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Rheumatology (Oxford). 2016 Apr;55(4):640-8. doi: 10.1093/rheumatology/kev388. Epub 2015 Nov 25.

Multibiomarker disease activity score and C-reactive protein in a cross-sectional observational study of patients with rheumatoid arthritis with and without concomitant fibromyalgia.

Author information

1
Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Boston, MA, ylee9@partners.org.
2
Hackett & Associates Inc., San Diego, CA and.
3
Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Boston, MA.
4
Medical and Scientific Affairs, Crescendo Bioscience Inc., South San Francisco, CA, USA.

Abstract

OBJECTIVES:

To examine the association between a multibiomarker disease activity (MBDA) score, CRP and clinical disease activity measures among RA patients with and without concomitant FM.

METHODS:

In an observational cohort of patients with established RA, we performed a cross-sectional analysis comparing MBDA scores with CRP by rank correlation and cross-classification. MBDA scores, CRP and clinical measures of disease activity were compared between patients with RA alone and RA with concomitant FM (RA and FM) by univariate and multivariate analyses.

RESULTS:

CRP was ⩽1.0 mg/dl for 184 of 198 patients (93%). MBDA scores correlated with CRP (r = 0.755, P < 0.001), but were often discordant, being moderate or high for 19%, 55% and 87% of patients with CRP ⩽0.1, 0.1 to ⩽0.3, or 0.3 to ⩽1.0 mg/dl, respectively. Among patients with CRP ⩽1.0 mg/dl, swollen joint count (SJC) increased linearly across levels of MBDA score, both with (P = 0.021) and without (P = 0.004) adjustment for CRP, whereas CRP was not associated with SJC. The 28-joint-DAS-CRP, other composite measures, and their non-joint-count component measures were significantly greater for patients with RA and FM (n = 25) versus RA alone (n = 173) (all P ⩽ 0.005). MBDA scores and CRP were similar between groups.

CONCLUSION:

MBDA scores frequently indicated RA disease activity when CRP did not. Neither one was significantly greater among patients with RA and FM versus RA alone. Thus, MBDA score may be a useful objective measure for identifying RA patients with active inflammation when CRP is low (⩽1.0 mg/dl), including RA patients with concomitant FM.

KEYWORDS:

C-reactive protein; RAPID3; biomarkers; disease activity; fibromyalgia; multibiomarker; rheumatoid arthritis

PMID:
26608972
PMCID:
PMC4795537
DOI:
10.1093/rheumatology/kev388
[Indexed for MEDLINE]
Free PMC Article

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