A multi-biomarker score measures rheumatoid arthritis disease activity in the BeSt study

Abstract

Objective: To evaluate a multi-biomarker disease activity (MBDA) score, a novel index based on 12 serum proteins, as a tool to guide management of RA patients.

Methods: A total of 125 patients with RA from the Behandel Strategieën study were studied. Clinical data and serum samples were available from 179 visits, 91 at baseline and 88 at year 1. In each serum sample, 12 biomarkers were measured by quantitative multiplex immunoassays and the concentrations were used as input to a pre-specified algorithm to calculate MBDA scores.

Results: MBDA scores had significant correlation with DAS28-ESR (Spearman's ρ = 0.66, P < 0.0001) and also correlated with simplified disease activity index, clinical disease activity index and HAQ Disability Index (all P < 0.0001). Changes in MBDA between baseline and year 1 were also correlated with changes in DAS28-ESR (ρ = 0.55, P < 0.0001). Groups stratified by European League Against Rheumatism disease activity (DAS28-ESR ≤ 3.2, 3.2-5.1 and > 5.1) had significantly different MBDA scores (P < 0.0001) and MBDA score could discriminate ACR/EULAR Boolean remission with an area under the receiver operating characteristic curve of 0.83 (P < 0.0001).

Conclusion: The MBDA score reflects current clinical disease activity and can track changes in disease activity over time.

Keywords: bioinformatics; biomarkers; cytokines and inflammatory mediators; disability evaluation; molecular biology; outcome measures; rheumatoid arthritis.

Fig. 1

Relationship between the MBDA score and clinical disease activity indices.(A–C) Correlation and linear regression of MBDA score with DAS28-ESR (A), SDAI (B) and CDAI (C). Spearman’s rank correlation coefficient was 0.66 (P < 0.0001), 0.67 (P < 0.0001), 0.56 (P < 0.0001), respectively. (D–F) Correlation and linear regression of ΔMBDA score with ΔDAS28-ESR (D), ΔSDAI (E) and ΔCDAI (F). Spearman’s rank correlation coefficient was 0.55 (P < 0.0001), 0.35 (P = 0.0158), 0.18 (P = 0.2270), respectively.