Pretreatment multi-biomarker disease activity score and radiographic progression in early RA: results from the SWEFOT trial. Issue 6 (8th May 2014)

• Record Type: Journal Article
• Authors: Hambardzumyan, Karen; Bolce, Rebecca; Saevarsdottir, Saedis; Cruickshank, Scott E; Sasso, Eric H; Chernoff, David; Forslind, Kristina; Petersson, Ingemar F; Geborek, Pierre; van Vollenhoven, Ronald F
• Is Part Of: Annals of the rheumatic diseases. Volume 74:Issue 6(2015)
• Page Start: 1102
• Page End: 1109
• Publication Date: 2014-05-08
• Subjects: Rheumatoid Arthritis -- Disease Activity -- Anti-TNF -- Cytokines -- Patient perspective; Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2013-204986
• Languages: English
• ISSNs: 0003-4967

Abstract

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 .