{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:48:22Z","timestamp":1782780502189,"version":"3.54.5"},"reference-count":48,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T00:00:00Z","timestamp":1742342400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>We aimed to identify the impact of rheumatoid factor (RF) or anticyclic citrullinated peptide antibody (ACPA) titres on the retention of biological disease-modifying antirheumatic drugs (bDMARDs) and Janus kinase inhibitors (JAKis) in patients with rheumatoid arthritis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We retrospectively analysed 5312 courses of bDMARDs or JAKis from the ANSWER cohort. To calculate hazard ratios (HRs) for treatment discontinuation, we used multivariate Cox proportional hazards modelling, adjusted for potential confounders.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>HRs for discontinuation due to ineffectiveness were calculated based on RF classification, revealing that anti-interleukin-6 receptor (aIL-6R) antibodies exhibited the highest retention rates regardless of RF titre. In the RF-positive group, tumour necrosis factor inhibitors (TNFis) showed lower retention rates, whereas cytotoxic T lymphocyte-associated antigen-4-Ig (CTLA4-Ig) and JAKis followed aIL-6R in the retention rates. When classified based on ACPA, aIL-6R also exhibited the highest retention rates across all ACPA groups. TNFis showed lower retention rates compared with other agents in the ACPA-positive group, whereas CTLA4-Ig showed lower retention rates in the ACPA-negative group compared with other agents.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Considering effectiveness, aIL-6R showed the highest retention rates regardless of seropositivity. Although CTLA4-Ig and JAKis followed aIL-6R in RF or ACPA-positive cases, CTLA4-Ig showed the lowest retention rates in ACPA-negative cases.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/mr\/roaf029","type":"journal-article","created":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T02:32:26Z","timestamp":1742351546000},"page":"820-829","source":"Crossref","is-referenced-by-count":3,"title":["Distinct impact of RF and ACPA titre on the effectiveness and persistency of biologics and JAK inhibitors: The ANSWER cohort study"],"prefix":"10.1093","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5741-5969","authenticated-orcid":false,"given":"Yuki","family":"Etani","sequence":"first","affiliation":[{"name":"Department of Sports Medical Biomechanics, Osaka University Graduate School of Medicine , Suita,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3620-8412","authenticated-orcid":false,"given":"Yasutaka","family":"Okita","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine and Clinical Immunology, Graduate School of Medicine, Osaka University , Suita,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6831-8205","authenticated-orcid":false,"given":"Yuichi","family":"Maeda","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine and Clinical Immunology, Graduate School of Medicine, Osaka University , Suita,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6958-2983","authenticated-orcid":false,"given":"Kohei","family":"Tsujimoto","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine and Clinical Immunology, Graduate School of Medicine, Osaka University , Suita,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1408-7851","authenticated-orcid":false,"given":"Makoto","family":"Hirao","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Osaka Minami Medical Center , Kawachi-Nagano,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3120-1273","authenticated-orcid":false,"given":"Akira","family":"Onishi","sequence":"additional","affiliation":[{"name":"Department of Advanced Medicine for Rheumatic Diseases, Graduate School of Medicine, Kyoto University , Kyoto,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9372-726X","authenticated-orcid":false,"given":"Hideo","family":"Onizawa","sequence":"additional","affiliation":[{"name":"Department of Advanced Medicine for Rheumatic Diseases, Graduate School of Medicine, Kyoto University , Kyoto,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0873-5728","authenticated-orcid":false,"given":"Takaichi","family":"Okano","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Clinical Immunology, Kobe University Graduate School of Medicine , Kobe,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5100-9166","authenticated-orcid":false,"given":"Keisuke","family":"Nishimura","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Clinical Immunology, Kobe University Graduate School of Medicine , Kobe,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1927-1295","authenticated-orcid":false,"given":"Ayaka","family":"Yoshikawa","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine (IV), Osaka Medical and Pharmaceutical University , Takatsuki,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9785-4533","authenticated-orcid":false,"given":"Hideyuki","family":"Shiba","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine (IV), Osaka Medical and Pharmaceutical University , Takatsuki,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7299-2884","authenticated-orcid":false,"given":"Hideki","family":"Amuro","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine, Kansai Medical University , Osaka Hirakata,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7244-7715","authenticated-orcid":false,"given":"Yonsu","family":"Son","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine, Kansai Medical University , Osaka Hirakata,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9241-060X","authenticated-orcid":false,"given":"Motomu","family":"Hashimoto","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology, Graduate School of Medicine, Osaka Metropolitan University , Osaka,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8849-9824","authenticated-orcid":false,"given":"Tadashi","family":"Okano","sequence":"additional","affiliation":[{"name":"Center for Senile Degenerative Disorders (CSDD), Osaka Metropolitan University Graduate School of Medicine , Osaka,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8000-3196","authenticated-orcid":false,"given":"Ryota","family":"Hara","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Nara Medical University , Nara,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0810-4221","authenticated-orcid":false,"given":"Wataru","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Health Information Management, Kurashiki Sweet Hospital , Kurashiki,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7680-8071","authenticated-orcid":false,"given":"Shotaro","family":"Tachibana","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Kobe University Graduate School of Medicine , Kobe,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4308-9845","authenticated-orcid":false,"given":"Shinya","family":"Hayashi","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Kobe University Graduate School of Medicine , Kobe,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9938-6780","authenticated-orcid":false,"given":"Takaaki","family":"Noguchi","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Osaka University Graduate School of Medicine , Suita,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4749-7117","authenticated-orcid":false,"given":"Atsushi","family":"Kumanogoh","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine and Clinical Immunology, Graduate School of Medicine, Osaka University , Suita,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5107-8209","authenticated-orcid":false,"given":"Seiji","family":"Okada","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Osaka University Graduate School of Medicine , Suita,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8964-4229","authenticated-orcid":false,"given":"Ken","family":"Nakata","sequence":"additional","affiliation":[{"name":"Department of Health and Sport Sciences, Osaka University Graduate School of Medicine , Suita,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2426-1024","authenticated-orcid":false,"given":"Kosuke","family":"Ebina","sequence":"additional","affiliation":[{"name":"Department of Sports Medical Biomechanics, Osaka University Graduate School of Medicine , 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