with a small, cool effusion on the right. ©2017 MFMER | slide-5 Laboratory Case 3 • You conclude that she has generalized osteoarthritis, no signs of RA and that the positive RF is likely age related. • Which one of the following tests could you order to further support your opinion? 1. C-reactive protein 2.
    [Show full text]
  • Anti-Neutrophil Cytoplasmic Antibodies in Rheumatoid Arthritis: Two Case Reports and Review of Literature David Spoerl*, Yves-Marie Pers and Christian Jorgensen
    Spoerl et al. Allergy, Asthma & Clinical Immunology 2012, 8:19 http://www.aacijournal.com/content/8/1/19 ALLERGY, ASTHMA & CLINICAL IMMUNOLOGY CASE REPORT Open Access Anti-neutrophil cytoplasmic antibodies in rheumatoid arthritis: two case reports and review of literature David Spoerl*, Yves-Marie Pers and Christian Jorgensen Abstract Background: Anti-neutrophil cytoplasmic antibodies are typically detected in anti-neutrophil cytoplasmic antibody associated vasculitis, but are also present in a number of chronic inflammatory non-vasculitic conditions like rheumatoid arthritis. Rare cases of granulomatosis with polyangiitis (formerly known as Wegener’s granulomatosis, a vasculitic disorder frequently associated with the presence of anti-neutrophil cytoplasmic antibodies) in patients with rheumatoid arthritis have been described in literature. Case presentation: We report two middle-aged female patients with rheumatoid arthritis who developed anti-neutrophil cytoplasmic antibodies and symptoms reminiscent of granulomatosis with polyangiitis. Despite the lack of antibodies specific for proteinase 3 and the absence of a classical histology, we report a probable case of granulomatosis with polyangiitis in the first patient, and consider rheumatoid vasculitis in the second patient. Conclusion: Taken together with previous reports, these cases highlight that anti-neutrophil cytoplasmic antibodies have to be evaluated very carefully in patients with rheumatoid arthritis. In this context, anti-neutrophil cytoplasmic antibodies detected by indirect
    [Show full text]
  • Antisynthetase Syndrome Positive for Anti-Threonyl- Trna Synthetase (Anti-PL7) Antibodies
    6 Gieffers J, Fullgraf H, Jahn J, et al. Chlamydia pneumoniae infection 10 Hammerschlag MR, Chirgwin K, Roblin PM, et al. Persistent in circulating human monocytes is refractory to antibiotic infection with Chlamydia pneumoniae following acute respiratory treatment. Circulation 2001; 103: 351–356. illness. Clin Infect Dis 1992; 14: 178–182. 7 Boman J, Gaydos CA. Polymerase chain reaction detection of 11 Miyashita N, Niki Y, Nakajima M, et al. Prevalence of asympto- Chlamydia pneumoniae in circulating white blood cells. J Infect Dis matic infection with Chlamydia pneumoniae in subjectively healthy 2000; 181: Suppl. 3, S452–S454. adults. Chest 2001; 119: 1416–1419. 8 Yamaguchi H, Yamada M, Uruma T, et al. Prevalence of viable 12 Blasi F, Damato S, Cosentini R, et al. Chlamydia pneumoniae and Chlamydia pneumoniae in peripheral blood mononuclear cells of chronic bronchitis: association with severity and bacterial clear- healthy blood donors. Transfusion 2004; 44: 1072–1078. ance following treatment. Thorax 2002; 57: 672–676. 9 Boman J, Soderberg S, Forsberg J, et al. High prevalence of 13 Wolf K, Fischer E, Hackstadt T. Degradation of Chlamydia pneumoniae Chlamydia pneumoniae DNA in peripheral blood mononuclear cells by peripheral blood monocytic cells. Infect Immun 2005; 73: 4560–4570. in patients with cardiovascular disease and in middle-aged blood donors. J Infect Dis 1998; 178: 274–277. DOI: 10.1183/09031936.00102310 Antisynthetase syndrome positive for anti-threonyl- tRNA synthetase (anti-PL7) antibodies To the Editors: Pulmonary hypertension was suspected by echocardiography when systolic pulmonary arterial pressure was .40 mmHg. Antisynthetase syndrome (ASS) is characterised by an inflam- matory myositis associated with interstitial lung disease (ILD) For the follow-up, we defined pulmonary aggravation/improve- and antisynthetase antibodies.
