Validation of the adjusted multi-biomarker disease activity score as a prognostic test for radiographic progression in rheumatoid arthritis: a combined analysis of multiple studies

Arthritis Research & Therapy

Merete Lund Hetland¹  Mikkel Østergaard¹  Cecilie H. Brahe¹  Eric H. Sasso²  Saedis Saevarsdottir³  Nancy A. Shadick⁴  Michael E. Weinblatt⁴  T. W. Huizinga⁵  Megan Horton⁶  Darl D. Flake⁶  Brent Mabey⁶  Rotem Ben-Shachar⁶  Jeffrey R. Curtis⁷ 

[1] Copenhagen Center for Arthritis Research and DANBIO, Center for Rheumatology and Spine Diseases, Rigshospitalet;Crescendo Bioscience, Inc.;Division of Rheumatology and Clinical Epidemiology, Department of Medicine, Solna, Karolinska Institutet;Divison of Rheumatology, Inflammation and Immunity, Brigham and Women’s Hospital;Leiden University Medical Center;Myriad Genetics, Inc.;University of Alabama at Birmingham;

关键词: Biomarker;    Rheumatoid arthritis;    Disease activity;    Radiographic progression;    Risk prediction;   

DOI  :  10.1186/s13075-020-02389-4

来源: DOAJ

【 摘 要 】

Abstract Background The multi-biomarker disease activity (MBDA) test measures 12 serum protein biomarkers to quantify disease activity in RA patients. A newer version of the MBDA score, adjusted for age, sex, and adiposity, has been validated in two cohorts (OPERA and BRASS) for predicting risk for radiographic progression. We now extend these findings with additional cohorts to further validate the adjusted MBDA score as a predictor of radiographic progression risk and compare its performance with that of other risk factors. Methods Four cohorts were analyzed: the BRASS and Leiden registries and the OPERA and SWEFOT studies (total N = 953). Treatments included conventional DMARDs and anti-TNFs. Associations of radiographic progression (ΔTSS) per year with the adjusted MBDA score, seropositivity, and clinical measures were evaluated using linear and logistic regression. The adjusted MBDA score was (1) validated in Leiden and SWEFOT, (2) compared with other measures in all four cohorts, and (3) used to generate curves for predicting risk of radiographic progression. Results Univariable and bivariable analyses validated the adjusted MBDA score and found it to be the strongest, independent predicator of radiographic progression (ΔTSS > 5) compared with seropositivity (rheumatoid factor and/or anti-CCP), baseline TSS, DAS28-CRP, CRP SJC, or CDAI. Neither DAS28-CRP, CDAI, SJC, nor CRP added significant information to the adjusted MBDA score as a predictor, and the frequency of radiographic progression agreed with the adjusted MBDA score when it was discordant with these measures. The rate of progression (ΔTSS > 5) increased from < 2% in the low (1–29) adjusted MBDA category to 16% in the high (45–100) category. A modeled risk curve indicated that risk increased continuously, exceeding 40% for the highest adjusted MBDA scores. Conclusion The adjusted MBDA score was validated as an RA disease activity measure that is prognostic for radiographic progression. The adjusted MBDA score was a stronger predictor of radiographic progression than conventional risk factors, including seropositivity, and its prognostic ability was not significantly improved by the addition of DAS28-CRP, CRP, SJC, or CDAI.

【 授权许可】

Unknown