title: Characterization of a multiplex, 12-biomarker test for rheumatoid arthritis.
abstract: Rheumatoid arthritis (RA) is a chronic inflammatory disorder that primarily involves the joints. Accurate and frequent assessment of RA disease activity is critical to optimal treatment planning. A novel algorithm has been developed to determine a multi-biomarker disease activity (MBDA) score based upon measurement of the concentrations of 12 serum biomarkers in multiplex format. Biomarker assays from several different platforms were used in feasibility studies to identify biomarkers of potential significance. These assays were adapted to a multiplex platform for training and validation of the algorithm. In this study, the analytical performance of the underlying biomarker assays and the MBDA score was evaluated. Quantification of 12 biomarkers was performed with multiplexed sandwich immunoassays in three panels. Biomarker-specific capture antibodies were bound to specific locations in each well; detection antibodies were labeled with electrochemiluminescent tags. Data were acquired with a Sector Imager 6000, and analyte concentrations were determined. Parallelism, dynamic range, cross-reactivity, and precision were established for each biomarker as well as for the MBDA score. Interference by serum proteins, heterophilic antibodies, and common RA therapies was also assessed. The individual biomarker assays had 3-4 orders of magnitude dynamic ranges, with good reproducibility across time, operators, and reagent lots; the MBDA score had a median coefficient of variation of <2% across the score range. Cross-reactivity as well as interference by serum rheumatoid factor (RF), human anti-mouse antibodies (HAMA), or common RA therapies, including disease-modifying antirheumatic drugs and biologics, was minimal. The same MBDA score was observed in different subjects despite having different biomarker profiles, supporting prior literature reports that multiple pathways contribute to RA.
authors: Crescendo Bioscience Inc., 341 Oyster Point Blvd, South San Francisco, CA 94080, USA. seastman@crescendobio.com
authors: P Scott
authors: PS
authors: Eastman
authors: William C
authors: WC
authors: Manning
authors: Ferhan
authors: F
authors: Qureshi
authors: Douglas
authors: D
authors: Haney
authors: Guy
authors: G
authors: Cavet
authors: Claire
authors: C
authors: Alexander
authors: Lyndal K
authors: LK
authors: Hesterberg
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy; D015415:Biomarkers / Q000097:blood; D001798:Blood Proteins / Q000032:analysis*; D002138:Calibration; D005260:Female; D006801:Humans; D007118:Immunoassay / Q000379:methods / Q000592:standards; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D011489:Protein Denaturation; D055550:Protein Stability; D012015:Reference Standards; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D018501:Antirheumatic Agents; D015415:Biomarkers; D001798:Blood Proteins