by Drug retention rate at 52?weeks estimated by the KaplanCMeier curve was significantly higher in the ACPA-positive group. who achieved low disease activity (LDA; SDAI??11) at 52?weeks was significantly higher in the ACPA-positive group. Multivariate logistic regression analysis identified ACPA positivity as an independent predictor for achievement of LDA at 52?weeks. Drug retention rate at 52?weeks estimated by the KaplanCMeier curve was significantly higher in the ACPA-positive group. Achievement rate of structural remission (mTSS??0.5) at 52?weeks was similar between groups. ABA treatment demonstrated a significantly higher clinical response and higher drug retention rate in ACPA-positive patients. Progression of joint destruction was similar between the ACPA-negative and ACPA-positive groups. Close attention should be paid to joint destruction even in patients showing a favorable response to ABA, especially when the ACPA status is IGLL1 antibody positive. valueanti-citrullinated protein/peptide antibody, rheumatoid factor, estimated glomerular filtration rate, Krebs von den Lungen-6, methotrexate, prednisolone, simplified disease activity index, tender joint count, swollen joint count, patients global assessment, physicians global assessment, C-reactive protein, matrix metalloproteinase-3, modified health assessment questionnaire, van der Heijde modified total Sharp score. aMean among patients receiving the drug. Changes in disease activity Mean SDAI score decreased significantly, from 22.2??12.7 at baseline to 8.7??8.1 at 52?weeks in the ACPA (+) group, and from 20.8??14.0 to 11.6??10.8 in the ACPA (?) group. We also observed a significant difference between groups at 52?weeks (anti-citrullinated protein/peptide antibody, simplified disease activity index. *anti-citrullinated protein/peptide antibody, simplified disease activity index, high disease activity, moderate disease activity, low disease activity, remission. *anti-citrullinated protein/peptide antibody, simplified disease activity index, tender joint count, swollen joint count, patients global assessment, physicians global assessment, C-reactive protein. *anti-citrullinated Aripiprazole (D8) protein/peptide antibody. Factors predicting achievement of LDA at 52?weeks Univariate and multivariate logistic regression analyses were performed to identify predictors of LDA achievement at 52?weeks. In the univariate logistic regression analysis, the following variables at baseline were found to be associated with LDA achievement at 52?weeks after ABA initiation: SDAI score, mHAQ score, and ACPA positivity (Table ?(Table2).2). The multivariate logistic regression analysis revealed the same three variables to be independently associated with LDA achievement at 52?weeks. Table 2 Predictive factors for LDA achievement at 52?weeks. valuevaluelow disease activity, odds ratio, methotrexate, prednisolone, simplified disease activity index, modified health assessment questionnaire, anti-citrullinated protein/peptide antibody. Structural outcomes Sequential radiographs of bilateral hands/wrists and feet at baseline and 52?weeks were obtained from 142 patients Aripiprazole (D8) in the ACPA (+) group and 29 patients in the ACPA (?) group. The structural remission at 52?weeks, defined as a change in mTSS from baseline??0.5, was achieved in 94 patients (66.2%) in the ACPA (+) group and 18 patients (62.1%) in the ACPA (?) group, with no significant difference observed between groups ( em p /em ?=?0.670) (Fig.?5A). There was no significant difference in mean change from baseline to 52?weeks in mTSS (1.17??1.98 vs 1.66??4.42, em p /em ?=?0.561), erosion score (0.53??1.17 vs 0.60??2.01, em p /em ?=?0.861), and JSN score (0.638??1.15 vs 1.06??2.92, em p /em ?=?0.446) between the ACPA (?) and ACPA (+) groups (Fig.?5B). Open in a separate window Figure 5 Comparisons of structural outcomes between ACPA-negative [ACPA (?)] and ACPA-positive [ACPA (+)] groups. (A) Cumulative probability plot of change from baseline to 52?weeks in van der Heijde modified total Sharp score (mTSS). (B) Mean value of Aripiprazole (D8) Aripiprazole (D8) mTSS, erosion score, and joint space narrowing (JSN) score. We found no significant difference in the baseline characteristics between the overall patients and the patients with sequential radiographs of bilateral hands/wrists and feet at baseline and 52?weeks (Table S1). Discussion The main findings from this retrospective observational cohort study are as follows. The SDAI-LDA achievement rate at 52?weeks was significantly higher in the ACPA-positive group, and ACPA positivity was an independent predictor for LDA achievement. Interestingly, disease activity decreased consistently to 52?weeks in the ACPA-positive group, while statistically reached plateau by 12?weeks in the ACPA-negative group. The retention rate of ABA treatment was significantly higher in the ACPA-positive group. The achievement rates of radiographic remission at 52?weeks were similar between the ACPA-negative and ACPA-positive groups. Consistent with previous reports3,4,10,24, we found that ACPA positivity was significantly associated with a good clinical response to ABA treatment also in Japanese patients who are genetically different from Caucasian. Another strength of our study was the novel demonstration of the detailed change in SDAI from baseline to 52?weeks in the ACPA-negative and ACPA-positive groups. We found that improvement in disease activity in the ACPA-negative group reached a plateau by 12?weeks while the disease activity continuously improved after 12?weeks to 52?weeks in the ACPA-positive Aripiprazole (D8) group. We.
