title: Association of a multibiomarker disease activity score at multiple time-points with radiographic progression in rheumatoid arthritis: results from the SWEFOT trial.
abstract: OBJECTIVE
  In rheumatoid arthritis (RA), predictive biomarkers for subsequent radiographic progression (RP) could improve therapeutic choices for individual patients. We previously showed that the multibiomarker disease activity (MBDA) score in patients with newly diagnosed RA identified patients at risk for RP. We evaluated the MBDA score at multiple time-points as a predictor of RP during 2 years of follow-up.
  
  
  METHODS
  A subset of patients with RA (N=220) from the Swedish Farmacotherapy (SWEFOT) trial were analysed for MBDA score, disease activity score of 28 joints (DAS28), C reactive protein (CRP) and erythrocyte sedimentation rate (ESR) at baseline (BL), month 3 and year 1, for predicting RP based on modified Sharp/van der Heijde scores at BL, year 1 and year 2.
  
  
  RESULTS
  Patients with persistently low MBDA (<30) scores or those with a decrease from moderate (30-44) to low MBDA scores, did not develop RP during 2 years of follow-up. The highest risk for RP during 2 years of follow-up (42%) was observed among patients with persistently high (>44) MBDA scores. Among methotrexate non-responders with a high MBDA score at BL or month 3, significantly more of those who received triple therapy had RP at year 2 compared with those who received antitumour necrosis factor therapy.
  
  
  CONCLUSIONS
  Measuring the MBDA score both before and during treatment in RA was useful for the assessment of individual patient risk for RP during 2 years of follow-up. In comparison with low CRP, ESR or DAS28, a low MBDA score at any time-point was associated with numerically lower proportions of RP.
  
  
  BACKGROUND
  NCT00764725.
authors.affiliation: Unit of Clinical Therapy Research, Inflammatory Diseases (ClinTRID), Department of Medicine , Karolinska Institutet, Karolinska University Hospital , Stockholm , Sweden.
authors.forename: Karen
authors.initials: K
authors.lastname: Hambardzumyan
authors.affiliation: Crescendo Bioscience Inc , South San Francisco, California , USA.
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Bolce
authors.affiliation: Unit of Clinical Therapy Research, Inflammatory Diseases (ClinTRID), Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden; Rheumatology Unit, Department of Medicine, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden.
authors.forename: Saedis
authors.initials: S
authors.lastname: Saevarsdottir
authors.affiliation: Section of Rheumatology, Department of Clinical Sciences, Lund University, Helsingborg, Sweden; Section of Rheumatology, Department of Medicine, Helsingborg's Lasarett, Helsingborg, Sweden.
authors.forename: Kristina
authors.initials: K
authors.lastname: Forslind
authors.affiliation: Section of Rheumatology, Department of Clinical Sciences , Lund University , Lund , Sweden.
authors.forename: Johan K
authors.initials: JK
authors.lastname: Wallman
authors.affiliation: Scott Cruickshank and Associates Inc , Santa Barbara, California , USA.
authors.forename: Scott E
authors.initials: SE
authors.lastname: Cruickshank
authors.affiliation: Crescendo Bioscience Inc , South San Francisco, California , USA.
authors.forename: Eric H
authors.initials: EH
authors.lastname: Sasso
authors.affiliation: Crescendo Bioscience Inc , South San Francisco, California , USA.
authors.forename: David
authors.initials: D
authors.lastname: Chernoff
authors.affiliation: Unit of Clinical Therapy Research, Inflammatory Diseases (ClinTRID), Department of Medicine , Karolinska Institutet, Karolinska University Hospital , Stockholm , Sweden.
authors.forename: Ronald F
authors.initials: RF
authors.lastname: van Vollenhoven
keywords: Anti-TNF; Cytokines; Disease Activity; Patient perspective; Rheumatoid Arthritis