Vectra DA—a test that measures several biologic markers of rheumatoid arthritis (RA) activity—may help to identify remission in people with RA. These results were presented at the 2012 annual meeting of the European League Against Rheumatism.
Rheumatoid arthritis (RA) affects an estimated 1.3 million adults in theUnited States. The condition causes pain, swelling, and stiffness of joints. The good news is that important advances have been made in the management of RA: use of more effective drugs earlier in the course of RA reduces symptoms and joint damage, and allows some patients to achieve a remission (little or no active disease).
Regular and systematic assessment of RA disease activity plays a key role in the management of this condition. Disease activity refers to ongoing inflammation, symptoms, and/or joint damage. Information about the level of disease activity allows doctors to monitor your response to treatment and to adjust your treatment as needed. Commonly used measures of disease activity consider factors such as counts of tender and swollen joints, your own assessment of your health, and lab tests to identify inflammation.
A newer way to measure disease activity is the Vectra DA test, which is a blood test that allows doctors to test for several biological markers (or biomarkers) of RA simultaneously. Vectra DA measures the levels of 12 proteins in the blood—biomarkers that have been linked to RA disease activity—and then combines them into a single score (between 1 and 100) that classifies the current level of RA disease activity as “low”, “moderate”, or “high”. The test does not replace a doctor’s evaluation, but it does provide a precise, objective measure of the underlying biology of the RA.
To explore whether Vectra DA could improve the identification of RA remission, researchers inHollandevaluated patients who were part of the Leiden Early Arthritis Cohort.
Three different definitions of RA remission were compared: two conventional definitions (ACR/EULAR Boolean and DAS28CRP) and Vectra DA.
The main outcome of interest was worsening joint damage (bone erosion and cartilage loss). This was assessed by x-ray over the course of a year.
- Patients who met the Vectra DA criteria for remission were less likely to have worsening joint damage during the following year than patients who met the conventional criteria for remission. Worsening joint damage was observed in 7% of patients who met the Vectra DA criteria for remission, 20% of patients who met the DAS28CRP criteria for remission, and 17% of patients who met the ACR/EULAR Boolean criteria for remission.
- Among patients who met the DAS28CRP criteria for remission, the Vectra DA score provided information about the likelihood of ongoing joint damage. Patients with a high Vectra DA score were more likely to have ongoing joint damage than patients with a low Vectra DA score.
These results suggest that the Vectra DA test is a useful addition to conventional, clinical measures of RA activity. Among other things, Vectra DA may help to identify patients who are at high risk of ongoing joint damage in spite of meeting the criteria for clinical remission.
Reference: van der Helm-van Mil AHM, Knevel R, Qureshi R et al. Evaluation of definitions of rheumatoid arthritis remission by assessing radiographic progression in the Leiden Early Arthritis Cohort. . Paper presented at: 2012 Annual Meeting of the European League Against Rheumatism; June 1-5, 2012;Chicago,IL. Abstract SAT0082.