Academic Journal
Predictive value of a multi-biomarker disease activity score for clinical remission and radiographic progression in patients with early rheumatoid arthritis:a post-hoc study of the OPERA trial
| العنوان: | Predictive value of a multi-biomarker disease activity score for clinical remission and radiographic progression in patients with early rheumatoid arthritis:a post-hoc study of the OPERA trial |
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| المؤلفون: | Brahe, C H, Østergaard, M, Johansen, J S, Defranoux, N, Wang, X, Bolce, R, Sasso, E H, Ørnbjerg, L M, Hørslev-Petersen, K, Stengaard-Pedersen, K, Junker, P, Ellingsen, T, Ahlquist, P, Lindegaard, H, Linauskas, A, Schlemmer, A, Dam, M Y, Hansen, I, Lottenburger, T, Ammitzbøll, C, Jørgensen, A, Krintel, S B, Raun, J, Hetland, M L |
| المصدر: | Brahe , C H , Østergaard , M , Johansen , J S , Defranoux , N , Wang , X , Bolce , R , Sasso , E H , Ørnbjerg , L M , Hørslev-Petersen , K , Stengaard-Pedersen , K , Junker , P , Ellingsen , T , Ahlquist , P , Lindegaard , H , Linauskas , A , Schlemmer , A , Dam , M Y , Hansen , I , Lottenburger , T , Ammitzbøll , C , Jørgensen , A , Krintel , S B , Raun , J & Hetland .... |
| سنة النشر: | 2019 |
| المجموعة: | Aarhus University: Research |
| مصطلحات موضوعية: | Adalimumab/therapeutic use, Adult, Aged, 80 and over, Antirheumatic Agents/therapeutic use, Arthritis, Rheumatoid/blood, Biomarkers/blood, C-Reactive Protein/metabolism, Disease Progression, Double-Blind Method, Drug Therapy, Combination, Female, Follow-Up Studies, Humans, Immunosuppressive Agents, Male, Methotrexate/therapeutic use, Middle Aged, Radiography, Remission Induction/methods, Severity of Illness Index, Treatment Outcome, Young Adult |
| الوصف: | OBJECTIVES: Measurement of serum biomarkers at disease onset may improve prediction of disease course in patients with early rheumatoid arthritis (RA). We evaluated the multi-biomarker disease activity (MBDA) score and early changes in MBDA score for prediction of 28-joint Disease Activity Score based on C-reactive protein (DAS28-CRP) remission and radiographic progression in the double-blinded OPERA trial. METHOD: Treatment-naïve RA patients (N = 180) with moderate or high DAS28 were randomized to methotrexate (MTX) + adalimumab (n = 89) or MTX + placebo (n = 91) in combination with glucocorticoid injection into swollen joints. X-rays of hands and feet were evaluated at months 0 and 12 (n = 164) by the total Sharp van der Heijde score (TSS). The smallest detectable change (1.8 TSS units) defined radiographic progression (∆TSS ≥ 2). Clinical remission (DAS28-CRP < 2.6) was assessed at baseline and 6 months. MBDA score was determined at 0 and 3 months and tested in a multivariable logistic regression model for predicting DAS28 remission at 6 months and radiographic progression at 1 year. RESULTS: Baseline MBDA score was independently associated with radiographic progression at 1 year [odds ratio (OR) = 1.03/unit, 95% confidence interval (CI) = 1.01-1.06], and changes in MBDA score from baseline to 3 months with clinical remission at 6 months [OR = 0.98/unit, 95% CI 0.96-1.00). In anti-cyclic citrullinated peptide antibody (anti-CCP)-positive patients, 35 of 89 with high MBDA score (> 44) showed radiographic progression (PPV = 39%), compared with 0 of 15 patients (NPV = 100%) with low/moderate MBDA score (≤ 44) (p = 0.003). CONCLUSION: Early changes in MBDA score were associated with clinical remission based on DAS28-CRP at 6 months. In anti-CCP-positive patients, a non-high baseline MBDA score (≤ 44) had a clinical value by predicting very low risk of radiographic progression at 12 months. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| Relation: | https://pure.au.dk/portal/en/publications/9d771167-0be9-46f7-b8ce-9b19ca2812be |
| DOI: | 10.1080/03009742.2018.1464206 |
| الاتاحة: | https://pure.au.dk/portal/en/publications/9d771167-0be9-46f7-b8ce-9b19ca2812be https://doi.org/10.1080/03009742.2018.1464206 |
| Rights: | info:eu-repo/semantics/restrictedAccess |
| رقم الانضمام: | edsbas.43C9DFF2 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1080/03009742.2018.1464206 |
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