Thu0101 torque Teno Viral Load for Monitoring of Biological Therapies in Rheumatoid Arthritis

Abstract

Background:The apathogenic and highly prevalent Torque Teno Virus (TTV) is associated with the immunocompetence of its host and has been proposed for immunologic monitoring in solid organ transplantation.Objectives:Herein we explore TTV levels in rheumatoid arthritis (RA) patients receiving biological disease-modifying anti-rheumatic drugs (bDMARDs) in the context of clinical response.Methods:The BIOBIO study was designed to evaluate biomarkers for prediction of clinical response in patients with RA. Within this multicentre open-label trial, patients with insufficient response to MTX were randomized to TNFi (infliximab; INF), anti-IL-6 receptor (tocilizumab; TCZ), CTLA4-Ig (abatacept; ABA) or anti-CD20 (rituximab; RTX) in addition to MTX. TTV in peripheral blood samples was quantified at baseline and 3 months by RT-PCR.Results:TTV was measured in 95 RA patients [INF (n=23), TCZ (n=22), ABA (n=27) or RTX (n=23)]. Median TTV levels at baseline were 4.2x104 c/ml with no difference between the treatment groups. After 3 months of treatment patients with INF (p=0.018), ABA (p=0.071) and RTX (p≤0.001) showed an increase in TTV levels compared to baseline. There was no change in TTV in patients with TCZ, who were omitted from further analyses. TTV at 3 months after treatment was higher in patients achieving a SDAI85 response at month 6 (p=0.019). Levels of above 5.6x105 c/ml at month 3 showed a 67% specificity and 81% sensitivity for a SDAI85 response at month 6, corresponding to a positive likelihood ratio of 2.6 (95% CI: 1.6-4.1). Patients in the top tertile of month 3 TTV (>7.8x105 c/ml) had lower SDAI, CDAI and DAS28 and higher SDAI85 response rates at month 6 (OR: 4.18, CI: 1.41-16.42; p=0.012). The highest non-response rates were found in patients within the lowest TTV tertile (Table A), and the highest remission rates were found in the highest TTV tertile (Table B). No patient below a TTV value of 2.7x104 c/ml at month 3 showed SDAI85 treatment response at month 6.Conclusion:Our data suggest that TTV levels in patients with RA treated with INF, ABA or RTX at month 3 are associated with clinical responses at month 6, and thus may constitute a biomarker for therapeutic monitoring.Abstract THU0101 –Table 1Acknowledgement:This study was supported by a grant of the Austrian Science Funds (FWF, grant-ID: KLI072)Disclosure of Interests:Paul Studenic: None declared, Gregor Bond: None declared, Andreas Kerschbaumer Speakers bureau: Bristol-Myers-Squibb, Celgene, Pfizer, Manuel Becede: None declared, Karel Pavelka: None declared, Dmitry Karateev: None declared, Jutta Stieger: None declared, Rudolf Puchner: None declared, Rudiger Muller: None declared, Elisabeth Puchhammer-Stöckl: None declared, Martina Durechova: None declared, Michaela Loiskandl: None declared, Thomas Perkmann: None declared, Marta Olejárova: None declared, Elena Luchikhina: None declared, Carl-Walter Steiner: None declared, Michael Bonelli: None declared, Josef S. Smolen Grant/research support from: AbbVie, Eli Lilly, Janssen, MSD, Pfizer Inc, Roche, Consu...

Quantification of Torque Teno Virus (TTV) in plasma and saliva of individuals with liver cirrhosis: a cross sectional study

“…TTV is not known causes disease in healthy individuals and the viral load is increased in immunosuppressed patients with autoimmune or inflammatory diseases (10). Recent studies have identified the feasibility of using TTV to monitor the immune state of HIV patients (9), may be helpful for predicting the occurrence of severe nosocomial infections and mortality in patients with severe COVID-19 (12), predict graft outcomes in patients after solid organ transplantation and hematopoietic stem cell transplantation (13), predict clinical deterioration in intensive care unit patients (14), monitor immunosuppressed patients with rheumatoid arthritis who are on biological disease-modifying anti-rheumatic drugs (15) and indicate pulmonary function and severity of the disease in chronic obstructive pulmonary disease patients (16).…”