Predictive biomarkers improve therapeutic choices for patients.

“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.”

Hambardzumyan K, et al. Association of a multibiomarker disease activity score at multiple time-points with radiographic progression in rheumatoid arthritis: results from the SWEFOT trial. RMD Open. 2016; 2(1):e000197.

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Patients with lower Vectra DA algorithm score (MBDA score) were more likely to respond to intensified non-biologic DMARD therapy.

“In patients with RA who responded insufficiently to MTX [methotrexate], the MBDA score categories were differentially associated with response to subsequent therapies. Thus, patients with post-MTX biochemical improvements (lower MBDA) were more likely to respond to TT [triple therapy] than to MTX+infliximab.”

Hambardzumyan K, et al. A multi-biomarker disease activity score and the choice of second-line therapy in early rheumatoid arthritis after methotrexate failure. Arthritis Rheumatol. 2016 Dec 19. doi: 10.1002/art.40019.

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Vectra DA algorithm score (MBDA score) may help predict sustained remission in RA patients undergoing tapering.

“Moderate-to-high MBDA scores were found in 33% of patients with RA overall. Twice as many patients who relapsed (58%) had moderate/high MBDA compared with patients who remained in remission (21%). Baseline MBDA scores were significantly higher in patients with RA who were relapsing than those remaining in stable remission (N=94; p=0.0001) and those tapering/stopping (N=59; p=0.0001). Multivariate regression analysis identified MBDA scores as independent predictor for relapses in addition to anticitrullinated protein antibody (ACPA) status. Relapse rates were low (13%) in patients who were MBDA−/ACPA−, moderate in patients who were MBDA+/ACPA− (33.3%) and MBDA−ACPA+ (31.8%) and high in patients who were MBDA+/ACPA+ (76.4%). MBDA improved the prediction of relapses in patients with RA in stable remission undergoing DMARD tapering. If combined with ACPA testing, MBDA allowed prediction of relapse in more than 80% of the patients.”

Rech J, et al. Prediction of disease relapses by multibiomarker disease activity and autoantibody status in patients with rheumatoid arthritis on tapering DMARD treatment. Ann Rheum Dis 2016; 75:1637–44. doi:10.1136/annrheumdis-2015-207900.

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Prediction of RP in eRA useful for optimal choice of therapy.

“In patients with eRA [early rheumatoid arthritis], the MBDA score at baseline was a strong independent predictor of 1-year RP. These results suggest that when choosing initial treatment in eRA the MBDA test may be clinically useful to identify a subgroup of patients at low risk of RP.”

Hambardzumyan K, et al. Pretreatment multi-biomarker disease activity score and radiographic progression in early RA: Results from the SWEFOT trial. Ann Rheum Dis. 2015 Jun; 74(6):1102-9.

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Multi-biomarker disease activity-defined remission indicates limited radiographic progression over next 12 months.

“Ninety-three per cent of patients in MBDA-defined remission did not experience progression, compared with 70% of patients not in MBDA remission (P = 0.001). […] Among patients in DAS28-CRP remission, those with a high MBDA score were 2.3 times as likely (95% CI 1.1, 3.7) to have joint damage progression during the next year.”

van der Helm-van Mil AHM, et al. An evaluation of molecular and clinical remission in rheumatoid arthritis by assessing radiographic progression. Rheumatology. 2013; 52:839-46.

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