Abatacept reduces disease activity and ultrasound power Doppler in ACPA-negative undifferentiated arthritis: a proof-of-concept clinical and imaging study

Buch, Maya H; Hensor, Elizabeth M A; Rakieh, Chadi; Freeston, Jane; Middleton, Edward T.; Horton, Sarah; Das, Sudipto; Peterfy, Charles; Tan, Ai Lyn; Wakefield, Richard J.; Emery, Paul

doi:10.1093/rheumatology/kew357

Cited by 6 publications

(4 citation statements)

References 21 publications

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“…There are also lines of evidence implicating T-cell-independent effect of abatacept on monocytes/macrophages and osteoclasts [17,18]. In fact, abatacept exerted therapeutic effect in animal models without CD4 T cells [19], and in patients with seronegative arthritis as well [20]. Further clinical and basic studies are required to understand the effect of abatacept on the pathogenesis of joint inflammation and ACPA production in RA, which is important for optimizing the use of abatacept for the treatment of RA.…”

Section: Discussionmentioning

confidence: 99%

Abatacept reduces disease activity of rheumatoid arthritis independently of modulating anti-citrullinated peptide antibody production

Yamada

Tsuru

Otsuka³

et al. 2020

Immunological Medicine

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Abatacept may exert its clinical effect on rheumatoid arthritis (RA) by suppressing anti-cyclic citrullinated peptide (CCP) antibody production. This study was undertaken to test this hypothesis by examining the changes of disease activity of RA and anti-CCP antibody levels over time after starting abatacept. Sixty Japanese RA patients who started abatacept were included in this multicenter, prospective observational study. Simple Disease Activity Index (SDAI) and anti-CCP antibody levels were evaluated at 12, 24, and 52 weeks. The mean SDAI score significantly decreased within 12 weeks after starting abatacept and was maintained thereafter. On the contrary, the mean anti-CCP antibody levels did not change until 52 weeks. At the individual level, there were substantial changes of anti-CCP antibody levels, but these were not correlated with the changes of disease activity at any time points. Thus, abatacept reduces the disease activity of RA independently of modulating anti-CCP antibody production.

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Section: Discussionmentioning

confidence: 99%

Abatacept reduces disease activity of rheumatoid arthritis independently of modulating anti-citrullinated peptide antibody production

Yamada

Tsuru

Otsuka³

et al. 2020

Immunological Medicine

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“…Undifferentiated arthritis (UA) is defined as an inflammatory arthritis not satisfying classification criteria for rheumatoid arthritis (RA) (1)(2)(3) or peripheral spondyloarthritis (pSpA) (4), including psoriatic arthritis (PsA) (5). UA represents 33-35% of patients in early arthritis clinics, usually as mono-or oligoarthritis.…”

Section: Introductionmentioning

confidence: 99%

Synovial Immunohistological Biomarkers of the Classification of Undifferentiated Arthritis Evolving to Rheumatoid or Psoriatic Arthritis

et al. 2021

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Background: Undifferentiated arthritis (UA) is defined as an inflammatory arthritis that does not fulfill criteria for a definite diagnosis. Delay in reaching a specific diagnostic and therapy may lead to impaired functional outcomes. Our aim was to identify synovial biomarkers associated with definitive diagnostic classification in patients with UA.Methods: DMARD-naïve UA patients with available initial synovial tissue (ST) and a final diagnosis of rheumatoid arthritis (RA) or psoriatic arthritis (PsA) during follow-up were included and compared with patients with well-defined disease (RA or PsA). Clinical, arthroscopic, and pathological data were compared between groups. Pathology included quantitative immunohistochemical (IHC) analysis of cell types and human interferon-regulated MxA. Principal component analysis (PCA) was performed to extract disease patterns.Results: One hundred and five patients were included: 31 patients with DMARD-naïve UA (19 evolving to RA and 12 to PsA during a median follow up of 7 years), 39 with established RA, and 35 with established PsA. ST from the UA group showed higher macrophage density compared with the established RA and PsA groups. Patients with UA evolving to RA (UA-RA) showed higher MxA expression and CD3+ T-cell density compared with established RA. UA patients evolving to PsA (UA-PsA) showed increased vascularity and lining synovial fibroblast density compared with established PsA. Synovitis of UA-PsA patients showed more mast cells and lining fibroblasts compared with UA-RA. No between-group differences in local or systemic inflammation markers were found.Conclusions: Our results show differences in the cellular composition of UA synovium compared with RA and PsA, with higher density of the cellular infiltrate in the UA groups. Initial expression of the interferon inducible gene MxA could be a biomarker of progression to RA, while higher mast cell and fibroblastic density may be associated with PsA progression.

