Biomarkers for RA
I read the article, “Finding Biomarkers in RA Remains Elusive Goal” (February 2015 The Rheumatologist), with great interest. The author correctly identifies the multi-biomarker disease activity assay (MBDA; Vectra DA) as a potential biomarker that identifies RA patients at risk for radiographic progression. The author names a study presented at the 2014 ACR/ARHP Annual Meeting supporting this. I would like to point out that data from the SWEFOT clinical trial that were published earlier in 2014 (and presented at the 2013 ACR/ARHP Annual Meeting) demonstrated this same property of the MBDA, with the added point that when measured prior to treatment start in early RA (with MTX) the MBDA could distinguish patients at very low risk vs. those at moderate risk, with greater accuracy than CRP, ESR or DAS28.1
Moreover, the article in The Rheumatologist discusses the possibility that a (set of) biomarker(s) could help steer therapy. At the 2014 ACR/ARHP Annual Meeting we did, in fact, present data suggesting that the change in MBDA during MTX treatment could predict whether the most effective subsequent therapy will be “triple therapy” (MTX + sulfasalazine + hydroxychloroquine) or MTX + anti-TNF.2
Sincerely,
Ronald van Vollenhoven, MD, PhD, Professor and Chief, Unit for Clinical Therapy Research, Inflammatory Diseases (ClinTRID), The Karolinska Institute, and Chief, Clinical Trials Unit, Department of Rheumatology, The Karolinska University Hospital, Stockholm, Sweden
References
- Hambardzumyan K, Bolce R, Saevarsdottir S, et al. Pretreatment multi-biomarker disease activity score and radiographic progression in early RA: Results from the SWEFOT trial. Ann Rheum Dis. 2014 May 8; pii: annrheumdis-2013-204986.
- Hambardzumyan K, Bolce RJ, Saevarsdottir S, et al. In early rheumatoid arthritis patients with non-response to methotrexate monotherapy the change in multi-biomarker disease activity score is differentially associated with subsequent response to non-biological versus biological therapy. Arthritis Rheumatol (ACR/ARHP Annual Meeting Abstracts). 2014;66(suppl 10):Abstract 45617.