Multibiomarker disease activity scores were significantly associated with joint damage after 1 year in rheumatoid arthritis patients taking nonbiologic disease-modifying antirheumatic drug therapy even after adjustment for several established risk factors for joint damage in an observational study.
Lead author Dr. Wanying Li of Crescendo Bioscience and associates determined multibiomarker disease activity (MBDA) scores during 271 visits in 163 patients with established rheumatoid arthritis who received nonbiologic disease-modifying antirheumatic drug therapy. The MBDA combines the serum concentrations of 12 biomarkers via a validated algorithm to quantify disease activity. The patients had a mean MBDA score of 43 (possible range 1-100), a mean age of 55 years, and two-thirds were female. Rheumatoid factor and anti-CCP each was positive in two-thirds of patients.
The investigators noted that radiographic progression – both joint space narrowing and joint erosion – was infrequent during the following year when MBDA scores were low, but the frequency and severity of radiographic progression increased as MBDA scores became higher. Progression was not observed for all patients with MBDA scores greater than 44 – the optimal score threshold for predicting progression – but the risk of progression continued to increase within the high MBDA range. The MBDA score remained significantly associated with subsequent joint damage after adjusting for 28-joint swollen joint count, 28-joint disease activity score using C-reactive protein (CRP), CRP, total Sharp van der Heijde score, and serologic status.
“These findings suggest that the MBDA score may be able to complement conventional tools for assessing RA patients during DMARD therapy and to help determine which patients need treatment intensification to prevent progressive joint damage,” the authors wrote.
Read the full article in Rheumatology (doi: 10.1093/rheumatology/kev341).