gms | German Medical Science

43. Kongress der Deutschen Gesellschaft für Rheumatologie, 29. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie, 25. Wissenschaftliche Jahrestagung der Gesellschaft für Kinder- und Jugendrheumatologie

02.-05. September 2015, Bremen

Impact of baseline anti-cyclic citrullinated peptide 2 antibody titre on efficacy outcomes following treatment with subcutaneous abatacept or adalimumab: 2-year results from the AMPLE trial

Meeting Abstract

  • J. Sokolove - Stanford University School of Medicine, Stanford, United States of America
  • Michael Schiff - University of Colorado School of Medicine, Rheumatology Division, Denver, United States of America
  • R. Fleischmann - University of Texas Southwestern Medical Center, Dallas, United States of America
  • M. E. Weinblatt - Brigham and Women's Hospital, Boston, United States of America
  • S.E. Connolly - Bristol-Myers Squibb, Princeton, United States of America
  • A. Johnsen - Bristol-Myers Squibb, Princeton, United States
  • J. Zhu - Bristol-Myers Squibb, Princeton, United States of America
  • Michael Maldonado - Bristol-Myers Squibb, Princeton, United States of America
  • S. Patel - Bristol-Myers Squibb, Princeton, United States of America
  • WH Robinson - Stanford University School of Medicine, Stanford, United States of America

Deutsche Gesellschaft für Rheumatologie. Deutsche Gesellschaft für Orthopädische Rheumatologie. Gesellschaft für Kinder- und Jugendrheumatologie. 43. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh); 29. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh); 25. wissenschaftliche Jahrestagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR). Bremen, 02.-05.09.2015. Düsseldorf: German Medical Science GMS Publishing House; 2015. Doc48.07 - RA.03

doi: 10.3205/15dgrh015, urn:nbn:de:0183-15dgrh0159

Published: September 1, 2015

© 2015 Sokolove et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at



Introduction: The AMPLE (Abatacept versus Adalimumab Comparison in Biologic-Naïve RA Subjects with Background Methotrexate) study provides an opportunity to compare the treatment and mechanistic effects of a T-cell co-stimulation modulator versus a TNF inhibitor [1]. The predictive value of baseline titres of anti-citrullinated protein antibodies (ACPA), a biomarker for RA [2], on treatment outcomes is not well understood. This information may offer a predictor of response to specific treatments. Here, we assessed the efficacy of SC abatacept (ABA) and adalimumab (ADA) according to baseline levels of anti-cyclic citrullinated peptide 2 (CCP2) antibodies (a surrogate for ACPA).

Methods: In this post hoc analysis of the AMPLE study, patient samples were analysed by anti-CCP2 ELISA [3]. Efficacy outcomes were assessed in positive patients divided into equal quartiles, Q1 to Q4, representing increasing titres of anti-CCP2 antibody. Efficacy outcomes analysed were: adjusted mean change from baseline in DAS28 (CRP) and HAQ-DI over time as determined by analysis of covariance (data from anti-CCP2 antibody-negative patients are also presented for change in DAS28 [CRP]), and remission rates in terms of CDAI, SDAI and DAS28 (CRP) <2.6-defined remission.

Results: The numbers of patients per treatment group in each quartile were (ABA, ADA): Q1=42, 55; Q2=51, 46; Q3=46, 51; Q4=46, 51. Baseline characteristics were generally comparable, with no discernible pattern across quartiles and treatment groups; e.g. DAS28 (CRP) scores were numerically higher but HAQ-DI scores were lower in ABA Q4 and ADA Q2 compared with other quartiles. For ABA, mean improvements from baseline in DAS28 (CRP) and HAQ-DI were greater in the highest titre anti-CCP2 quartile compared with the other quartiles (Figure 1 [Fig. 1]). Improvement in DAS28 (CRP) and HAQ-DI by Year 2 were comparable in Q1–3 in both ABA and ADA treatment groups; there was no apparent association between these measures and baseline anti-CCP2 titre in the ADA group. Remission rates were broadly similar in ABA and ADA groups in Q1–3, but were numerically greater in Q4 compared with Q1–3 in the ABA treatment group only.

Conclusion: Higher titre anti-CCP2 antibody at baseline is correlated with better efficacy in patients from the AMPLE study treated with abatacept, but not with adalimumab.

Note: This abstract was first presented at the EULAR Congress, 10–13 June 2015, Rome, Italy (AB0274) and published in the corresponding supplement of Ann Rheum Dis.


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