A multi-biomarker disease activity score tracks clinical response consistently in patients with rheumatoid arthritis treated with different anti-tumor necrosis factor therapies: A retrospective observational study

Figures & data

Table 1. Patient characteristics at baseline.

	Adalimumab	Etanercept	Infliximab	Total
Number of patients	49	49	49	147
Categorical variable	%	%	%	%
Gender (% female)	88	86	80	84
RF status (% positive)	86	85	86	86
Concomitant use of MTX (%)*	98	61	100	86

Continuous variable	Median (IQR)	Median (IQR)	Median (IQR)	Median (IQR)
Age (years)*	64 (55–68)	61 (54–69)	55 (42–64)	60 (50–68)
RA duration (months)*	48 (15–156)	108 (26–240)	47 (15–108)	60 (18–168)
MTX dose^a (mg/week)*	9 (8–12)	8 (8–10)	8 (8–10)	8 (8–10)
TJC-28	6 (3–13)	8 (4–14)	8 (4–16)	8 (4–15)
SJC-28	6 (3–10)	8 (4–12)	7 (4–11)	7 (4–11)
CRP (mg/dL)	0.8 (0.3–4.9)	1.7 (0.8–3.8)	1.4 (0.6–2.9)	1.4 (0.4–3.8)
PGA, mm*	43 (27–63)	62 (35–73)	58 (50–70)	52 (35–70)
DAS28-ESR*	5.3 (4.4–6.2)	5.7 (5.3–6.7)	5.9 (5.3–6.5)	5.7 (5.0–6.5)
DAS28-CRP	4.6 (3.6–5.6)	4.9 (4.5–5.7)	5.1 (4.7–5.8)	5.0 (4.3–5.7)
SDAI	23 (15–36)^b	29 (25–44)^c	25 (22–28)^d	27 (19–40)^e
CDAI*	19 (13–33)^b	28 (23–41)^c	22 (19–27)^d	24 (18–37)^e
MBDA score	62 (50–76)	65 (50–77)	64 (46–74)	64 (49–76)

CDAI clinical disease activity index, CRP C-reactive protein, DAS28-CRP 28-joint disease activity score with CRP, DAS28-ESR 28-joint disease activity score with erythrocyte sedimentation rate, IQR interquartile range, MBDA multi-biomarker disease activity, MTX methotrexate, PGA patient global assessment, RF rheumatoid factor, RA rheumatoid arthritis, SDAI simplified disease activity index, SJC-28 swollen 28-joint count, TJC-28 tender 28-joint count.

‘*’Indicates variables that show statistical differences across the three TNF inhibitors (p < 0.05).

^aFor patients receiving concomitant MTX; ^bn = 35; ^cn = 30; ^dn = 22; ^en = 87.

Figure 1. MBDA scores at baseline and after 52 weeks of treatment with TNF inhibitors (N = 147). Box and whisker plot of MBDA scores at baseline and 52 weeks after initiation of TNF inhibitor treatment (ADA, ETN, and IFX). Thick horizontal line: median value; box: interquartile range (IQR); whiskers: most extreme points within 1.5 times the IQR from the limits of the box. ADA: adalimumab; ETN: etanercept; IFX: infliximab; MBDA: multi-biomarker disease activity; TNF: tumor necrosis factor.

Figure 2. Scatterplot and regression lines for ΔDAS28-ESR (a) or ΔDAS28-CRP (b) versus ΔMBDA score from baseline to week 52, by TNF inhibitor. Each line was fitted by least square error separately for each group. ADA: adalimumab; DAS28-ESR: Disease Activity Score-28 with erythrocyte sedimentation rate; ETN: etanercept; IFX; infliximab; MBDA: Multi-biomarker disease activity; TNF: tumor necrosis factor.

Figure 3. Changes (Δ) in MBDA score by EULAR response at week 52. Box and whisker plot of ΔMBDA score from baseline to 52 weeks after initiation of TNF inhibitor treatment in patients with no, moderate, and good treatment response at 52 weeks as defined by EULAR criteria. Statistical significance of the difference between the responder groups was assessed by Wilcoxon's rank-sum test. Thick horizontal line: median; box: interquartile range (IQR); whiskers: most extreme points within 1.5 times the IQR from the limits of the box. BL: baseline; EULAR: European League Against Rheumatism; IQR: interquartile range; MBDA: multi-biomarker disease activity; TNF: tumor necrosis factor.