Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Multibiomarker Disease Activity Testing for RA

J Rheumatol; 2019 Mar; Curtis, Xie, Yang, et al

The multibiomarker disease activity (MBDA) score in rheumatoid arthritis (RA) was associated with both biologic and Janus kinase (JAK) inhibitor medication addition/switching and subsequent treatment outcomes. Using 2011–2015 Medicare data, researchers linked each patient with RA to their MBDA test result. Initiation of a biologic or JAK inhibitor in the 6 months following MBDA testing was described. For patients with high MBDA scores who added a new RA therapy and were subsequently retested, lack of improvement in the MBDA score was evaluated as a predictor of future RA medication failure, defined by the necessity to change RA medications again. They found:

  • Among 60,596 RA patients with MBDA testing, the proportion adding or switching biologics/JAK inhibitor among those not already taking a biologic/JAK inhibitor was 9.0% (low MBDA), 11.8% (moderate MBDA), and 19.7% (high MBDA).
  • Similarly, among those already taking biologics/JAK inhibitor, the proportions were 5.2%, 8.3%, and 13.5%.
  • After multivariable adjustment, referent to those with low disease MBDA scores, the likelihood of switching was 1.51-fold greater for patients with moderate MBDA scores, and 2.62 for patients with high MBDA scores.

Citation:

Curtis JR, Xie F, Yang S, Danila MI, Owensby JK, Chen L. Uptake and clinical utility of multibiomarker disease activity testing in the United States. J Rheumatol. 2019;46 (3):237-244. doi:10.3899/jrheum.180071.