title: A multi-biomarker disease activity score tracks clinical response consistently in patients with rheumatoid arthritis treated with different anti-tumor necrosis factor therapies: A retrospective observational study.
abstract: OBJECTIVE
  To assess the ability of a multi-biomarker disease activity (MBDA) score to track clinical response in patients with rheumatoid arthritis (RA) treated with different TNF inhibitors.
  
  
  METHODS
  The study included 147 patients who had received adalimumab, etanercept, or infliximab for a year or more, during routine clinical care at the University Hospital of Occupational and Environmental Health, Japan. MBDA scores and clinical measures of disease activity were evaluated at baseline and, after 24 weeks (N = 84) and 52 weeks of treatment. Relationships between the changes (∆) in MBDA score and changes in clinical measures or EULAR response categories were evaluated.
  
  
  RESULTS
  The median disease activity was 5.7 by DAS28-ESR and 64 by MBDA score at baseline, and decreased significantly with treatment. ∆MBDA scores over 1 year correlated with ∆DAS28-ESR (r = 0.48) and ∆DAS28-CRP (r = 0.46). Linear relationships between ∆MBDA scores and ∆DAS28-ESR or ∆DAS28-CRP were not significantly different between TNF inhibitors. The MBDA scores declined significantly more in good responders (median change: -29) than moderate (-21), and more in moderate than in non-responders (+ 2), by the EULAR criteria.
  
  
  CONCLUSIONS
  MBDA scores tracked disease activity and treatment response in patients with RA treated with three TNF inhibitors. The relationships between ∆MBDA scores and ∆DAS28-ESR or ∆DAS28-CRP were consistent across the three TNF inhibitor groups.
authors.affiliation: The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health Japan , Yahatanishi, Kitakyushu , Japan.
authors.forename: Shintaro
authors.initials: S
authors.lastname: Hirata
authors.forename: Wanying
authors.initials: W
authors.lastname: Li
authors.forename: Nadine
authors.initials: N
authors.lastname: Defranoux
authors.forename: Guy
authors.initials: G
authors.lastname: Cavet
authors.forename: Rebecca
authors.initials: R
authors.lastname: Bolce
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Yamaoka
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Saito
authors.forename: Yoshiya
authors.initials: Y
authors.lastname: Tanaka
mesh_terms: D000068879:Adalimumab / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000188:drug therapy*; D015415:Biomarkers; D018450:Disease Progression; D000068800:Etanercept / Q000627:therapeutic use; D005260:Female; D006801:Humans; D000069285:Infliximab / Q000627:therapeutic use; D007564:Japan; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents; D015415:Biomarkers; D000069285:Infliximab; D000068879:Adalimumab; D000068800:Etanercept
keywords: Biomarkers; Disease activity; Rheumatoid arthritis; TNF inhibitor