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. 2004 Oct;63(10):1218–1221. doi: 10.1136/ard.2003.014647

Decrease of anti-cyclic citrullinated peptide antibodies and rheumatoid factor following anti-TNFα therapy (infliximab) in rheumatoid arthritis is associated with clinical improvement

C Alessandri 1, M Bombardieri 1, N Papa 1, M Cinquini 1, L Magrini 1, A Tincani 1, G Valesini 1
PMCID: PMC1754775  PMID: 15361374

Abstract

Objective: To investigate the effect of infliximab treatment on anti-cyclic citrullinated peptide antibodies (anti-CCP) and rheumatoid factor (RF) in patients with rheumatoid arthritis.

Methods: 43 patients with rheumatoid arthritis not responding to disease modifying anti-rheumatic drugs (DMARD) received intravenous infliximab at a dose of 3 mg/kg at baseline and after two and six weeks, and subsequently bimonthly, in combination with methotrexate. Serum samples were collected at baseline and at week 24. A commercial enzyme linked immunosorbent assay was used to test for anti-CCP antibodies; RF were detected using a quantitative nephelometric assay.

Results: At baseline, 38 of the 43 patients (88%) were positive for anti-CCP antibodies, and 41 (95%) were positive for RF. The serum titre of anti-CCP and RF decreased significantly after six months of treatment (p = 0.0001 and p<0.0001, respectively). When the patients were grouped on the basis of their clinical response to infliximab, a significant decrease in serum anti-CCP antibodies and RF was observed only in patients who had clinical improvement (ACR 20 and ACR 50).

Conclusions: Anti-TNFα treatment in rheumatoid arthritis results in a decrease in the serum titres of RF and anti-CCP antibodies in patients showing clinical improvement, suggesting that these measurements may be a useful adjunct in assessing treatment efficacy.

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Figure 1.

Figure 1

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 (A) Box and whisker plot of anti-cyclic citrullinated peptide (CCP) serum levels at baseline, classified according to American College of Rheumatology (ACR) response rate after infliximab treatment. Median, quartiles, and ranges are shown. (B) Box and whisker plot of rheumatoid factor (RF) serum levels at baseline, classified according to ACR response rate after infliximab treatment. Median, quartiles, ranges, and a possibly extreme value are shown.

Selected References

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