Predictive value of a multi-biomarker disease activity score for clinical remission and radiographic progression in patients with early rheumatoid arthritis: a post-hoc study of the OPERA trial

Brahe, Cecilie Heegaard; Østergaard, Mikkel; Johansen, Julia S.; Defranoux, Nadine; Wang, X; Bolce, Rebecca; Sasso, Eric H.; Ørnbjerg, Lykke Midtbøll; Hørslev‐Petersen, Kim; Stengaard‐Pedersen, Kristian; Junker, Peter; Ellingsen, Torkell; Ahlquist, Palle; Lindegaard, Hanne; Linauskas, Asta; Schlemmer, Annette; Dam, Mette Yde; Hansen, Ib Tønder; Lottenburger, Tine; Ammitzbøll, Christian Gytz; Jørgensen, Anette; Krintel, Sophine B.; Raun, Johnny Lillelund; Hetland, Merete Lund

doi:10.1080/03009742.2018.1464206

Cited by 20 publications

(32 citation statements)

References 17 publications

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“…Cross-classification analyses showed that the MBDA score predicted risk for radiographic progression even when it was discordant with DAS28-CRP or CRP, such as when the MBDA score was high and conventional measures indicated low disease activity 14 . Multivariate analyses showed that the MBDA score was the strongest independent predictor of radiographic progression, compared with DAS28-CRP, CRP and other risk factors for radiographic progression 9,10,13,14 .…”

Section: Introductionmentioning

confidence: 94%

“…The CRP categories employed here were low 10 mg/L, moderate >10-30 mg/L and high >30 mg/L, to be consistent with prior publications on the MBDA score 10,14 and with the ACR/EULAR definition of Boolean remission (CRP < 10 mg/L) 18 . CRP data was obtained from published results 10 or from patient-level data 9,12 , if available.…”

Section: Clinical Measuresmentioning

confidence: 99%

“…For each cohort included here, MBDA testing had been performed previously on serum samples that had been shipped frozen to the laboratories of Crescendo Bioscience Inc., in South San Francisco, CA, USA, for testing 9,10,12,16,17 . Serum concentrations were determined by electrochemiluminescence-based multiplexed sandwich immunoassays (Meso Scale Discovery, Rockville, MD, USA) for the following 12 biomarkers: vascular cell adhesion molecule 1, epidermal growth factor, vascular endothelial growth factor, interleukin 6, TNF receptor type I, matrix metalloproteinase (MMP) 1, MMP-3, bone glycoprotein 39 (YKL-40), leptin, resistin, serum amyloid A and CRP 5 .…”

Section: Multi-biomarker Disease Activity Score Measurementmentioning

confidence: 99%

“…The methodology of this study was adapted to be aligned with the availability of patient-level data from the selected studies, after they were identified, and to fill gaps in published analyses, where needed. Among the studies identified for the present analyses (Leiden University Early Arthritis Clinic (Leiden) 12,14 , the Optimized Treatment Algorithm for Patients with Early Rheumatoid Arthritis trial (OPERA) 9 , the Swedish Farmacotherapy trial (SWEFOT) 10 and the Abatacept versus Adalimumab Comparison in Biologic-Naive RA Subjects with Background Methotrexate trial (AMPLE) 16,17 , patient-level data were available for cohorts from Leiden, OPERA and SWEFOT. Patient-level data were not available from the AMPLE study.…”

Section: Data Availabilitymentioning

confidence: 99%

“…That the MBDA score detects not only clinically meaningful disease activity but also severity has been supported by studies demonstrating its association with radiographic progression, as assessed with the van der Heijde modified Sharp score (SHS) 8 . In several studies, rate of radiographic progression over one year was greatest among patients with baseline MBDA scores in the high category (>44) and lowest among patients with baseline MBDA scores in the low category (<30) [9][10][11][12][13][14] . Patients with moderate MBDA scores (30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44) tended to have progression rates almost as low as those with low MBDA scores.…”

Section: Introductionmentioning

confidence: 99%

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Predicting risk for radiographic damage in rheumatoid arthritis: comparative analysis of the multi-biomarker disease activity score and conventional measures of disease activity in multiple studies

