The effectiveness of biological and targeted therapy in seropositive and seronegative rheumatoid arthritis

Authors: K. Pavelka 1;  M. Svoboda 2;  Z. Křístková 2
Authors‘ workplace: Revmatologický ústav Praha 1;  Institut biostatistiky a analýz, s. r. o., Brno 2
Published in: Čes. Revmatol., 28, 2020, No. 2, p. 72-78.
Category: Original article


This review focuses on the issue of the effectiveness of 
biological and targeted treatment in seropositive and 
seronegative patients with rheumatoid arthritis. Rando-mized trials preferentially enroll strongly active patients, i.e. mostly seropositive, with a minority of patients being seronegative. Therefore, the evidence of efficacy in seronegative patients comes primarily from meta-analyses of open-label extensions and registries. Due to different methodologies, results are sometimes inconsistent. However, a larger body of evidence demonstrates that rituximab and abatacept are more effective in seropositive patients, and a trend for efficacy has also been shown for tocilizumab. In contrast, anti-TNF drugs are as effective in both seropositive and seronegative patients. In randomized controlled trials, tofacitinib was more effective in seropositive than in seronegative patients.

In conclusion, although some differences in the efficacy of biological and targeted drugs have been found between seropositive and seronegative patients, the differences are not so large as to be the only selection criterion in the selection of a biological or targeted drug.


rheumatoid arthritis – RF and anti-CCP positivity – biological and targeted therapy


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Dermatology & STDs Paediatric rheumatology Rheumatology
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