Positive ARA pre-HCT tied to low relapse risk in patients with SSc

Systemic sclerosis (SSc) patients with positive anti-RNA polymerase III (ARA) prior to autologous haematopoietic cell transplantation (HCT) show a reduced risk of relapse, reveals a study. Moreover, no association has been observed between post-HCT autoantibodies and relapse risk.

Thirty-eight consecutive evaluable patients with SSc who underwent HCT at a single centre were included in the analysis, with a median follow-up of 33 months. Sixteen patients (42 percent) had a relapse at a median of 14 months post-HCT. Immunoassays were used to determine autoantibody levels.

With regard to pre-HCT autoantibodies, univariate analyses revealed a lower cumulative incidence of relapse (CIR) in ARA-positive than -negative patients (hazard ratio [HR], 0.21; p=0.04). On the other hand, CIR was higher among those with positive anti-Ro52, but this difference did not reach statistical significance (HR, 2.90; p=0.053).

CIR was similar between patients who are positive and those who are negative for antitopoisomerase antibody or antinuclear antibody.

In bivariate analyses that included older age as a risk factor for relapse, pre-HCT ARA remained significantly associated with relapse (HR, 0.21; p=0.04), but not for Ro52 (HR, 2.21; p=0.16).

With regard to post-HCT autoantibody level trajectory, no significant difference was observed between patients with and those without relapse.

“Autologous HCT is an effective treatment for a subset of patients with SSc,” the researchers said. “Unfortunately, relapse is a significant problem, with no available tests to predict relapse.”