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Performance of a multi-biomarker score measuring rheumatoid arthritis disease activity in the CAMERA tight control study
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Performance of a multi-biomarker score measuring rheumatoid arthritis disease activity in the CAMERA tight control study
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Performance of a multi-biomarker score measuring rheumatoid arthritis disease activity in the CAMERA tight control study
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Journal Article
Performance of a multi-biomarker score measuring rheumatoid arthritis disease activity in the CAMERA tight control study
2012
Overview
Objectives To evaluate the performance of individual biomarkers and a multi-biomarker disease activity (MBDA) score in the early rheumatoid arthritis (RA) patient population from the computer assisted management in early rheumatoid arthritis (CAMERA) study. Methods Twenty biomarkers were measured in the CAMERA cohort, in which patients were treated with either intensive or conventional methotrexate-based treatment strategies. The MBDA score was calculated using the concentrations of 12 biomarkers (SAA, IL-6, TNF-RI, VEGF-A, MMP-1, YKL-40, MMP-3, EGF, VCAM-1, leptin, resistin and CRP) according to a previously trained algorithm. The performance of the scores was evaluated relative to clinical disease activity assessments. Change in MBDA score over time was assessed by paired Wilcoxon rank sum test. Logistic regression was used to evaluate the ability of disease activity measures to predict radiographic progression. Results The MBDA score had a significant correlation with the disease activity score based on 28 joints-C reactive protein (DAS28-CRP) (r=0.72; p<0.001) and an area under the receiver operating characteristic curve for distinguishing remission/low from moderate/high disease activity of 0.86 (p<0.001) using a DAS28-CRP cut-off of 2.7. In multivariate analysis the MBDA score, but not CRP, was an independent predictor of disease activity measures. Additionally, mean (SD) MBDA score decreased from 53 (18) at baseline to 39 (16) at 6 months in response to study therapy (p<0.0001). Neither MBDA score nor clinical variables were predictive of radiographic progression. Conclusions This multi-biomarker test performed well in the assessment of disease activity in RA patients in the CAMERA study. Upon further validation, this test could be used to complement currently available disease activity measures and improve patient care and outcomes.
Publisher
BMJ Publishing Group Ltd and European League Against Rheumatism,BMJ Publishing Group,Elsevier Limited,BMJ Group
Subject
Antirheumatic Agents - administration & dosage
/ Arthritis, Rheumatoid - blood
/ Arthritis, Rheumatoid - diagnostic imaging
/ Arthritis, Rheumatoid - drug therapy
/ Biological and medical sciences
/ Cameras
/ Clinical and Epidemiological Research
/ Diseases of the osteoarticular system
/ Humans
/ Methotrexate - administration & dosage
/ Pain
/ Patients
/ Studies
