Multibiomarker Screen Predicts Radiographic Progression in Rheumatoid Arthritis

rheumatoid arthritis hands x-ray ulnar deviation
rheumatoid arthritis hands x-ray ulnar deviation
Data from 6 cohorts were used to evaluate and establish the relationship between multibiomarker disease activity score and radiographic progression risk.
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SAN DIEGO — High multibiomarker disease activity test scores, which consider 12 serum protein biomarkers, were shown to be associated with an increased risk for radiographic progression in patients with rheumatoid arthritis, according to data presented here at the 2017 ACR/ARHP Annual Meeting.

In 6 independent cohorts, data on clinical variables, multibiomarker disease activity scores, and radiographic progression were collected. Patients within the cohorts received conventional disease-modifying antirheumatic drugs (csDMARDs) with or without biologics. The frequency of 1-year radiographic progression was compared between patients with low, moderate, and high multibiomarker disease activity scores.

The rates of radiographic progression ranged from 10% to 26% across the cohorts. In all cohorts, radiographic progression was significantly more common among patients with a high multibiomarker disease activity score (score >44) compared with low or medium scores (score ≤44; relative risk [RR] range, 3.6-9.5). Negative predictive values ranged from 93% to 97% for high multibiomarker disease activity scores, and positive predictive values ranged from 18% to 32%.

When the Leiden, SWEFOT Year 1, and OPERA Year 1 cohorts were considered together, multibiomarker disease activity categories were associated with a RR of progression of 5.1 (P <.0001), whereas Disease Activity Score 28-joint count C reactive protein and C reactive protein had relative risks of 1.4 (P =.23) and 1.6 (P =.01).

According to the study authors, published multivariate analyses from the Leiden and SWEFOT Year 1 cohorts indicated that multibiomarker disease activity scores were associated with radiographic progression after adjustment for other variables. Moreover, multibiomarker disease activity score was strongly predictive of radiographic progression among patients with high swollen joint criteria or high Disease Activity Score 28-joint count C reactive protein in the Leiden study (positive predictive value, 57%).

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The study authors concluded that “high [multi-biomarker disease activity] scores were associated with increased risk for [radiographic progression] in 6 study cohorts, including patients treated with csDMARDs, [tumor necrosis factor inhibitors], and abatacept…. Combining the [multibiomarker disease activity] score with clinical measures yielded [positive predictive values] approaching 60%, suggesting that biomarkers can help stratify patients by their risk for [radiographic progression].”

Disclosures: Dr Curtis reports relationships with Crescendo Biosciences. Dr Østergaard reports relationships with AbbVie, BMS, Celgene, Crescendo Bioscience, Janssen, Merck, Boehringer Ingelheim, Eli Lilly, Centocor, GSK, Hospira, Novartis, Orion, Pfizer, Regeneron, Roche, Takeda, and UCB. Dr Lund Hetland reports relationships with AbbVie, Biogen, BMS, CelltrionRoche, Crescendo Bioscience Inc., Eli Lilly, MSD, Pfizer, UCB, and Orion. Dr Wang reports relationships with Myriad Genetics Inc., and Crescendo Bioscience Inc. Dr Huizinga reports relationships with Merck, USB, Bristol Myers Squibb, Biotest AG, Pfizer, GSK, Novartis, Roche, Sanofi-Aventis, Abbott, Crescendo Bioscience Inc., Nycomed, Boehringer, Takeda, Zydus, Epirus, and Eli Lilly.

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Curtis JR, Brahe CH, Østergaard M, et al. High multi-biomarker disease activity score is associated with high risk of radiographic progression in six cohorts. Presented at: ACR/ARHP 2016 Annual Meeting; November 3-8, 2017; San Diego, CA. Poster 438.