Low Serum BAFF Concentration Is Associated with Response to TNF Inhibitors in Seropositive Patients with Rheumatoid Arthritis

We investigated B-cell-activating factor (BAFF) in relation to response to treatment with TNF inhibitors (TNFis) in rheumatoid arthritis (RA). This was a longitudinal study including 158 patients with RA treated with TNFis and followed up for 6 months. Clinical response at 6 months of treatment was...

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Published in:Journal of clinical medicine 2022-09, Vol.11 (17), p.5207
Main Authors: Hernández-Breijo, Borja, Parodis, Ioannis, Novella-Navarro, Marta, Martínez-Feito, Ana, Navarro-Compán, Victoria, Díaz-Almirón, Mariana, Pascual-Salcedo, Dora, Balsa, Alejandro, Plasencia-Rodríguez, Chamaida
Format: Article
Language:English
Subjects:
autoantibodies
autoimmune diseases
B cells
BAFF
biologics
biomarkers
Clinical medicine
Medical prognosis
Medicin och hälsovetenskap
Multivariate analysis
Patients
Rheumatoid arthritis
Rheumatology
Software
TNF inhibitors
Tumor necrosis factor-TNF
Variables
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Summary:We investigated B-cell-activating factor (BAFF) in relation to response to treatment with TNF inhibitors (TNFis) in rheumatoid arthritis (RA). This was a longitudinal study including 158 patients with RA treated with TNFis and followed up for 6 months. Clinical response at 6 months of treatment was defined according to the EULAR criteria for good responders (GRs). BAFF concentration was measured in serum samples, collected at baseline and at 6 months. Associations with EULAR response were evaluated using univariable and multivariable logistic regression models. ROC analysis was performed to determine the optimal threshold of serum BAFF concentration associated with good EULAR response to treatment. After 6 months of TNFi treatment, 24% of patients were GRs. They had a lower BMI, lower baseline DAS28 and lower baseline serum BAFF concentration than non-responders. After 6 months of TNFi treatment, autoantibody-positive patients who attained GR had significantly lower serum BAFF concentrations compared with patients who did not. Serum BAFF < 968 pg/mL at 6 months represented the concentration likely to best discriminate between GR and non-GR at 6 months of TNFi treatment. Autoantibody-seropositive patients who had serum BAFF < 968 pg/mL at 6 months demonstrated a more than four-fold increased probability to be GRs compared with patients with higher BAFF concentrations. In conclusion, serum BAFF concentrations were associated with response to TNFis in seropositive RA patients, corroborating the importance of the B-cell compartment in RA.
ISSN:2077-0383
2077-0383
DOI:10.3390/jcm11175207