Evaluating disease activity via multi-biomarker disease activity scores in rheumatoid arthritis patients treated with abatacept or adalimumab
Rheumatoid arthritis (RA) is a long-term inflammatory ill-condition which affects the joints like those in hands and feet. This study was performed to analyze the ability of a multi-biomarker disease activity (MBDA) test (Vectra DA) to review clinical measures of disease activity in patients enrolled in the AMPLE (Abatacept Versus Adalimumab Comparison in Biologic-Naïve RA Subjects with Background Methotrexate) trial.
In this AMPLE trial, patients with active RA who were naive to biologic agents and had an inappropriate response to methotrexate were randomized (1:1). They sustained subcutaneous abatacept (125 mg every week) or subcutaneous adalimumab (40 mg every 2 weeks), with background methotrexate, for 2 years. The serum samples were used to obtain the MBDA score at baseline, month 3, and years 1 and 2. The adjusted mean change from baseline in the MBDA score was distinguished between the abatacept and adalimumab treatment groups. Cross-tabulation was used to compare the MBDA score with the clinical measures of disease activity. These are Clinical Disease Activity Index (CDAI), Simplified Disease Activity Index (SDAI), Disease Activity Score in 28 joints using the C-reactive protein level (DAS28-CRP), and Routine Assessment of Patient Index Data 3 (RAPID-3).
A total 318 patients were randomized to receive abatacept and 328 to receive adalimumab. MBDA data were accessible for 259 and 265 patients, respectively. There was no relationship between the MBDA score and disease activity as per the CDAI, SDAI, DAS28-CRP, or RAPID-3 in the abatacept and adalimumab treatment groups.
The MBDA score did not reflect clinical disease activity in patients enrolled in AMPLE. It should not be used to direct decision-making in the RA management, especially for patients who receive abatacept or adalimumab as the initial biologic agent.