Preferential decrease in IgG4 anti-citrullinated protein antibodies during treatment with tumour necrosis factor blocking agents in patients with rheumatoid arthritis

W.H. Bos, G.M. Bartelds, M. Vis, A. Horst, G. Wolbink, R.J. van de Stadt, D. van Schaardenburg, B.A.C. Dijkmans, W.F. Lems, M.T. Nurmohamed, L. Aarden, D. Hamann

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Abstract

Objective: To investigate the dynamics of IgG1 and IgG4 anti-citrullinated protein antibody ( ACPA) subclasses during anti-tumour necrosis factor (TNF) treatment in patients with rheumatoid arthritis ( RA). Methods: IgG, IgG1 and IgG4 ACPA levels were determined by ELISA on anti-citrullinated fibrinogen (ACF) and IgG1 : IgG4 ACPA ratios were calculated. A pilot study was performed in 28 ACF-positive patients treated with infliximab for one year. Confirmation of the results was obtained using a cohort of 180 consecutive patients treated with adalimumab for 28 weeks. Results: The median reduction in ACF levels was 31% for total IgG, 29% for IgG1, 40% for IgG4 and 22% for the IgG4 : IgG1 ACF ratio in the infliximab cohort. In adalimumab-treated patients, ACF levels declined 14% for total IgG and IgG1, and 36% for IgG4 ACF; the IgG4 : IgG1 ratio was reduced by 24% ( all percentage values p
Original languageEnglish
Pages (from-to)558-563
Number of pages6
JournalAnnals of the Rheumatic Diseases
Volume68
Issue number4
DOIs
Publication statusPublished - 2009

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