Eva Salgado1, José Ramón Maneiro2, Loreto Carmona3, Juan Gómez-Reino4. 1. Rheumatology Division, Complejo Hospitalario Universitario de Santiago, Travesía da Choupana s/n, 15701 Santiago de Compostela, Spain. Electronic address: eva.salgado.perez@gmail.com. 2. Rheumatology Division, Complejo Hospitalario Universitario de Santiago, Travesía da Choupana s/n, 15701 Santiago de Compostela, Spain. 3. Rheumatology Division, Complejo Hospitalario Universitario de Santiago, Travesía da Choupana s/n, 15701 Santiago de Compostela, Spain; Health Sciences School, Universidad Camilo José Cela, Madrid, Spain. 4. Rheumatology Division, Complejo Hospitalario Universitario de Santiago, Travesía da Choupana s/n, 15701 Santiago de Compostela, Spain; Department of Medicine, Facultad de Medicina, Universidad de Santiago, Santiago de Compostela, Spain.
Abstract
OBJECTIVE: To systematically analyze literature with the aim of examining whether rheumatoid factor (RF) is a predictor of response to tumor necrosis factor (TNF) antagonists in rheumatoid arthritis (RA). METHODS: A systematic review and meta-analysis of observational studies were conducted. All studies on the association of baseline RF (titer and/or status) and response to any TNF antagonists, or with enough information to estimate this association were included. Qualitative analysis and meta-analysis using random-effects approach by type of outcome response and RF test was performed. Risk of publication bias was also evaluated. RESULTS: The systematic review included 18 studies of 4163 identified articles, involving 5703 patients with homogeneous baseline characteristics. The most common outcome to assess response was European League Against Rheumatism (EULAR) response criteria, normally merging good and moderate categories as response. The weighted mean difference (WMD) of baseline IgM RF titer in meta-analysis was higher in the non-responders group [-101.58 (95% CI -156.58,-46.59) I2=0.0]. Combined odds ratios (ORs) of positive IgM RF, positive IgA RF, and positive IgG RF to achieve good/moderate response were 1.08 (0.80, 1.47), I2=40.9%; 0.83 (0.39, 1.73), I2=39.8%, and 1.30 (0.48, 3.51), I2=62.9%, respectively. We did not find an association between a positive IgM RF and EULAR good response or remission. CONCLUSIONS: This meta-analysis does not support baseline IgM RF titer as a predictor of response to TNF antagonists in RA. However, this conclusion is hampered by high heterogeneity in the studies included in this meta-analysis.
OBJECTIVE: To systematically analyze literature with the aim of examining whether rheumatoid factor (RF) is a predictor of response to tumor necrosis factor (TNF) antagonists in rheumatoid arthritis (RA). METHODS: A systematic review and meta-analysis of observational studies were conducted. All studies on the association of baseline RF (titer and/or status) and response to any TNF antagonists, or with enough information to estimate this association were included. Qualitative analysis and meta-analysis using random-effects approach by type of outcome response and RF test was performed. Risk of publication bias was also evaluated. RESULTS: The systematic review included 18 studies of 4163 identified articles, involving 5703 patients with homogeneous baseline characteristics. The most common outcome to assess response was European League Against Rheumatism (EULAR) response criteria, normally merging good and moderate categories as response. The weighted mean difference (WMD) of baseline IgM RF titer in meta-analysis was higher in the non-responders group [-101.58 (95% CI -156.58,-46.59) I2=0.0]. Combined odds ratios (ORs) of positive IgM RF, positive IgA RF, and positive IgG RF to achieve good/moderate response were 1.08 (0.80, 1.47), I2=40.9%; 0.83 (0.39, 1.73), I2=39.8%, and 1.30 (0.48, 3.51), I2=62.9%, respectively. We did not find an association between a positive IgM RF and EULAR good response or remission. CONCLUSIONS: This meta-analysis does not support baseline IgM RF titer as a predictor of response to TNF antagonists in RA. However, this conclusion is hampered by high heterogeneity in the studies included in this meta-analysis.
Authors: Mohammad E Naffaa; Fadi Hassan; Avivit Golan-Cohen; Eugene Merzon; Ilan Green; Amir Saab; Ziv Paz Journal: Rheumatol Int Date: 2021-09-16 Impact factor: 2.631
Authors: Babak Aberumand; Lillian Barra; Yang Cao; Nicole Le Riche; Andrew E Thompson; Gina Rohekar; Sherry Rohekar; Ashley Bonner; Janet E Pope Journal: Open Rheumatol J Date: 2014-10-17
Authors: Ignacio Ortea; Bernd Roschitzki; Rosario López-Rodríguez; Eva G Tomero; Juan G Ovalles; Javier López-Longo; Inmaculada de la Torre; Isidoro González-Alvaro; Juan J Gómez-Reino; Antonio González Journal: PLoS One Date: 2016-04-06 Impact factor: 3.240