Although anti-citrullinated protein antibodies (ACPA) including anti-CCP2 antibodies are
known to promote inflammation and joint destruction in patients suffering from ACPA-positive
rheumatoid arthritis, there are currently no therapies available to efficiently eliminate
autoantibody production and to re-induce immune tolerance in these patients. However, both a
B cell-targeting therapy (Rituximab) and a T cell targeting therapy (Abatacept) were
described to lower anti-CCP2 antibody levels and occasionally trigger disappearance of these
autoantibodies (sero conversion). By sequentially combining Rituximab and Abatacept, we thus
aim to enhance the tolerogenic potential of these drugs and seek to eliminate autoantibody
production and significantly lower ACPA titers. This would for the first time correspond to a
"deep" immunological remission and a re-induction of immune tolerance.