title: Impact of a multi-biomarker disease activity test on rheumatoid arthritis treatment decisions and therapy use.
abstract: OBJECTIVE
  To assess how use of a multi-biomarker disease activity (MBDA) blood test for rheumatoid arthritis (RA) affects treatment decisions made by health care providers (HCPs) in clinical practice.
  
  
  METHODS
  At routine office visits, 101 patients with RA were assessed by their HCPs (N = 6), and they provided blood samples for MBDA testing. HCPs completed surveys before and after viewing the MBDA test result, recording dosage and frequency for all planned RA medications and physician global assessment of disease activity. Frequency and types of change in treatment plan that resulted from viewing the MBDA test result were determined.
  
  
  METHODS
  Percentage of cases in which the HCP changed the planned treatment after viewing the MBDA test result.
  
  
  RESULTS
  Prior to HCP review of the MBDA test, disease modifying anti-rheumatic drug (DMARD) use by the 101 patients included methotrexate in 62% of patients; hydroxychloroquine 29%; TNF inhibitor 42%; non-TNF inhibitor biologic agent 19%; and other drugs at lower frequencies. Review of MBDA test results changed HCP treatment decisions in 38 cases (38%), of which 18 involved starting, discontinuing or switching a biologic or non-biologic DMARD. Other changes involved drug dosage, frequency or route of administration. The total frequency of use of the major classes of drug therapy changed by <5%. Treatment plans changed 63% of the time when the MBDA test result was perceived as being not consistent or somewhat consistent with the HCP assessment of disease activity.
  
  
  CONCLUSIONS
  Limited sample size; lack of control group; no longitudinal follow-up.
  
  
  CONCLUSIONS
  The addition of the MBDA test to clinical assessment led to meaningful changes in the treatment plans of 38% of RA patients being cared for by HCPs in office practice. Even though treatment was potentially improved, the overall quantity of drug use was minimally affected.
authors.affiliation: Crescendo Bioscience, South San Francisco, CA, USA.
authors.forename: Wanying
authors.initials: W
authors.lastname: Li
authors.forename: Eric H
authors.initials: EH
authors.lastname: Sasso
authors.forename: Daniel
authors.initials: D
authors.lastname: Emerling
authors.forename: Guy
authors.initials: G
authors.lastname: Cavet
authors.forename: Kerri
authors.initials: K
authors.lastname: Ford
mesh_terms: D000368:Aged; D018501:Antirheumatic Agents / Q000008:administration & dosage*; D001172:Arthritis, Rheumatoid / Q000097:blood* / Q000188:drug therapy*; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D006886:Hydroxychloroquine / Q000008:administration & dosage*; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage*; D008875:Middle Aged
chemical_list: D018501:Antirheumatic Agents; D015415:Biomarkers; D006886:Hydroxychloroquine; D008727:Methotrexate