Pretreatment multi-biomarker disease activity score and radiographic progression in early RA: results from the SWEFOT trial.

Abstract

OBJECTIVES:

Prediction of radiographic progression (RP) in early rheumatoid arthritis (eRA) would be very useful for optimal choice among available therapies. We evaluated a multi-biomarker disease activity (MBDA) score, based on 12 serum biomarkers as a baseline predictor for 1-year RP in eRA.

METHODS:

Baseline disease activity score based on erythrocyte sedimentation rate (DAS28-ESR), disease activity score based on C-reactive protein (DAS28-CRP), CRP, MBDA scores and DAS28-ESR at 3 months were analysed for 235 patients with eRA from the Swedish Farmacotherapy (SWEFOT) clinical trial. RP was defined as an increase in the Van der Heijde-modified Sharp score by more than five points over 1 year. Associations between baseline disease activity measures, the MBDA score, and 1-year RP were evaluated using univariate and multivariate logistic regression, adjusted for potential confounders.

RESULTS:

Among 235 patients with eRA, 5 had low and 29 moderate MBDA scores at baseline. None of the former and only one of the latter group (3.4%) had RP during 1 year, while the proportion of patients with RP among those with high MBDA score was 20.9% (p=0.021). Among patients with low/moderate CRP, moderate DAS28-CRP or moderate DAS28-ESR at baseline, progression occurred in 14%, 15%, 14% and 15%, respectively. MBDA score was an independent predictor of RP as a continuous (OR=1.05, 95% CI 1.02 to 1.08) and dichotomised variable (high versus low/moderate, OR=3.86, 95% CI 1.04 to 14.26).

CONCLUSIONS:

In patients with eRA, the MBDA score at baseline was a strong independent predictor of 1-year RP. These results suggest that when choosing initial treatment in eRA the MBDA test may be clinically useful to identify a subgroup of patients at low risk of RP.

TRIAL REGISTRATION NUMBER:

WHO database at the Karolinska Institute: CT20080004; and clinicaltrials.gov: NCT00764725.

• Authors: Karen Hambardzumyan, Rebecca Bolce, Saedis Saevarsdottir, Scott E Cruickshank, Eric H Sasso, David Chernoff, Kristina Forslind, Ingemar F Petersson, Pierre Geborek, Ronald F van Vollenhoven
• Journal: Annals of the rheumatic diseases (Ann Rheum Dis) Vol. 74 Issue 6 Pg. 1102-9 (Jun 2015) ISSN: 1468-2060 [Electronic] England
• PMID: 24812287 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Chemical References

• Adipokines
• Antibodies, Monoclonal
• Antirheumatic Agents
• Biomarkers
• CHI3L1 protein, human
• Chitinase-3-Like Protein 1
• IL6 protein, human
• Interleukin-6
• Lectins
• Leptin
• Receptors, Tumor Necrosis Factor, Type I
• Resistin
• Serum Amyloid A Protein
• Vascular Cell Adhesion Molecule-1
• Vascular Endothelial Growth Factor A
• Sulfasalazine
• Hydroxychloroquine
• Epidermal Growth Factor
• C-Reactive Protein
• Infliximab
• MMP3 protein, human
• Matrix Metalloproteinase 3
• MMP1 protein, human
• Matrix Metalloproteinase 1
• Methotrexate

Topics

• Adipokines (metabolism)
• Antibodies, Monoclonal (therapeutic use)
• Antirheumatic Agents (therapeutic use)
• Arthritis, Rheumatoid (diagnostic imaging, drug therapy, metabolism)
• Biomarkers (metabolism)
• C-Reactive Protein (metabolism)
• Chitinase-3-Like Protein 1
• Disease Progression
• Drug Therapy, Combination
• Epidermal Growth Factor (metabolism)
• Female
• Foot Joints (diagnostic imaging)
• Hand Joints (diagnostic imaging)
• Humans
• Hydroxychloroquine (therapeutic use)
• Infliximab
• Interleukin-6 (metabolism)
• Lectins (metabolism)
• Leptin (metabolism)
• Logistic Models
• Male
• Matrix Metalloproteinase 1 (metabolism)
• Matrix Metalloproteinase 3 (metabolism)
• Methotrexate (therapeutic use)
• Multivariate Analysis
• Prognosis
• Radiography
• Receptors, Tumor Necrosis Factor, Type I (metabolism)
• Resistin (metabolism)
• Serum Amyloid A Protein (metabolism)
• Severity of Illness Index
• Sulfasalazine (therapeutic use)
• Treatment Outcome
• Vascular Cell Adhesion Molecule-1 (metabolism)
• Vascular Endothelial Growth Factor A (metabolism)