This preprint is under consideration at Arthritis Research & Therapy. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
Research article
Wataru Hirose
Hirose Clinic of Rheumatology
Corresponding Author
ORCiD: https://orcid.org/0000-0001-9095-6951
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Objectives
The aim of this study was to compare the clinical effectiveness of tofacitinib and abatacept and clarify the impact of the HLA-DRB1 shared epitope (SE) on responses to these treatments in patients with rheumatoid arthritis (RA).
Methods
After adjustments by propensity score matching, 70 out of 161 patients receiving tofacitinib and 70 out of 131 patients receiving abatacept were extracted. The clinical effectiveness of both drugs over 24 weeks and the impact of the copy numbers of SE on effectiveness outcomes were investigated.
Results
The percentage of patients in remission in the 28-joint count disease activity score using the erythrocyte sedimentation rate (DAS28-ESR) did not significantly differ between patients receiving tofacitinib and abatacept at week 24 (32% vs 37%, p=0.359). The mean change at week 4 in DAS28-ESR from baseline was significantly greater in patients receiving tofacitinib than in those receiving abatacept (-1.516 vs -0.827, p=0.0003). The percentage of patients in remission at week 4 was 30% with tofacitinib and 15% with abatacept (p=0.016). When patients were stratified by the copy numbers of SE alleles, differences in these numbers did not affect DAS28-ESR scores of patients receiving tofacitinib. However, among patients receiving abatacept, DAS28-ESR scores were significantly lower in patients carrying 2 copies of SE alleles than in those carrying 0 copies at each time point throughout the 24-week period. Furthermore, the percentage of patients in remission with DAS28-ESR at week 24 was not affected by the copy numbers of SE alleles in patients receiving tofacitinib (p=0.947), whereas it significantly increased as the copy numbers became higher in patients receiving abatacept (p=0.00309). Multivariable logistic regression analyses showed a correlation between the presence SE and DAS28-ESR remission in patients receiving abatacept (OR=25.881, 95%CI=3.140−213.351, p=0.0025), but not in those receiving tofacitinib (OR=1.473, 95%CI=0.291−7.446, p=0.639).
Conclusions
Although the clinical effectiveness of tofacitinib and abatacept was similar at week 24, tofacitinib was superior to abatacept for changes from baseline in DAS28-ESR and the achievement of remission at week 4. SE positivity was associated with the achievement of DAS28-ESR remission by week 24 in patients receiving abatacept, but not in those receiving tofacitinib.
Keywords
rheumatoid arthritis, shared epitope, tofacitinib, abatacept, propensity score matching
Figure 1
Figure 1
Figure 1
Figure 2
Figure 2
Figure 3
Figure 3
Figure 4
Figure 4
Figure 4
Figure 4
Figure 5
Figure 5
Figure 8
This is a list of supplementary files associated with this preprint. Click to download.
Loading...
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 17 Dec, 2020
No community comments so far
Editorial decision: Major revision
On 18 Jun, 2021
Review #1 received
Received 17 Jun, 2021
Review #2 received
Received 15 Jun, 2021
Review #3 received
Received 13 Jun, 2021
Review #4 received
Received 13 Jun, 2021
Reviewer #4 agreed
On 02 Jun, 2021
Reviews received
Received 02 Jun, 2021
Reviewer #2 agreed
On 01 Jun, 2021
Reviewer #3 agreed
On 01 Jun, 2021
Reviewer #1 agreed
On 01 Jun, 2021
Reviewers invited
Invitations sent on 02 Feb, 2021
Editor assigned
On 14 Dec, 2020
Submission checks complete
On 14 Dec, 2020
Editor invited
On 14 Dec, 2020
First submitted
On 13 Dec, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Learn more about our company.
A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
This preprint is under consideration at Arthritis Research & Therapy. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Wataru Hirose
Hirose Clinic of Rheumatology
Corresponding Author
ORCiD: https://orcid.org/0000-0001-9095-6951
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 17 Dec, 2020
No community comments so far
Editorial decision: Major revision
On 18 Jun, 2021
Review #1 received
Received 17 Jun, 2021
Review #2 received
Received 15 Jun, 2021
Review #3 received
Received 13 Jun, 2021
Review #4 received
Received 13 Jun, 2021
Reviewer #4 agreed
On 02 Jun, 2021
Reviews received
Received 02 Jun, 2021
Reviewer #2 agreed
On 01 Jun, 2021
Reviewer #3 agreed
On 01 Jun, 2021
Reviewer #1 agreed
On 01 Jun, 2021
Reviewers invited
Invitations sent on 02 Feb, 2021
Editor assigned
On 14 Dec, 2020
Submission checks complete
On 14 Dec, 2020
Editor invited
On 14 Dec, 2020
First submitted
On 13 Dec, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Objectives
The aim of this study was to compare the clinical effectiveness of tofacitinib and abatacept and clarify the impact of the HLA-DRB1 shared epitope (SE) on responses to these treatments in patients with rheumatoid arthritis (RA).
Methods
After adjustments by propensity score matching, 70 out of 161 patients receiving tofacitinib and 70 out of 131 patients receiving abatacept were extracted. The clinical effectiveness of both drugs over 24 weeks and the impact of the copy numbers of SE on effectiveness outcomes were investigated.
Results
The percentage of patients in remission in the 28-joint count disease activity score using the erythrocyte sedimentation rate (DAS28-ESR) did not significantly differ between patients receiving tofacitinib and abatacept at week 24 (32% vs 37%, p=0.359). The mean change at week 4 in DAS28-ESR from baseline was significantly greater in patients receiving tofacitinib than in those receiving abatacept (-1.516 vs -0.827, p=0.0003). The percentage of patients in remission at week 4 was 30% with tofacitinib and 15% with abatacept (p=0.016). When patients were stratified by the copy numbers of SE alleles, differences in these numbers did not affect DAS28-ESR scores of patients receiving tofacitinib. However, among patients receiving abatacept, DAS28-ESR scores were significantly lower in patients carrying 2 copies of SE alleles than in those carrying 0 copies at each time point throughout the 24-week period. Furthermore, the percentage of patients in remission with DAS28-ESR at week 24 was not affected by the copy numbers of SE alleles in patients receiving tofacitinib (p=0.947), whereas it significantly increased as the copy numbers became higher in patients receiving abatacept (p=0.00309). Multivariable logistic regression analyses showed a correlation between the presence SE and DAS28-ESR remission in patients receiving abatacept (OR=25.881, 95%CI=3.140−213.351, p=0.0025), but not in those receiving tofacitinib (OR=1.473, 95%CI=0.291−7.446, p=0.639).
Conclusions
Although the clinical effectiveness of tofacitinib and abatacept was similar at week 24, tofacitinib was superior to abatacept for changes from baseline in DAS28-ESR and the achievement of remission at week 4. SE positivity was associated with the achievement of DAS28-ESR remission by week 24 in patients receiving abatacept, but not in those receiving tofacitinib.
Figure 1
Figure 1
Figure 1
Figure 2
Figure 2
Figure 3
Figure 3
Figure 4
Figure 4
Figure 4
Figure 4
Figure 5
Figure 5
Figure 8
This is a list of supplementary files associated with this preprint. Click to download.
Loading...