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Rheumatoid arthritis
Original article
Association of a multibiomarker disease activity score at multiple time-points with radiographic progression in rheumatoid arthritis: results from the SWEFOT trial
  1. Karen Hambardzumyan1,
  2. Rebecca J Bolce2,
  3. Saedis Saevarsdottir1,3,
  4. Kristina Forslind4,5,
  5. Johan K Wallman6,
  6. Scott E Cruickshank7,
  7. Eric H Sasso2,
  8. David Chernoff2 and
  9. Ronald F van Vollenhoven1
  1. 1Unit of Clinical Therapy Research, Inflammatory Diseases (ClinTRID), Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
  2. 2Crescendo Bioscience Inc, South San Francisco, California, USA
  3. 3Rheumatology Unit, Department of Medicine, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden
  4. 4Section of Rheumatology, Department of Clinical Sciences, Lund University, Helsingborg, Sweden
  5. 5Section of Rheumatology, Department of Medicine, Helsingborg's Lasarett, Helsingborg, Sweden
  6. 6Section of Rheumatology, Department of Clinical Sciences, Lund University, Lund, Sweden
  7. 7Scott Cruickshank and Associates Inc, Santa Barbara, California, USA
  1. Correspondence to Dr Karen Hambardzumyan; karen.hambardzumyan{at}ki.se

Abstract

Objectives In rheumatoid arthritis (RA), predictive biomarkers for subsequent radiographic progression (RP) could improve therapeutic choices for individual patients. We previously showed that the multibiomarker disease activity (MBDA) score in patients with newly diagnosed RA identified patients at risk for RP. We evaluated the MBDA score at multiple time-points as a predictor of RP during 2 years of follow-up.

Methods A subset of patients with RA (N=220) from the Swedish Farmacotherapy (SWEFOT) trial were analysed for MBDA score, disease activity score of 28 joints (DAS28), C reactive protein (CRP) and erythrocyte sedimentation rate (ESR) at baseline (BL), month 3 and year 1, for predicting RP based on modified Sharp/van der Heijde scores at BL, year 1 and year 2.

Results Patients with persistently low MBDA (<30) scores or those with a decrease from moderate (30–44) to low MBDA scores, did not develop RP during 2 years of follow-up. The highest risk for RP during 2 years of follow-up (42%) was observed among patients with persistently high (>44) MBDA scores. Among methotrexate non-responders with a high MBDA score at BL or month 3, significantly more of those who received triple therapy had RP at year 2 compared with those who received antitumour necrosis factor therapy.

Conclusions Measuring the MBDA score both before and during treatment in RA was useful for the assessment of individual patient risk for RP during 2 years of follow-up. In comparison with low CRP, ESR or DAS28, a low MBDA score at any time-point was associated with numerically lower proportions of RP.

Trial registration number NCT00764725.

  • Rheumatoid Arthritis
  • Anti-TNF
  • Cytokines
  • Disease Activity
  • Patient perspective

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/rmdopen-2015-000197

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