The multibiomarker disease activity (MBDA) score may help predict healthcare costs as well as risk for serious infection events, myocardial infarction (MI), and coronary heart disease (CHD) among patients with rheumatoid arthritis (RA), according to a study published in the Annals of the Rheumatic Diseases.
In this longitudinal cohort study, MBDA test scores were examined in patients with RA (n=77,641). The MBDA scores were used to evaluate the association between RA and serious infection events for pneumonia or sepsis, MI and/or MI with percutaneous coronary intervention and coronary artery bypass grafting procedures, and total healthcare costs covered by Medicare.
During the course of the study (16,424 person-years), a total of 452 serious infection events, 181 CHD events, and 132 MIs occurred. The investigators found higher MBDA scores among participants experiencing serious infection events (hazard ratio [HR]=1.32; 95% Cl, 1.23-1.41/10-unit MBDA score change). Additionally, greater RA disease activity correlated with a higher risk for CHD (HR=1.54; 95% Cl, 1.01-2.34) and MI (HR=1.52; 95% Cl, 0.92- 2.49). A subgroup analysis of those with RA who had medical and pharmacy insurance coverage (n=10,058) found that higher RA disease activity, as based on MBDA score, was associated with numerically higher baseline healthcare costs.
Considering that 79% of this study cohort was comprised of women and all participants had a mean age 69 at baseline, the findings may not be generalizable across all patients with RA in clinical practice. This study is also limited in that it did not identify patients who had started therapy to lower RA activity, which would have subsequently reduced the risk for CHD, serious infection events, and MI.
The use of the MBDA score for risk stratification, “may be possible to help clinicians identify those at greatest risk [who would be] targets for early intervention, including intensive RA management.”
Curtis JR, Xie F, Chen L, Saag KG, Yun H, Munter P. Biomarker-related risk for myocardial infarction and serious infections in patients with rheumatoid arthritis: a population-based study [published online December 21, 2017]. Ann Rheum Dis. doi:10.1136/annrheumdis-2017-211727.