Curtis

Brahe

Østergaard

et al. 2019

Current Medical Research and Opinion

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Objective: To compare the multi-biomarker disease activity (MBDA) score with the DAS28-CRP and CRP for predicting risk of radiographic progression in patients with rheumatoid arthritis. Methods: Published studies of the MBDA score and radiographic progression with 100 patients per cohort were evaluated. Rates of radiographic progression over 1 year were determined across the low/moderate/high categories for MBDA score (low/moderate/high: <30, 30-44, >44), DAS28-CRP (low/ moderate/high: 2.67, >2.67-4.09, >4.09) and CRP (low/moderate/high: 10, >10-30, >30 mg/L), with positive and negative predictive value (PPV, NPV) and relative risk (RR) determined for high vs. not-high (i.e. low and moderate combined) categories. Patient-level data from studies having all three measures was pooled to: (1) determine a combined RR for radiographic progression in the high vs. not-high categories for each measure; and (2) compare the predictive ability of MBDA score vs. DAS28-CRP by comparing the rates of radiographic progression observed in subgroups created by cross-classifying the high and not-high categories of each measure. Results: Five cohorts were identified for inclusion (total N¼929). In each, radiographic progression was more frequent with increasing MBDA scores. Among the three cohorts with requisite data, PPVs were generally similar using categories of MBDA score, DAS28-CRP or CRP but NPVs were greater for MBDA score (93-97%) than DAS28-CRP or CRP (77-87%). RRs for radiographic progression were greater when based on categories of MBDA score than DAS28-CRP or CRP and the combined RR was greater for MBDA score (4.6, p < .0001) than DAS28-CRP (1.7, p ¼ .02) or CRP (1.7, p ¼ .002). For patients cross-classified by MBDA score and DAS28-CRP, high vs. not-high MBDA score significantly predicted radiographic progression independently of DAS28-CRP. Conclusions: High and not-high MBDA scores were associated with increased and low risk, respectively, for radiographic progression over one year. MBDA score was a better predictor of radiographic progression than DAS28-CRP or CRP.

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Section: Introductionmentioning

confidence: 94%

Section: Clinical Measuresmentioning

confidence: 99%

Section: Multi-biomarker Disease Activity Score Measurementmentioning

confidence: 99%

Section: Data Availabilitymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Predicting risk for radiographic damage in rheumatoid arthritis: comparative analysis of the multi-biomarker disease activity score and conventional measures of disease activity in multiple studies

Curtis

Brahe

Østergaard

et al. 2019

Current Medical Research and Opinion

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The Relation Between Disease Activity, Patient‐Reported Outcomes, and Grip Force Over Time in Early Rheumatoid Arthritis

Rydholm

Wikström

Hagel

et al. 2019

ACR Open Rheumatology

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ObjectiveThe objective of this study is to identify early predictors of future reduced grip force in patients with rheumatoid arthritis (RA) and to identify early predictors of grip force over time.MethodsIn a structured follow‐up of an inception cohort of patients with early RA, average grip force values of the dominant hand were evaluated and compared with the expected based on age‐ and sex‐specific reference values. Potential predictors of reduced grip force (less than 50% of expected) at 5 years were examined using logistic regression. Differences in percentage of expected grip force values over the study period and differences in change over time, by baseline disease parameters, were estimated using mixed linear‐effects models.ResultsAmong 200 patients with early RA, 44% had reduced grip force 5 years after diagnosis. Baseline characteristics that predicted reduced grip force at 5 years included high scores for the Health Assessment Questionnaire Disability Index (odds ratio 1.54 per SD; 95% confidence interval 1.13‐2.11), high scores for pain and patient global assessment, and low grip force. C‐reactive protein levels, the erythrocyte sedimentation rate, the 28‐joint Disease Activity Score (DAS28), rheumatoid factor, anti–cyclic citrullinated peptide antibodies, joint counts, and synovitis of individual joints in the dominant upper extremity did not predict reduced grip force. Patients with baseline synovitis of the wrist or metacarpophalangeal joints or patients with a high DAS28 had lower estimated grip force at inclusion but also greater improvement of grip force over time.ConclusionPatient‐reported outcomes predicted reduced grip strength 5 years after diagnosis. This underlines the prognostic importance of disability in early RA. Joint counts and synovitis in individual joints may change rapidly in early RA and appear to be less predictive of long‐term hand function.

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Stroke risk in rheumatoid arthritis patients: exploring connections and implications for patient care

Al-Ewaidat,

Naffaa

2024

Clin Exp Med

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Rheumatoid arthritis (RA) can independently increase the risk of stroke, affecting both young and adult RA patients. Recent attention has been drawn to the association between stroke and RA, supported by mounting evidence. Given that stroke is a significant and an urgent public health concern, this review aims to highlight the relationship between stroke and RA, covering mechanisms, underlying risk factors, early detection tools, and treatment implications. By uncovering the connection that links RA to stroke, we can pave the way for targeted healthcare practices and the development of preventive strategies for individuals with RA. Therefore, further research is imperative to deepen our understanding of this association and, ideally, guide treatment decisions for individuals at risk of both RA and stroke.

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Predictive value of a multi-biomarker disease activity score for clinical remission and radiographic progression in patients with early rheumatoid arthritis: a post-hoc study of the OPERA trial

Abstract: Early changes in MBDA score were associated with clinical remission based on DAS28-CRP at 6 months. In anti-CCP-positive patients, a non-high baseline MBDA score (≤ 44) had a clinical value by predicting very low risk of radiographic progression at 12 months.

Cited by 20 publications

References 17 publications

Predicting risk for radiographic damage in rheumatoid arthritis: comparative analysis of the multi-biomarker disease activity score and conventional measures of disease activity in multiple studies

Predicting risk for radiographic damage in rheumatoid arthritis: comparative analysis of the multi-biomarker disease activity score and conventional measures of disease activity in multiple studies

The Relation Between Disease Activity, Patient‐Reported Outcomes, and Grip Force Over Time in Early Rheumatoid Arthritis

Stroke risk in rheumatoid arthritis patients: exploring connections and implications for patient care

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