Torque Teno Virus quantification for monitoring of immunomodulation with biologic compounds in the treatment of rheumatoid arthritis.

Abstract

OBJECTIVES:

RA patients who fail to respond to MTX can receive biologic dMARDs (bDMARDs). The Torque Teno Virus (TTV) is a potential novel candidate for monitoring of immunosuppression. We explore TTV in these patients and its association with clinical response to bDMARDs.

METHODS:

The BioBio Study is a multicentre randomized open-label trial, including RA patients with insufficient response to MTX. Patients were randomized to either TNFi (infliximab, INF), anti-IL-6 (tocilizumab, TCZ), CTLA4-Ig (abatacept, ABA) or anti-CD20 (rituximab, RTX) in addition to MTX. PCR was used to quantify TTV in the peripheral blood.

RESULTS:

TTV was measured in 95 patients (INF, n = 23; TCZ, n = 22; ABA, n = 27; RTX; n = 23). TTV increased by a median of 4.5 × 104 copies/ml [c/ml; interquartile range (IQR) 0-7.5 × 105] after 3 months. TTV levels at month 3 were associated with the Simplified Disease Activity Index (SDAI) (P = 0.03) and the Clinical Disease Activity Index (CDAI) response (P = 0.026) at month 6. A TTV cut-off level of 1.2 × 106 c/ml at month 3 had a positive likelihood ratio of 2.7 for prediction of an 85% reduction in SDAI at month 6.

CONCLUSION:

Our data suggest that TTV levels increase upon TNF, CD20 and costimulation blockade and are associated with the clinical response to bDMARDs in RA patients.

TRIAL REGISTRATION:

ClinicalTrials.gov; https://clinicaltrials.gov; NCT01638715.

• Authors: Paul Studenic, Gregor Bond, Andreas Kerschbaumer, Manuel Bécède, Karel Pavelka, Dmitry Karateev, Jutta Stieger, Rudolf Puchner, Ruediger B Mueller, Elisabeth Puchhammer-Stöckl, Martina Durechova, Michaela Loiskandl, Thomas Perkmann, Martina Olejarova, Elena Luchikhina, Carl-Walter Steiner, Michael Bonelli, Josef S Smolen, Daniel Aletaha
• Journal: Rheumatology (Oxford, England) (Rheumatology (Oxford)) Vol. 61 Issue 7 Pg. 2815-2825 (07 06 2022) ISSN: 1462-0332 [Electronic] England
• PMID: 34792562 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: © The Author(s) 2021. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: [email protected].

Chemical References

• Antirheumatic Agents
• Biological Products
• Abatacept

Topics

• Abatacept (therapeutic use)
• Antirheumatic Agents (therapeutic use)
• Arthritis, Rheumatoid (drug therapy)
• Biological Products (therapeutic use)
• Humans
• Immunomodulation
• Torque teno virus
• Treatment Outcome