Pediatrics

Can Plasma Biomarkers Predict Short-Term Disease Activity in JIA?

When combined with a set of clinical features at the time of diagnosis, a panel of 5 plasma biomarkers can more accurately predict short-term disease activity in juvenile idiopathic arthritis (JIA) than clinical characteristics alone, according to findings from a new study.

To identify early predictors of disease activity in JIA, the researchers analyzed clinical and biomarker data that was collected from 82 children at the time of their diagnosis of nonsystemic JIA. The researchers then assessed the clinical features’ and biomarkers’ ability to predict an active joint count of 0, a physician global assessment of disease activity of 1 cm or less, and inactive disease by Wallace 2004 criteria 18 months later.

Of the original 112 features the researchers assessed, 13 were determined to effectively predict 18-month outcomes.

The clinical features at enrollment that could predict short-term disease activity were:

  • Age
  • Number of active/effused joints
  • Wrist, ankle, and/or knee involvement
  • Erythrocyte sedimentation rate
  • Antinuclear antibody positivity

 

The plasma levels of 5 inflammatory biomarkers that were collected at enrollment also predicted disease activity. This panel comprised interleukin 10, interleukin 17, interleukin 12p70, soluble low-density lipoprotein receptor-related protein 1, and vitamin D.

Together, the clinical features and plasma biomarker panel had the following prediction accuracies:

  • Active joint count of 0: 0.79
  • Physician global assessment of 1 cm or less: 0.80
  • Inactive disease after 18 months: 0.83

 

These accuracies were all greater than the prediction accuracies that clinical features alone yielded:

  • Active joint count of 0: 0.75
  • Physician global assessment of 1 cm or less: 0.72
  • Inactive disease after 18 months: 0.80

 

“If validated in external cohorts, such a panel may guide more rationally conceived, biologically based, personalized treatment strategies in early JIA,” the researchers concluded.

—Colleen Murphy

Reference:

Rezaei E, Hogan D, Trost B, et al. Clinical and associated inflammatory biomarker features predictive of short-term outcomes in non-systemic juvenile idiopathic arthritis [published online January 9, 2020]. Rheumatology. doi:10.1093/rheumatology/kez615.