Psoriatik artritli hastalarda bDMARD tedavisi öncesi ve sonrası otoantikor profili

Öz

Amaç: Bu çalışmanın amacı, biyolojik ajanlarla tedavi edilen psoriatik artrit (PsA) hastalarında sık kullanılan otoantikorların gerçek yaşam verilerindeki prevalansını değerlendirmektir. Yöntem: Hacettepe Üniversitesi Romatoloji Biyolojik Veritabanı’na (HUR-BIO) kayıtlı psoriatik artritli hastalar, biyolojik tedavi başlanmadan önce ve başlandıktan sonra elde edilen antinükleer antikor (ANA), romatoid faktör (RF) ve anti-siklik sitrüline peptid (anti-CCP) profilleri açısından değerlendirildi. Laboratuvar testleri ile biyolojik tedavi başlangıcı arasındaki süre, seropozitiflik oranları, antikor titreleri ve ANA desen alt tipleri kaydedilip analiz edildi. Bulgular: Toplam 520 PsA hastasının %69,4’ü kadındı; tanı yaşı ortalama 39,2 ± 5,2 yıl, hastalık süresi ortalama 3,3 ± 5,2 yıl idi. Biyolojik tedavi öncesinde test yapılan hastaların %69’unda en az bir otoantikor pozitifliği saptandı. ANA, en sık gözlenen otoantikor olup tedavi öncesinde %40,0, tedavi sonrasında ise %55,3 oranında pozitifti. Eş zamanlı RF ve anti-CCP pozitifliği, sırasıyla tedavi öncesinde %2,8 ve tedavi sonrasında %6,3 oranında görüldü. En sık ANA paternleri tedavi öncesinde AC4–5, tedavi sonrasında ise AC1–4–5 olarak belirlendi. Hem tedavi öncesi hem sonrası ANA testi bulunan 31 hastanın 6’sında (%19,4) biyolojik tedavi sonrasında negatiften pozitife dönüş gözlendi. Sonuç: bDMARD tedavisi alan PsA hastalarına ait gerçek yaşam verileri, hastaların yalnızca %20–30’unun üç temel otoantikor açısından seronegatif olduğunu göstermektedir. Önceki çalışmalarla uyumlu olarak, biyolojik tedavi sonrası ANA pozitifliği oranlarında artış saptanmıştır.

Anahtar Kelimeler

• psoriatik artrit
• otoantikorlar
• seroloji
• biyolojik hastalık modifiye edici ajanlar

Autoantibody profile in patients with psoriatic arthritis before and after bdMARD therapy

Öz

Background: This study aimed to evaluate the real-life prevalence of commonly tested autoantibodies among patients with psoriatic arthritis (PsA) treated with biologic agents. Methods Patients with psoriatic arthritis (PsA) from the Hacettepe University Rheumatology Biologic Database (HUR-BIO) were evaluated for antinuclear antibody (ANA), rheumatoid factor (RF), and anti-cyclic citrullinated peptide (anti-CCP) profiles before and after the initiation of biologic therapy. Demographic characteristics, time interval between the laboratory tests and initiation of the biologic agents, seropositivity rates, antibody titers, and ANA pattern subtypes were recorded and analyzed. Results Among 520 patients with psoriatic arthritis (PsA), 69.4% were female, with a mean age of 39.2 ± 5.2 years at diagnosis and a mean disease duration of 3.3 ± 5.2 years. Prior to initiating biologic therapy, 69% of the tested patients demonstrated positivity for at least one autoantibody. ANA exhibited the highest frequency of seropositivity, detected in 40.0% before and 55.3% after biologic treatment. Concurrent RF and anti-CCP positivity were observed in 2.8% and 6.3% of patients before and after treatment, respectively. The most frequent ANA patterns were AC4-5 prior to, and AC1-4-5 following biologic therapy. Among 31 patients with ANA testing available both before and after treatment, 6 (19.4%) converted from negative to positive following biologic treatment. Conclusion: Real-world serological data from patients with PsA in a bDMARD cohort indicated that only 20–30% were seronegative for all three routinely assessed autoantibodies. Consistent with previous reports, ANA positivity rates increased following bDMARD.

Anahtar Kelimeler

• psoriatic arthritis
• autoantibodies
• serology
• biologic disease-modifying antirheumatic drugs

Kaynakça

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