A Multibiomarker Disease Activity Score for Rheumatoid Arthritis Predicts Radiographic Joint Damage in the BeSt Study

作者：Markusse Iris M^*; Dirven Linda; van den Broek Marianne; Bijkerk Casper; Han K Huub; Ronday H Karel; Bolce Rebecca; Sasso Eric H; Kerstens Pit J S M; Lems Willem F; Huizinga Tom W J; Allaart Cornelia F

来源：Journal of Rheumatology, 2014, 41(11): 2114-2119.

DOI：10.3899/jrheum.131412

• RHEUMATOID ARTHRITIS
• RADIOGRAPHIC JOINT DAMAGE PROGRESSION
• BIOMARKERS
• PREDICTIVE VALUE OF TESTS
• MULTIBIOMARKER DISEASE ACTIVITY SCORE

Objective. To determine whether a multibiomarker disease activity (MBDA) score predicts radiographic damage progression in the subsequent year in patients with early rheumatoid arthritis. %26lt;br%26gt;Methods. There were 180 serum samples available in the BeSt study (trial numbers NTR262, NTR 265): 91 at baseline (84 with radiographs available) and 89 at 1-year followup (81 with radiographs available). Radiographs were assessed using the Sharp/van der Heijde Score (SvdH). Twelve serum biomarkers were measured to determine MBDA scores using a validated algorithm. Receiver-operating curves and Poisson regression analyses were performed, with Disease Activity Score (DAS) and MBDA score as independent variables, and radiographic progression as dependent variable. %26lt;br%26gt;Results. At baseline, MBDA scores discriminated more between patients who developed radiographic progression (increase in SvdH %26gt;= 5 points) and patients who did not [area under the curve (AUC) 0.767, 95% CI 0.639-0.896] than did DAS (AUC 0.521, 95% CI 0.358-0.684). At 1 year, MBDA score had an AUC of 0.691 (95% CI 0.453-0.929) and DAS had an AUC of 0.649 (95% CI 0.417-0.880). Adjusted for anticitrullinated protein antibody status and DAS, higher MBDA scores were associated with an increased risk for SvdH progression [relative risk (RR) 1.039, 95% CI 1.018-1.059 for baseline MBDA score; 1.037, 95% CI 1.009-1.065 for Year 1 MBDA score]. Categorized high MBDA scores were also correlated with SvdH progression (RR for high MBDA score at baseline 3.7; low or moderate MBDA score as reference). At 1 year, high MBDA score gave a RR of 4.6 compared to low MBDA score. %26lt;br%26gt;Conclusion. MBDA scores predict radiographic damage progression at baseline and during disease course.

• 出版日期2014-11