Background: In rheumatoid arthritis (RA), there is variability in the clinical response to targeted treatments, particularly biological treatments. It has been shown that rituximab (RTX): a monoclonal antibody, directed against B lymphocytes, is effective to treat patients with RA resistant to conventional disease-modifying treatments (c DMARDs). RTX could have a greater action in anti-CCP+ RA than in anti-CCP− RA.

Objectives: The objective of this study is to demonstrate that the titer of anti-CCP antibodies has an impact on the response to RTX at M6 in patients with active RA.

Methods: This is a cross-sectional study including RA patients treated with RTX. The primary endpoint was the reduction in DAS28 greater than 1.2 at 6 months (M6). The secondary endpoints were a good response and remission according to EULAR criteria.

Results: Eighty patients were included with a clear female predominance of 92.5%. The mean age was 45.3 ±13.05 years. The average duration of disease progression was 11.55 ±7.86 years. The average anti-CCP antibody level was 374.87 ± 642.10. The average DAS-28 before and after the introduction of rituximab was 5.79 ± 1.35 and 4.34 ± 1.14, respectively. The average corticosteroid dose was 10.97 ± 5.05 mg/day. The average duration of corticosteroid therapy was 10.33 ± 6.74 years. The average sedimentation rate and average CRP were respectively 35.71 ± 23.86 mm/H. and 20.18 ±20.01 mg/L. the average pain VAS was 6.95±1.33.

A decrease in DAS28 > 1.2 was observed in 45% of patients. In multivariate analysis, an anti-CCP level > 500 U/ml was more frequently associated with a reduction DAS28 > 1.2, EULAR remission (2.38, p=0.048).

Thus, a high level of anti-CCP was also predictive of a very significant decrease in NAD (p = 0.031) and NAG (p = 0.0049) at M6.

Conclusion: A high level of anti-CCP antibodies is predictive of the response to RTX during RA. Rituximab is a therapeutic prospect that could be used in many autoimmune diseases and in particular in RA.

REFERENCES: NIL.

Acknowledgements: NIL.

Disclosure of Interests: None declared.