Abstract | OBJECTIVE: METHODS: RESULTS: Fifty patients (8.5%) were anti-HTLV-I antibody-positive. The ages of the patients in this group were significantly higher at entry compared with the ages of patients who were anti-HTLV-I antibody-negative (n = 535). The median Disease Activity Score in 28 joints using the erythrocyte sedimentation rate (DAS28-ESR) was 5.21. Among the total group of patients, 82% were anti-citrullinated protein antibody (ACPA)-positive. The persistence rate of TNF inhibitors at 24 weeks was 89%. The median DAS28-ESR was significantly decreased at 24 weeks in each group. The European League Against Rheumatism (EULAR) response rate was significantly better in the anti-HTLV-I antibody-negative patients (P = 0.0277). Multiple regression analysis demonstrated that anti-HTLV-I antibody status was significantly associated with the EULAR response rate and change in the DAS28-ESR and was prominent especially in the ACPA-negative subjects. No patients developed adult T cell leukemia/lymphoma (ATL) or HTLV-I-associated myelopathy (HAM) during the 24-week treatment period. CONCLUSION: The efficacy of TNF inhibitors may be attenuated in anti-HTLV-I antibody-positive patients with RA. ATL and HAM did not develop when TNF inhibitors were used for 24 weeks, but the long-term risk is not known.
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Authors | Takahisa Suzuki, Shoichi Fukui, Kunihiko Umekita, Junya Miyamoto, Masataka Umeda, Ayako Nishino, Akitomo Okada, Tomohiro Koga, Shin-Ya Kawashiri, Naoki Iwamoto, Kunihiro Ichinose, Mami Tamai, Keita Fujikawa, Toshiyuki Aramaki, Akinari Mizokami, Naoki Matsuoka, Yukitaka Ueki, Katsumi Eguchi, Shuntaro Sato, Toshihiko Hidaka, Tomoki Origuchi, Akihiko Okayama, Atsushi Kawakami, Hideki Nakamura |
Journal | Arthritis & rheumatology (Hoboken, N.J.)
(Arthritis Rheumatol)
Vol. 70
Issue 7
Pg. 1014-1021
(07 2018)
ISSN: 2326-5205 [Electronic] United States |
PMID | 29471588
(Publication Type: Journal Article, Observational Study, Research Support, Non-U.S. Gov't)
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Copyright | © 2018, American College of Rheumatology. |
Chemical References |
- Antibodies, Viral
- Antirheumatic Agents
- Tumor Necrosis Factor-alpha
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Topics |
- Aged
- Antibodies, Viral
(blood)
- Antirheumatic Agents
(therapeutic use)
- Arthritis, Rheumatoid
(blood, drug therapy, virology)
- Blood Sedimentation
- Female
- Human T-lymphotropic virus 1
(immunology)
- Humans
- Japan
- Leukemia-Lymphoma, Adult T-Cell
(prevention & control, virology)
- Male
- Middle Aged
- Paraparesis, Tropical Spastic
(prevention & control, virology)
- Regression Analysis
- Retrospective Studies
- Treatment Outcome
- Tumor Necrosis Factor-alpha
(antagonists & inhibitors)
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