    [Show full text]
  • Modeling Rheumatoid Arthritis in Vitro: from Experimental Feasibility to Physiological Proximity
    International Journal of Molecular Sciences Review Modeling Rheumatoid Arthritis In Vitro: From Experimental Feasibility to Physiological Proximity Alexandra Damerau 1,2 and Timo Gaber 1,2,* 1 Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Rheumatology and Clinical Immunology, 10117 Berlin, Germany; [email protected] 2 German Rheumatism Research Centre (DRFZ) Berlin, a Leibniz Institute, 10117 Berlin, Germany * Correspondence: [email protected] Received: 9 October 2020; Accepted: 23 October 2020; Published: 25 October 2020 Abstract: Rheumatoid arthritis (RA) is a chronic, inflammatory, and systemic autoimmune disease that affects the connective tissue and primarily the joints. If not treated, RA ultimately leads to progressive cartilage and bone degeneration. The etiology of the pathogenesis of RA is unknown, demonstrating heterogeneity in its clinical presentation, and is associated with autoantibodies directed against modified self-epitopes. Although many models already exist for RA for preclinical research, many current model systems of arthritis have limited predictive value because they are either based on animals of phylogenetically distant origin or suffer from overly simplified in vitro culture conditions. These limitations pose considerable challenges for preclinical research and therefore clinical translation. Thus, a sophisticated experimental human-based in vitro approach mimicking RA is essential to
    [Show full text]
  • Role of Salivary Anti-SSA/B Antibodies for Diagnosing Primary Sjögren's
    Med Oral Patol Oral Cir Bucal. 2015 Mar 1;20 (2):e156-60. Salivary SSA/B in Sjögren’s Syndrome Journal section: Oral Medicine and Pathology doi:10.4317/medoral.20199 Publication Types: Research http://dx.doi.org/doi:10.4317/medoral.20199 Role of salivary anti-SSA/B antibodies for diagnosing primary Sjögren’s syndrome Pan Wei 1, Chunlei Li 1, Lu Qiang 1, Jing He 2, Zhanguo Li 2, Hong Hua 1 1 Department of Oral Medicine Peking University School and Hospital of Stomatology, Beijing 100081, PR China 2 Department of Rheumatology and Immunology, Peking University People’s Hospital, Beijing 100044, PR China Correspondence: Department of Oral Medicine Peking University School and Hospital of Stomatology Beijing 100081 Wei P, Li Ch, Qiang L, He J, Li Z, Hua H. Role of salivary anti-SSA/B [email protected] antibodies for diagnosing primary Sjögren’s syndrome. Med Oral Patol Oral Cir Bucal. 2015 Mar 1;20 (2):e156-60. http://www.medicinaoral.com/medoralfree01/v20i2/medoralv20i2p156.pdf Received: 26/05/2014 Article Number: 20199 http://www.medicinaoral.com/ Accepted: 12/08/2014 © Medicina Oral S. L. C.I.F. B 96689336 - pISSN 1698-4447 - eISSN: 1698-6946 eMail: [email protected] Indexed in: Science Citation Index Expanded Journal Citation Reports Index Medicus, MEDLINE, PubMed Scopus, Embase and Emcare Indice Médico Español Abstract The diagnosis of primary Sjögren’s syndrome (pSS) is complex, and the saliva test is a potential method to im- prove the existing diagnostic criteria. Objective: To estimate the diagnostic accuracy of salivary anti-SSA/B antibodies in primary Sjögren’s syndrome (pSS), and to analyze their correlations with clinical and laboratory profiles.
    [Show full text]
  • Rheumatoid Factor Tests in the Diagnosis and Prediction of Rheumatoid Arthritis
    Ann Rheum Dis: first published as 10.1136/ard.45.8.684 on 1 August 1986. Downloaded from Annals of the Rheumatic Diseases, 1986; 45, 684-690 Rheumatoid factor tests in the diagnosis and prediction of rheumatoid arthritis D J WALKER,' J D POUND,2 I D GRIFFITHS,' AND R J POWELL2 From the 'Department ofRheumatology, Royal Victoria Infirmary, Newcastle upon Tyne; and the 2Department of Immunology, University Hospital, Nottingham SUMMARY Four assays of rheumatoid factor (RF) have been measured on serum from 213 individuals from 13 families containing at least two sufferers from classical or definite rheumatoid arthritis (RA). Families were not uniformly RF positive or negative, and there was no evidence that non-RA RF positivity was inherited. Four individuals developed definite RA over a two year period, showing that the family members were at increased risk of RA. IgG RF and latex RF assays predicted the RA in the four cases. An association of RF positivity in RA with DR4 was observed, but this may be related to disease severity. Key words: HLA, inheritance, family study. copyright. The role of rheumatoid factor (RF) in the Patients and methods aetiopathogenesis of RA remains unclear. It is known that RFs may be present before the onset of Four assays for RF were performed on serum from clinical disease,' but more usually RFs are not 213 individuals from 13 families selected for contain- detectable in serum until several months after onset, ing at least two individuals suffering from classical or and some patients with clinical RA remain persis- definite RA by American Rheumatism Association tently seronegative by conventional RF tests.
