The Clinical Impact of Seropositivity on Treatment Response in Patients with Rheumatoid Arthritis Treated with Etanercept: A Real-World Iraqi Experience

Asal Ridha,1 Saba Hussein,2 Ali AlJabban,3 Levent Mert Gunay,3 Faiq I Gorial,4 Nizar Abdulateef Al Ani4 1Rheumatology Unit, Department of Medicine, Baghdad Teaching Hospital, Medical City, Baghdad, Iraq; 2Rheumatology Unit, Department of Medicine, Al-Kindy Teaching Hospital, Baghdad, Iraq; 3Medical...

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Main Authors: Ridha A, Hussein S, AlJabban A, Gunay LM, Gorial FI, Al Ani NA
Format: Article
Language:English
Published: Dove Medical Press 2022-06-01
Series:Open Access Rheumatology: Research and Reviews
Subjects:
Online Access:https://www.dovepress.com/the-clinical-impact-of-seropositivity-on-treatment-response-in-patient-peer-reviewed-fulltext-article-OARRR
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author Ridha A
Hussein S
AlJabban A
Gunay LM
Gorial FI
Al Ani NA
author_facet Ridha A
Hussein S
AlJabban A
Gunay LM
Gorial FI
Al Ani NA
author_sort Ridha A
collection DOAJ
description Asal Ridha,1 Saba Hussein,2 Ali AlJabban,3 Levent Mert Gunay,3 Faiq I Gorial,4 Nizar Abdulateef Al Ani4 1Rheumatology Unit, Department of Medicine, Baghdad Teaching Hospital, Medical City, Baghdad, Iraq; 2Rheumatology Unit, Department of Medicine, Al-Kindy Teaching Hospital, Baghdad, Iraq; 3Medical Department, Pfizer, Baghdad, Iraq; 4Rheumatology Unit, Department of Medicine, College of Medicine, University of Baghdad, Baghdad, IraqCorrespondence: Ali AlJabban, Medical Department, Pfizer, Building 5, Street 51, Sec. 611, AlDawoodi, Baghdad, Iraq, Tel +964 7706056226, Email aliabdulmohsinabdulkareem.aljabban@pfizer.comPurpose: To assess the clinical impact of rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibody (ACPA)’s seropositivity on treatment response in patients with rheumatoid arthritis (RA) treated with etanercept.Patients and Methods: A retrospective analysis of patients with RA registered in Baghdad Teaching Hospital Registry from May 2012 to August 2019 was conducted. Patients aged ≥ 18 years, meeting the ACR/EULAR 2010 criteria for RA, being treated with etanercept, and followed up at ≥ 1 year after etanercept initiation were included; patients who received any other biologics for RA were excluded. Patients were classified as seropositive (RF- and ACPA-positive), seronegative (RF- and ACPA-negative), RF-positive, RF-negative, ACPA-positive, and ACPA-negative. The primary outcomes included Clinical Disease Activity Index (CDAI) and Disease Activity Score 28 (DAS28) which were measured at one year after treatment initiation.Results: At baseline, a total of 1318 (88.3%) patients were seropositive; 1122 (75.2%) and 1054 (70.6%) patients were RF- and ACPA-positive, respectively. Baseline mean CDAI scores were significantly (P = 0.001) higher among seropositive patients compared with seronegative patients. The baseline mean DAS28 score was also significantly higher in ACPA-positive group compared with the ACPA-negative group (P = 0.021). At baseline, the number of patients who had high CDAI scores was significantly higher among the seropositive, RF-positive, and ACPA-positive groups (P = 0.001, P = 0.001, and P = 0.002, respectively). After one year of treatment with etanercept, among seropositive versus seronegative and ACPA-positive versus ACPA-negative groups, there was a significant improvement in terms of the mean CDAI score (P = 0.004 and P = 0.017, respectively) and CDAI response (P = 0.011 and P = 0.048, respectively). At one year, the proportion of patients among the seropositive versus seronegative group who reached remission were 566 (42.9%) versus 78 (44.6%) and 642 (47.3%) versus 83 (47.4%), for CDAI and DAS28 response, respectively.Conclusion: The results imply that seropositivity and ACPA-positivity may influence the treatment response in patients with RA, who were treated with etanercept.Keywords: anti-cyclic citrullinated peptide antibody, Iraq, real-world, rheumatoid factor
