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Study: Biomarker test may help predict RA treatment response
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The multi-biomarker disease activity score may help predict whether patients with rheumatoid arthritis who are methotrexate-incomplete responders are more likely to respond to treatment with triple therapy compared with anti-tumor necrosis factor therapy, according to recently published data.
Researchers from Sweden and San Francisco assessed the multi-biomarker disease activity (MBDA) score (Vectra DA, Crescendo Bioscience), which combines concentrations from 12 serum proteins into a single score on a scale from 1 to 100. They analyzed the score in 157 patients who had an inadequate response to methotrexate — defined as a DAS28-ESR of greater than 3.2 — who were randomized to receive 3 months of either methotrexate and infliximab or triple therapy, which includes methotrexate, sulfasalazine and hydroxychloroquine. A low MBDA score was less than 30, a moderate score was between 30 and 44 and a high score was greater than 44. For the Breslow-Day test, a lower MBDA score was no greater than 38 and a higher MBDA was greater than 38.
Researchers found 12% of patients had a low score, 32% were moderate and 56% were high. Of patients with a low score, 88% responded to subsequent triple therapy, while 18% who responded to methotrexate and infliximab. Of those with a high score, 35% responded to triple therapy, while 58% responded to methotrexate and infliximab.
For the Breslow-Day test, the researchers found 29% of patients had a lower score and 71% had a higher score. Of those with a lower score, 79% of patients responded to subsequent triple therapy, while 44% of patients responded to methotrexate and infliximab. Of those with a higher score, 36% of patients responded to triple therapy, while 58% of patients responded to methotrexate and infliximab.
Overall, researchers found the score at 3 months was a better independent predictor of treatment response at 1 year than clinical or single inflammatory biomarkers (C-reactive protein and erythrocyte sedimentation rate) or DAS28. – by Will Offit
Disclosures: Hambardzumyan reports no relevant financial disclosures. Please see the full study for a list of all other relevant financial disclosures.
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