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- Title
Brief Report: Attenuated Effectiveness of Tumor Necrosis Factor Inhibitors for Anti–Human T Lymphotropic Virus Type I Antibody–Positive Rheumatoid Arthritis.
- Authors
Suzuki, Takahisa; Fukui, Shoichi; Umekita, Kunihiko; Miyamoto, Junya; Umeda, Masataka; Nishino, Ayako; Okada, Akitomo; Koga, Tomohiro; Kawashiri, Shin‐ya; Iwamoto, Naoki; Ichinose, Kunihiro; Tamai, Mami; Fujikawa, Keita; Aramaki, Toshiyuki; Mizokami, Akinari; Matsuoka, Naoki; Ueki, Yukitaka; Eguchi, Katsumi; Sato, Shuntaro; Hidaka, Toshihiko
- Abstract
Objective: To evaluate the effectiveness of tumor necrosis factor (TNF) inhibitors for the treatment of human T lymphotropic virus type I (HTLV‐I)–positive patients with rheumatoid arthritis (RA) in an area endemic for HTLV‐I infection. Methods: We conducted an observational study of 585 RA patients in whom TNF inhibitors were newly introduced as a first biologic disease‐modifying antirheumatic drug in an area in southwestern Japan that is endemic for HTLV‐I infection. 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.
- Subjects
AGE distribution; BLOOD sedimentation; SCIENTIFIC observation; REGRESSION analysis; RETROVIRUS diseases; RHEUMATOID arthritis; TUMOR necrosis factors; VIRAL antibodies; TREATMENT effectiveness; TREATMENT duration; CHEMICAL inhibitors; THERAPEUTICS
- Publication
Arthritis & Rheumatology, 2018, Vol 70, Issue 7, p1014
- ISSN
2326-5191
- Publication type
Article
- DOI
10.1002/art.40461