AB0122 THE NORA PROJECT - PREDICTION OF THERAPY RESPONSE IN RHEUMATOID ARTHRITIS

• Published in: Annals of the Rheumatic Diseases
• Main Authors: Mathsson-Alm, L., Gehring, I., Poorafshar, M., Rönnelid, J., Askling, J., Haavardsholm, E., Berner Hammer, H.
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMJ 2021
• Subjects: General Biochemistry, Genetics and Molecular Biology; Immunology; Immunology and Allergy; Rheumatology; Arctic; Elia
• Online Access: http://dx.doi.org/10.1136/annrheumdis-2021-eular.2024; https://syndication.highwire.org/content/doi/10.1136/annrheumdis-2021-eular.2024

Background: Personalized medicine in Rheumatoid arthritis (RA) especially regarding therapy response is still in early stages. The Nordic RA (NORA) project is aiming to improve the prediction of therapy outcome by combining established serologic marker with new markers, genetic information and patient-derived data. Objectives: As an initial step in the project the aim was to select clinically characterized patient cohorts and evaluate if changes or patterns in serological markers could predict therapy response and/or disease progress. Methods: The ARCTIC ( A iming for R emission in rheumatoid arthritis: a randomised trial examining the benefit of ultrasound in a C linical TI ght C ontrol regimen) study [1] was designed to compare two tight control treatment strategies for early Rheumatoid arthritis and was used as a first cohort. Plasma samples (n=1622) from 224 RA patients from the ARCTIC study were included and taken at baseline and 3, 4, 6, 8, 10, 12, 14, 16, 20, and 24 months from trial start, and analyzed for the presence of EliA TM RF (IgM, IgA, IgG), anti-CCP (IgG, IgA) and anti-RA33 (IgM, IgA, IgG) autoantibodies, as well as Calprotectin using the EliA instrument platform (Phadia AB, Uppsala, Sweden). In addition, a custom-made multiplex chip (Thermo Fisher Scientific, Sweden) [2] was used for measurement of anti-IgG antibodies against RA-specific antigens (citrullinated, acetylated and carbamylated), and established CTD-markers (Connective Tissue Disease), e.g. Ro52/60 and dsDNA. The citrullinated peptides on the multiplex chip were both multiple as well as single citrullinated at different positions within the peptide sequence. Additionally, we included an ELISA to measure antibodies against native human collagen II [3]. Results: The different single assays in the baseline samples varied between 7 – 80% positive test results, e.g. anti-CCP IgG 80%. For some patients we could see changes in levels for anti-CCP, RF and anti-RA33 in the follow up samples, which varied from negative to more than 3-10xULN ...