SAT0130 ANTI-CITRULLINATED PEPTIDE ANTI-BODIES TITERS DECREASE AFTER RITUXIMAB BUT NOT AFTER ABATACEPT OR TNF BLOCKERS TREATMENT: A REAL-LIFE ANALYSIS

Background There is an increasing body of evidence suggesting a direct pathophysiological role of ACPA in Rheumatoid Arthritis (RA). Therefore, on the top of clinical, biological and imaging remission, one target could be immunological remission, defined as the normalization of the ACPA titers after therapy. In this sense, data related to the capacity of different biologics to normalize ACPA are contradictory. Objectives To evaluate the changes in ACPA titers before and after treatment with different biologics. Methods RA patients treated with biologics were identified via the hospital’s pharmacy and/or the Electronic Medical Record of the patients; thereafter, for each patient, ACPA titers before/after treatment were retrieved from the department of biology. To be included, patients had to be diagnosed with RA, to have received a biologic (either abatacept IV or SC, TNF-inhibitors(TNFi) (Infliximab iv and Etanercept SC), or Rituximab IV) and to have at least two dosages of ACPA (at least one before and one after biologic treatment). ACPA titers were compared before and after treatment in each of the treatment groups. A mixed model analysis including an interaction between the drug and time was also performed. Results Among the 328 selected RA patients 92 patients (female: 84%, mean age: 62 years) had enough biological data to be included for the analysis: 36 patients had received rituximab, 21 abatacept, 35 TNFi. Mean (Standard deviation) ACPA levels in the whole group before treatment was 924.8 (1164.6) UI/L. ACPA titers (summarized in figure 1) decreased significantly after Rituximab (from 1287 (1322) to 301(387) UI/L; p Conclusion In this real-life study, ACPA titers decrease slightly only after Rituximab therapy. These data suggest that there is potentially a huge unmet need in RA if the target is to achieve an immunological remission. Disclosure of Interests Stephane Hilliquin: None declared, Loriane Gutermann: None declared, Claire Goulvestre: None declared, Jerome Avouac: None declared, maxime dougados Grant/research support from: Eli Lilly and Company, Pfizer, AbbVie, and UCB Pharma, Consultant for: Eli Lilly and Company, Pfizer, AbbVie, and UCB Pharma, Anna Molto: None declared