MBDA Score Is Advantageous in Management of Rheumatoid Arthritis

A high multibiomarker disease activity (MBDA) score demonstrates when a patient with rheumatoid arthritis will most likely add or switch their biologic or Janus Kinase (JAK) inhibitor therapy, according to study findings.

The clinical advantage of the MBDA test for RA management in routine care had not been thoroughly considered.

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For this study, Dr Jeffrey Curtis from University of Alabama and colleagues used Medicare data to link 60,596 individuals with RA to their MBDA test result to evaluate the rate of adding or switching of a biologic or JAK inhibitor.

Individuals with high MBDA scores who added a new RA therapy were subsequently retested. Among these, the lack of improvement in the MBDA score was measured as a predictor of future RA medication failure, which was defined by the urgency to change RA medications again.

Among participants who were not already taking biologics or a JAK inhibitor, the fraction who added or switched a biologic or JAK inhibitor was 9% (low MBDA), 11.8% (moderate MBDA), and 19.7% (high MBDA). Among participants who were not already taking biologics or a JAK inhibitor, the proportions were 5.2%, 8.3%, and 13.5%.

Multivariate adjustment analysis showed participants with moderate MBDA scores had a 1.51-fold greater likelihood of switching medications, whereas participants with high MBDA scores has a 2.62-fold greater likelihood of switching.

A lack of improvement in MBDA score was associated with an increased likelihood of future RA treatment failure (odds ratio = 1.61; 95% CI, 1.27–2.03) among those with high MBDA scores who subsequently added a biologic or JAK inhibitor.

—Colleen Murphy

Reference:

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. [published online November 15, 2018]. J Rheumatol. https://doi.org/10.3899/jrheum.180071