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“…Previously, we have demonstrated that infiltrating inflammatory cells in RA synovium may modulate not only inflammation but also bone and cartilage destruction [11]. A therapeutic strategy against synovitis may have the potential to inhibit inflammation, joint pain (arthralgia), and the degeneration of bone and cartilage tissues [9][10]. In this study, we focused on the synovitis to develop a new therapeutic strategy for RA.…”

Section: Introductionmentioning

confidence: 99%

“…In RA synovium, large numbers of infiltrating T cells, macrophages, osteoclast precursor cells and synovial fibroblasts can be seen. It has been demonstrated that infiltrating lymphocytes and macrophages in RA synovial tissue produce excessive levels of pro inflammatory cytokines, such as tumor necrosis factor (TNF)-, interleukin (IL)-1 and IL-6 [4][5][6][7][8][9][10][11][12][13]. These cytokines form a network and are key participants in the pathogenesis of arthritis.…”

Section: Introductionmentioning

confidence: 99%

Effects of Low-Level Laser Therapy on Clinical Characteristics and Laboratory Profiles in Synovitis in patients with Rheumatoid Arthritis

Yudoh

Karasawa

2018

NTAB

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Rheumatoid arthritis (RA) is a chronic disease that requires long-term administration of immunomodulatory drugs, resulting in a greater risk of side effects such as serious infections, malignancies, hepatic or renal dysfunction and cardiovascular diseases. The main treatment for RA is drug therapy and its therapeutic effect has steadily improved. However, problems including side effects such as infection due to suppression of the immune system and off-target effects at other locations such as the liver still exist because it is a systemic rather than a topical therapy.Despite the effectiveness of anti-rheumatic drugs, further studies are needed to reduce the risk of side effects. It has been revealed that light therapy by laser irradiation could accelerate wound healing and tissue repair, as well as provide relief of pain and inflammation. The purpose of this study was to clarify whether laser irradiation treatment has a therapeutic potential as an adjunctive therapy against RA synovitis. We recruited 15 patients with RA (mean age: 64.9 years old, mean duration of follow-up: 8.5 years). A laser therapy device (Pulse 10, Panasonic Healthcare Inc.) was used for diode laser treatment. The laser was applied at one point over the swollen or tender joint for 5 minutes, over a period of 4 weeks, once a week for a total of 5 sessions. Outcome measures included arthralgia, patients' global assessment, physician's global assessment, the levels of swelling and tenderness of arthritic joints and disability. Also, in addition to laboratory blood tests, serum concentrations of pro inflammatory cytokines were measured.A total of 26 joints were treated. After the third or 4th treatment with laser irradiation, there was a tendency for the number of swollen and tender joints to decrease. After the 4th treatment, the ADL and VAS scores showed a tendency to decrease significantly. Although no significant difference was observed in the C-reactive protein value, serum concentrations of a matrix degrading enzyme (metalloprotease-3) and a pro inflammatory cytokine (interleukin-6) were significantly reduced after the 5th laser irradiation treatment session. Our results indicate that treatment with laser irradiation may have therapeutic potential as an adjunctive therapy against RA synovitis.

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Abatacept reduces disease activity and ultrasound power Doppler in ACPA-negative undifferentiated arthritis: a proof-of-concept clinical and imaging study

Cited by 6 publications

References 21 publications

Abatacept reduces disease activity of rheumatoid arthritis independently of modulating anti-citrullinated peptide antibody production

Abatacept reduces disease activity of rheumatoid arthritis independently of modulating anti-citrullinated peptide antibody production

Synovial Immunohistological Biomarkers of the Classification of Undifferentiated Arthritis Evolving to Rheumatoid or Psoriatic Arthritis

Effects of Low-Level Laser Therapy on Clinical Characteristics and Laboratory Profiles in Synovitis in patients with Rheumatoid Arthritis

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