Performance of a multi-biomarker score measuring rheumatoid arthritis disease activity in the CAMERA tight control study.
Performance of a multi-biomarker score measuring rheumatoid arthritis disease activity in the CAMERA tight control study.
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DOI：
10.1136/annrheumdis-2011-200963
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发表时间：
2012-10
影响因子：
27.4
通讯作者：
Welsing PM
中科院分区：
文献类型：
--
作者：
Bakker MF;Cavet G;Jacobs JW;Bijlsma JW;Haney DJ;Shen Y;Hesterberg LK;Smith DR;Centola M;van Roon JA;Lafeber FP;Welsing PM
评估早期类风湿关节炎计算机辅助管理（CAMERA）研究中个体生物标志物和多生物标志物疾病活动性（MBDA）评分在早期类风湿关节炎（RA）患者群体中的表现。在CAMERA队列中测量了20种生物标志物，其中患者接受强化或传统的基于甲氨蝶呤的治疗策略。根据预先训练的算法，使用12种生物标志物（SAA、IL-6、TNF-RI、VEGF-A、MMP-1、YKL-40、MMP-3、EGF、VCAM-1、瘦素、抵抗素和CRP）的浓度计算MBDA评分。评分的表现相对于临床疾病活动性评估进行评估。采用配对Wilcoxon秩和检验评估MBDA评分随时间的变化。采用Logistic回归评估疾病活动性指标预测影像学进展的能力。MBDA评分与基于28关节- c反应蛋白（DAS28-CRP）的疾病活动性评分（r=0.72; p<0.001）和患者工作特征曲线下用于区分缓解/低与中/高疾病活动性的面积为0.86 (p<0.001)，使用DAS28-CRP截止值为2.7。在多变量分析中，MBDA评分，而不是CRP，是疾病活动性测量的独立预测因子。此外，平均（SD） MBDA评分从基线时的53（18）下降到研究治疗6个月时的39 (16)（p<0.0001）。无论是MBDA评分还是临床变量都不能预测影像学进展。在CAMERA研究中，这种多生物标志物测试在评估RA患者的疾病活动性方面表现良好。在进一步验证后，该测试可用于补充目前可用的疾病活动测量并改善患者护理和结果。
To evaluate the performance of individual biomarkers and a multi-biomarker disease activity (MBDA) score in the early rheumatoid arthritis (RA) patient population from the computer assisted management in early rheumatoid arthritis (CAMERA) study. Twenty biomarkers were measured in the CAMERA cohort, in which patients were treated with either intensive or conventional methotrexate-based treatment strategies. The MBDA score was calculated using the concentrations of 12 biomarkers (SAA, IL-6, TNF-RI, VEGF-A, MMP-1, YKL-40, MMP-3, EGF, VCAM-1, leptin, resistin and CRP) according to a previously trained algorithm. The performance of the scores was evaluated relative to clinical disease activity assessments. Change in MBDA score over time was assessed by paired Wilcoxon rank sum test. Logistic regression was used to evaluate the ability of disease activity measures to predict radiographic progression. The MBDA score had a significant correlation with the disease activity score based on 28 joints-C reactive protein (DAS28-CRP) (r=0.72; p<0.001) and an area under the receiver operating characteristic curve for distinguishing remission/low from moderate/high disease activity of 0.86 (p<0.001) using a DAS28-CRP cut-off of 2.7. In multivariate analysis the MBDA score, but not CRP, was an independent predictor of disease activity measures. Additionally, mean (SD) MBDA score decreased from 53 (18) at baseline to 39 (16) at 6 months in response to study therapy (p<0.0001). Neither MBDA score nor clinical variables were predictive of radiographic progression. This multi-biomarker test performed well in the assessment of disease activity in RA patients in the CAMERA study. Upon further validation, this test could be used to complement currently available disease activity measures and improve patient care and outcomes.