A multi-biomarker disease activity score tracks clinical response consistently in patients with rheumatoid arthritis treated with different anti-tumor necrosis factor therapies: A retrospective observational study

Abstract

Objectives. To assess the ability of a multi-biomarker disease activity (MBDA) score to track clinical response in patients with rheumatoid arthritis (RA) treated with diff erent TNF inhibitors. Methods. The study included 147 patients who had received adalimumab, etanercept, or infl iximab for a year or more, during routine clinical care at the University Hospital of Occupational and Environmental Health, Japan. MBDA scores and clinical measures of disease activity were evaluated at baseline and, after 24 weeks ( N ϭ 84) and 52 weeks of treatment. Relationships between the changes ( ∆ ) in MBDA score and changes in clinical measures or EULAR response categories were evaluated. Results. The median disease activity was 5.7 by DAS28-ESR and 64 by MBDA score at baseline, and decreased signifi cantly with treatment. ∆ MBDA scores over 1 year correlated with ∆ DAS28-ESR ( r ϭ 0.48) and ∆ DAS28-CRP ( r ϭ 0.46). Linear relationships between ∆ MBDA scores and ∆ DAS28-ESR or ∆ DAS28-CRP were not signifi cantly diff erent between TNF inhibitors. The MBDA scores declined signifi cantly more in good responders (median change: Ϫ 29) than moderate ( -21), and more in moderate than in non-responders ( ϩ 2), by the EULAR criteria. Conclusions . MBDA scores tracked disease activity and treatment response in patients with RA treated with three TNF inhibitors. The relationships between ∆ MBDA scores and ∆ DAS28-ESR or ∆ DAS28-CRP were consistent across the three TNF inhibitor groups.

Association of the multi-biomarker disease activity score with joint destruction in patients with rheumatoid arthritis receiving tumor necrosis factor-alpha inhibitor treatment in clinical practice

“…This study assessed the association of radiographic progression with biomarker-based (MBDA) and clinical (DAS28) disease activity scores in a cohort of 83 patients treated with a TNF inhibitor (ADA, ETN, or IFX) in clinical practice for at least 1 year (the study was not designed, however, to compare the efficacy between the different TNF inhibitors). Most improvement in disease activity occurred by Week 24, as demonstrated previously [22]. At 1 year, a majority of the patients had no radiographic progression (DmTSS 0.5), which is in agreement with previous studies [29][30][31][32].…”

“…Previous analyses of this cohort showed that the MBDA score tracked changes in disease activity during treatment with TNF inhibitors [22]. We have now analyzed this cohort to extend our understanding of MBDA score as a predictor of radiographic progression to patients receiving TNF-inhibitor therapy.…”

“…This study was performed retrospectively in a cohort of patients with RA who had received ADA, ETN, or IFX for at least 1 year from 2003 to 2010 as part of their routine clinical care at the University of Occupational and Environmental Health, Japan (UOEH), as previously described [22]. Patients fulfilled the 1987 American College of Rheumatology (ACR) revised criteria for RA and met the Japan College of Rheumatology criteria for initiation of anti-TNF therapy.…”

A multi-biomarker disease activity score for monitoring rheumatoid arthritis

“…27 A significant association was observed between ∆MBDA score and EULAR response, with a greater median decrease in MBDA score reported in EULAR good responders than in Abbreviations: CDAi, clinical disease activity index; DAS28, 28-joint disease activity score; eSR, erythrocyte sedimentation rate; MBDA, multi-biomarker disease activity; SDAi, simple disease activity index. …”

“…20,21,24,26,27 Curtis et al 20 reported on the ∆MBDA score from baseline to the final visit (week 6 or 12) in a group of 45 patients with active disease from the Nested-1 substudy of the Brigham Rheumatoid Arthritis Sequential Study (BRASS), 28 a prospective observational study of MTX and anti-TNF treatment designed to identify treatment response. In this work, Curtis et al showed that the ∆MBDA score was significantly associated with ∆DAS28-CRP (Spearman's r=0.51, P,0.001) and ACR-N (index of improvement of rheumatoid arthritis) scores at week 6 or 12 (r=0.45, P=0.002).…”