In this study, no significant association between autoantibody status and early remission in newly diagnosed RA-patients receiving MTX  in real-world clinical practice was observed. Therefore, present study results do not support the hypothesis that treatment should be modified to autoantibody status when it comes to starting MTX therapy as first-line therapy. The study further state MTX to be a useful initial treatment strategy despite of the autoantibody status.

The relationship between autoantibody status and treatment response to methotrexate (MTX) remains unclear in RA. The researchers aimed to find an association between autoantibody status and early remission in recently diagnosed RA patients treated with MTX using real-world data.

International observational database (METEOR) was utilized to screen RA-patients initially treated with MTX. Patients were divided  into autoantibody negative (RF- and ACPA-negative ) and autoantibody-positive (RF- and/or ACPA-positive) groups. Cox-proportional hazards regression was used to estimate the impact of autoantibody status on the chance of attaining remission within 3 to 6 months.

For analysis, data from 1826 RA patients were available. In 17% (318/1629) patients, DAS remission was achieved. For autoantibody-negative and positive patients, DAS remission was found to be similar. That is why; there was no connection between autoantibody positivity and remission [hazard ratio (HR) 0.89, 95% CI 0.57, 1.38]. Similar findings were found when stratified for combination treatment (HR 0.76, 95% CI 0.37, 1.54) or MTX monotherapy (HR 0.75, 95% CI 0.41, 1.37). In 33% (530/1590) of all patients, good physical function (HAQ < 0.5) was noted. Also, there was no relation between autoantibody-positivity and HAQ < 0.5 (HR 1.05, 95% CI 0.71, 1.57).

No significant relationship between autoantibody status and early remission in newly diagnosed RA-patients receiving MTX has been observed in the present study. This indicates that MTX is useful as an initial treatment strategy regardless of autoantibody status.