Association of the multi-biomarker disease activity score with joint destruction in patients with rheumatoid arthritis receiving tumor necrosis factor-alpha inhibitor treatment in clinical practice

Figures & data

Table 1. Patient demographics.

		Treatment group
Characteristics	All	ADA	ETN	IFX
N	83	41	19	23
Female (%)	84	88	79	83
RF+ (%)*	87	83	89	91
Age (years), mean (SD)	59 (14)	62	59	53
Disease duration (months), mean (SD)	98 (111)	103	128	63
Concomitant use of MTX (%)†	89	98	58	100
MTX dose (mg/week), mean (SD)‡	9.6 (2.5)	9.9	9.5	9.1
TJC28, mean (SD)	9.5 (7.2)	8.5	9.7	11.0
SJC28, mean (SD)	7.5 (5.5)	7.0	7.9	8.3
PGA (mm), mean (SD)	51 (23)	45	57	58
ESR (mm/hr), mean (SD)	56 (33)	52	70	51
CRP (mg/dL), mean (SD)	2.6 (2.7)	2.7	3.2	2.1
DAS28, mean (SD)	5.7 (1.2)	5.4	6.0	6.0
The MBDA score, mean (SD)	61 (18)	62	62	57
mTSS, mean (SD)	70 (104)	65	126	33

*N = 82; †p < 0.05; ‡MTX dose among MTX users.

RF, rheumatoid factor; SD, standard deviation; DAS28, disease activity score evaluated on 28 joints.

Figure 1. Disease activity at each time point (n = 83). Disease activity was measured by the MBDA score (a) and DAS28 (b). Boxes indicate interquartile range. Thick horizontal bars represent median values. Whiskers indicate most extreme points within 1.5 × IQR of the box. Gray lines represent connection between the scores of each individual subject over the three visits.

Table 2. Distribution of ΔmTSS from baseline to Week 52 following anti-TNF treatment.

	Total (n = 83)	ADA (n = 41)	ETN (n = 19)	IFX (n = 23)
ΔmTSS ≤ 0.5, n (%)	55 (66)	30 (73)	12 (63)	13 (57)
ΔmTSS > 0.5, n (%)	28 (34)	11 (27)	7 (37)	10 (43)
ΔmTSS > 3, n (%)	10 (12)	2 (5)	3 (16)	5 (22)
ΔmTSS > 5, n (%)	5 (6)	0 (0)	2 (11)	3 (13)
ΔmTSS, mean (SD)	1.03 (1.99)	0.48 (1.12)	1.34 (2.31)	1.76 (2.63)

Table 3. Spearman correlation between disease activity or change in disease activity and radiographic progression*.

	The MBDA score			DAS28
	r	p value	Adj. p	r	p value	Adj. p
Baseline	0.2	0.067	0.133	0.25	0.021	0.082
24 weeks	0.47	<0.001	<0.001	0.42	<0.001	<0.001
52 weeks	0.32	0.004	0.015	0.25	0.026	0.082
AUC across 1 year	0.44	<0.001	<0.001	0.41	<0.001	<0.001
Change from baseline to 24 weeks	0.23	0.034	0.102	0.2	0.067	0.133
Change from baseline to 52 weeks	0.11	0.318	0.318	0	0.992	0.992

*ΔmTSS from baseline to Week 52.

DAS28, disease activity score evaluated on 28 joints (based on erythrocyte sedimentation rate); Adj., adjusted.

Table 4. Relative risk of radiographic progression based on disease activity at Week 24.

Disease activity classification	N	Patients with radiographic progression, n (%)	RR (95% CI)	p Value*
ΔmTSS >0.5
The MBDA score
Moderate/high	55	26 (47)	6.6 (2.0–24.4)	<0.001
Low	28	2 (7)
DAS28
Moderate/high	44	21 (48)	2.7 (1.3–5.6)	0.005
Low	39	7 (18)
ΔmTSS >3
The MBDA score
High	32	9 (28)	14.3 (2.5–85.5)	0.001
Low/moderate	51	1 (2)
DAS28
High	11	4 (36)	4.4 (1.4–11.9)	0.024
Low/moderate	72	6 (8)

*p Values were derived by Fisher’s exact test for assessing the null hypothesis: RR = 1.

RR, relative risk; DAS28, disease activity score evaluated on 28 joints (based on erythrocyte sedimentation rate).

Figure 2. Moderate to high MBDA scores added value to DAS28 at Week 24 for identifying patients with ΔmTSS > 0.5.