    [Show full text]
  • Anti-Ro Antibodies in Rheumatoid Arthritis
    ARTIGO ORIGINAL Anti-Ro Antibodies in Rheumatoid Arthritis Laís Zanlorenzi 1, Paula de Oliveira Azevedo 1, Marilia Barreto Silva 1, Thelma Skare 1 ACTA REUMATOL PORT. 2012;37:149-152 ABSTRACT volvement are some of the clinical findings responsi - ble for this diversity as well as the antibody profile, in - Background: Some autoantibodies are associated with cluding rheumatoid factor (RF), anti citrullinated pro - peculiar clinical findings. Patients with rheumatoid tein antibodies (ACPA), antinuclear antibodies (ANA), arthritis (RA) may have anti-Ro antibodies. anti-Ro and anti La 2. Objective: To study prevalence and clinical associa - Some auto antibodies are associated with particular tions of anti-Ro antibodies in RA patients. clinical manifestations and their presence can help the Methods: We studied 385 patients with RA for anti-Ro clinician predict which of these events will be present 3,4 . by Elisa testing and for clinical profile, functional as - Anti-Ro, typically seen in primary Sjögren’s syndrome, sessment, DAS-28 4v. (ESR), extra-articular manifesta - has been linked to symptoms of oral and eye dryness tions, thyroid function, autoantibodies and treatment. and secondary Sjögren syndrome in RA 4,5 systemic lu - Results: The prevalence of anti-Ro was 8.31%. There pus erythematosus 3,4 (SLE), scleroderma 4 and primary was no significant difference in sex distribution, HAQ, biliary cirrhosis 4. Photosensitivity is also related to its DAS-28 or functional classification in patients with po - presence both in patients with SLE and in neonatal lu - si tive anti-Ro (p=ns). Patients with anti-Ro were pus or in sub acute cutaneous lupus 4.
    [Show full text]
  • Rheumatoid Arthritis Autoantibodies and Their Association with Age And
    Clinical and Experimental Rheumatology 2021; 39: 879-882. BRIEF PAPER Rheumatoid arthritis ABSTRACT Early studies showed that patients with Objective. To examine the association RF-positive RA are characterised by autoantibodies and between individual rheumatoid arthri- lower age of diagnosis as compared to their association with tis (RA) autoantibodies, sex and age at RF-negative patients (2, 3). These stud- age and sex RA onset. ies used isotype-unspecific methods Methods. Anti-CCP2, IgA-, IgG- and based on agglutination or nephelom- E. Pertsinidou1, V.A. Manivel1, IgM-RF were analysed centrally in etry, which primarily, but not exclu- H. Westerlind2, L. Klareskog3,4, baseline sera from 1600 RA patients sively, detect IgM RF. Similarly, the L. Alfredsson5,6, L. Mathsson-Alm1,7, diagnosed within one year of RA symp- occurrence of ACPA has repeatedly 3 3,8 tom onset. Cut-offs for RF isotypes were been shown to associate with younger M. Hansson , S. Saevarsdottir , th J. Askling2, J. Rönnelid1 determined at the 98 percentile based age at RA diagnosis (4, 5). Although on RA-free controls, close to the 98.4% there is a strong co-occurrence of RF 1Department of Immunology, Genetics anti-CCP2 specificity. and ACPA in RA, no studies so far have and Pathology, Uppsala University, Results. Anti-CCP2 was found in 1020 investigated the association between Uppsala, Sweden; 2Clinical Epidemiology patients (64%), IgA RF in 692 (43%), individual RA autoantibodies and age Division, 3Rheumatology Unit, Department IgG RF in 529 (33%) and IgM RF in at RA diagnosis, nor the corresponding of Medicine Solna, Karolinska University 916 (57%) of the patients.
    [Show full text]