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首页> 外文期刊>Arthritis care & research >Validation of a novel multibiomarker test to assess rheumatoid arthritis disease activity
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Validation of a novel multibiomarker test to assess rheumatoid arthritis disease activity

机译：新型多生物标志物测试以评估类风湿关节炎疾病活动的验证

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Objective Quantitative assessment of disease activity in rheumatoid arthritis (RA) is important for patient management, and additional objective information may aid rheumatologists in clinical decision making. We validated a recently developed multibiomarker disease activity (MBDA) test relative to clinical disease activity in diverse RA cohorts. Methods Serum samples were obtained from the Index for Rheumatoid Arthritis Measurement, Brigham and Women's Hospital Rheumatoid Arthritis Sequential Study, and Leiden Early Arthritis Clinic cohorts. Levels of 12 biomarkers were measured and combined according to a prespecified algorithm to generate the composite MBDA score. The relationship of the MBDA score to clinical disease activity was characterized separately in seropositive and seronegative patients using Pearson's correlations and the area under the receiver operating characteristic curve (AUROC) to discriminate between patients with low and moderate/high disease activity. Associations between changes in MBDA score and clinical responses 6-12 weeks after initiation of anti-tumor necrosis factor or methotrexate treatment were evaluated by the AUROC. Results The MBDA score was significantly associated with the Disease Activity Score in 28 joints using the C-reactive protein level (DAS28-CRP) in both seropositive (AUROC 0.77, P < 0.001) and seronegative (AUROC 0.70, P < 0.001) patients. In subgroups based on age, sex, body mass index, and treatment, the MBDA score was associated with the DAS28-CRP (P < 0.05) in all seropositive and most seronegative subgroups. Changes in the MBDA score at 6-12 weeks could discriminate both American College of Rheumatology criteria for 50% improvement responses (P = 0.03) and DAS28-CRP improvement (P = 0.002). Changes in the MBDA score at 2 weeks were also associated with subsequent DAS28-CRP response (P = 0.02). Conclusion Our findings establish the criterion and discriminant validity of a novel multibiomarker test as an objective measure of RA disease activity to aid in the management of RA in patients with this condition.
机译：客观评估类风湿关节炎（RA）中疾病活动对患者管理很重要，其他客观信息可能会帮助风湿病学家进行临床决策。我们验证了相对于各种RA队列中的临床疾病活动而言，最近开发的多生物标志物疾病活动（MBDA）测试。方法从类风湿关节炎测量指数，Brigham和妇女医院类风湿关节炎先后研究和莱顿早期关节炎临床队列中获得血清样本。测量了12种生物标志物的水平，并根据预先指定的算法进行组合以生成复合MBDA评分。血清阳性和血清阴性患者分别使用Pearson相关性和受试者工作特征曲线下面积（AUROC）来区分MBDA评分与临床疾病活动的关系，以区分低和中/高疾病活动的患者。抗肿瘤坏死因子或甲氨蝶呤治疗开始后6-12周，MBDA评分变化与临床反应之间的关联由AUROC评估。结果在血清反应阳性（AUROC 0.77，P <0.001）和血清阴性（AUROC 0.70，P <0.001）的患者中，使用C反应蛋白水平（DAS28-CRP），MBDA评分与28个关节的疾病活动评分显着相关。在基于年龄，性别，体重指数和治疗的亚组中，在所有血清阳性和大多数血清阴性的亚组中，MBDA评分均与DAS28-CRP相关（P <0.05）。 6-12周时MBDA评分的变化可以区分美国风湿病学会50％改善反应的标准（P = 0.03）和DAS28-CRP改善的标准（P = 0.002）。 2周时MBDA评分的变化也与随后的DAS28-CRP反应相关（P = 0.02）。结论我们的发现建立了一种新型的多生物标志物测试的判据和判别有效性，该测试是RA疾病活动的客观指标，有助于在这种情况下对RA进行管理。

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