Session Title: Rheumatoid Arthritis - Clinical Aspects III: Infections/Risk Factors for Incident Rheumatoid Arthritis/Metrology/Classification/Biomarkers/Predictors of Rheumatolid Arthritis Activity & Severity
Session Type: Abstract Submissions (ACR)
Background/Purpose: To identify disease and therapy response serum biomarkers in early untreated RA patients started on methotrexate as the only DMARD.
Methods: 186 patients with early treatment naïve RA (symptom disease duration less than 1 year), started on methotrexate (MTX) monotherapy at diagnosis were included in the current study. All patients are part of a larger cohort of early RA named EIRA (epidemiology investigation of rheumatoid arthritis) and had available blood samples at baseline and a median of 3 months after treatment initiation. Concentrations of 12 serum biomarkers were measured at baseline and a median of 3 months after treatment start to calculate multi-biomarker disease activity (MBDA) scores . Additionally ELISA for CCP-2 was performed at baseline. Associations between different biomarkers were calculated using Spearman’s rank correlation. The ability of MBDA score in tracking and differentiating clinical response was estimated by correlation between the change of MBDA score and the change of DAS28ESR from baseline to 3-months visit, and also by calculating area under the ROC curves (AUROCs) for classifying good/moderate EULAR responders versus non-responders at 3-months visit.
No differences in the baseline characteristics were observed between patients included in the current study and MTX treated patients in the original large EIRA cohort (n=873) with a median (IQR) age of 52 (42-59), % female of 72%, % anti-CCP positive of 67% and median (IQR) DAS28ESR of 5.7 (5.0-6.2). At 3 months, 29% of the patients were good EULAR responders, 37% were moderate responders and 34% were non-responders. The change of MBDA score from baseline to 3-months visit was significantly correlated with the change of DAS28ESR and able to differentiate EULAR responders and non-responders (AUROC = 0.79, p-value<0.001). The median decrease in the MBDA score was significantly greater in the anti-CCP negative group than in the positive group but correlated with DAS28ESR changes in both groups.
We confirm the value of MBDA as a surrogate marker for measuring clinical disease activity and differentiate clinical response in early RA patients treated with MTX whether they were anti citrullinated-protein antibodies (ACPA) negative or positive.
 J. R. Curtis, Validation of a Novel Multi-Biomarker Test to Assess Rheumatoid Arthritis Disease Activity, Arthritis Care & Research, accepted, to be online
A. Haj Hensvold,
employment at Crescendo Bioscience,
Crescendo Bioscience Inc.,
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