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spelling doaj.art-ad7060bdcefb4312a9b95093e54bb3882022-12-22T00:18:37ZengDove Medical PressOpen Access Rheumatology: Research and Reviews1179-156X2022-06-01Volume 1411312175940The Clinical Impact of Seropositivity on Treatment Response in Patients with Rheumatoid Arthritis Treated with Etanercept: A Real-World Iraqi ExperienceRidha AHussein SAlJabban AGunay LMGorial FIAl Ani NAAsal Ridha,1 Saba Hussein,2 Ali AlJabban,3 Levent Mert Gunay,3 Faiq I Gorial,4 Nizar Abdulateef Al Ani4 1Rheumatology Unit, Department of Medicine, Baghdad Teaching Hospital, Medical City, Baghdad, Iraq; 2Rheumatology Unit, Department of Medicine, Al-Kindy Teaching Hospital, Baghdad, Iraq; 3Medical Department, Pfizer, Baghdad, Iraq; 4Rheumatology Unit, Department of Medicine, College of Medicine, University of Baghdad, Baghdad, IraqCorrespondence: Ali AlJabban, Medical Department, Pfizer, Building 5, Street 51, Sec. 611, AlDawoodi, Baghdad, Iraq, Tel +964 7706056226, Email aliabdulmohsinabdulkareem.aljabban@pfizer.comPurpose: To assess the clinical impact of rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibody (ACPA)’s seropositivity on treatment response in patients with rheumatoid arthritis (RA) treated with etanercept.Patients and Methods: A retrospective analysis of patients with RA registered in Baghdad Teaching Hospital Registry from May 2012 to August 2019 was conducted. Patients aged ≥ 18 years, meeting the ACR/EULAR 2010 criteria for RA, being treated with etanercept, and followed up at ≥ 1 year after etanercept initiation were included; patients who received any other biologics for RA were excluded. Patients were classified as seropositive (RF- and ACPA-positive), seronegative (RF- and ACPA-negative), RF-positive, RF-negative, ACPA-positive, and ACPA-negative. The primary outcomes included Clinical Disease Activity Index (CDAI) and Disease Activity Score 28 (DAS28) which were measured at one year after treatment initiation.Results: At baseline, a total of 1318 (88.3%) patients were seropositive; 1122 (75.2%) and 1054 (70.6%) patients were RF- and ACPA-positive, respectively. Baseline mean CDAI scores were significantly (P = 0.001) higher among seropositive patients compared with seronegative patients. The baseline mean DAS28 score was also significantly higher in ACPA-positive group compared with the ACPA-negative group (P = 0.021). At baseline, the number of patients who had high CDAI scores was significantly higher among the seropositive, RF-positive, and ACPA-positive groups (P = 0.001, P = 0.001, and P = 0.002, respectively). After one year of treatment with etanercept, among seropositive versus seronegative and ACPA-positive versus ACPA-negative groups, there was a significant improvement in terms of the mean CDAI score (P = 0.004 and P = 0.017, respectively) and CDAI response (P = 0.011 and P = 0.048, respectively). At one year, the proportion of patients among the seropositive versus seronegative group who reached remission were 566 (42.9%) versus 78 (44.6%) and 642 (47.3%) versus 83 (47.4%), for CDAI and DAS28 response, respectively.Conclusion: The results imply that seropositivity and ACPA-positivity may influence the treatment response in patients with RA, who were treated with etanercept.Keywords: anti-cyclic citrullinated peptide antibody, Iraq, real-world, rheumatoid factorhttps://www.dovepress.com/the-clinical-impact-of-seropositivity-on-treatment-response-in-patient-peer-reviewed-fulltext-article-OARRRanti-cyclic citrullinated peptide antibodyiraqreal-worldrheumatoid factor
spellingShingle Ridha A
Hussein S
AlJabban A
Gunay LM
Gorial FI
Al Ani NA
The Clinical Impact of Seropositivity on Treatment Response in Patients with Rheumatoid Arthritis Treated with Etanercept: A Real-World Iraqi Experience
Open Access Rheumatology: Research and Reviews
anti-cyclic citrullinated peptide antibody
iraq
real-world
rheumatoid factor
title The Clinical Impact of Seropositivity on Treatment Response in Patients with Rheumatoid Arthritis Treated with Etanercept: A Real-World Iraqi Experience
title_full The Clinical Impact of Seropositivity on Treatment Response in Patients with Rheumatoid Arthritis Treated with Etanercept: A Real-World Iraqi Experience
title_fullStr The Clinical Impact of Seropositivity on Treatment Response in Patients with Rheumatoid Arthritis Treated with Etanercept: A Real-World Iraqi Experience
title_full_unstemmed The Clinical Impact of Seropositivity on Treatment Response in Patients with Rheumatoid Arthritis Treated with Etanercept: A Real-World Iraqi Experience
title_short The Clinical Impact of Seropositivity on Treatment Response in Patients with Rheumatoid Arthritis Treated with Etanercept: A Real-World Iraqi Experience
title_sort clinical impact of seropositivity on treatment response in patients with rheumatoid arthritis treated with etanercept a real world iraqi experience
topic anti-cyclic citrullinated peptide antibody
iraq
real-world
rheumatoid factor
url https://www.dovepress.com/the-clinical-impact-of-seropositivity-on-treatment-response-in-patient-peer-reviewed-fulltext-article-OARRR
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