TY  - JOUR
A1  - Rech, Juergen
A1  - Hueber, Axel J.
A1  - Finzel, Stephanie
A1  - Englbrecht, Matthias
A1  - Haschka, Judith
A1  - Manger, Bernhard
A1  - Kleyer, Arnd
A1  - Reiser, Michaela
A1  - Cobra, Jayme Fogagnolo
A1  - Figueiredo, Camille
A1  - Tony, Hans-Peter
A1  - Kleinert, Stefan
A1  - Wendler, Joerg
A1  - Schuch, Florian
A1  - Ronneberger, Monika
A1  - Feuchtenberger, Martin
A1  - Fleck, Martin
A1  - Manger, Karin
A1  - Ochs, Wolfgang
A1  - Schmitt-Haendle, Matthias
A1  - Lorenz, Hanns-Martin
A1  - Nuesslein, Hubert
A1  - Alten, Rieke
A1  - Henes, Joerg
A1  - Krueger, Klaus
A1  - Schett, Georg
T1  - Prediction of disease relapses by multibiomarker disease activity and autoantibody status in patients with rheumatoid arthritis on tapering DMARD treatment
T2  - Annals of the Rheumatic Diseases
N2  - Objective 
To analyse the role of multibiomarker disease activity (MBDA) score in predicting disease relapses in patients with rheumatoid arthritis (RA) in sustained remission who tapered disease modifying antirheumatic drug (DMARD) therapy in RETRO, a prospective randomised controlled trial. 

Methods 
MBDA scores (scale 1-100) were determined based on 12 inflammation markers in baseline serum samples from 94 patients of the RETRO study. MBDA scores were compared between patients relapsing or remaining in remission when tapering DMARDs. Demographic and disease-specific parameters were included in multivariate logistic regression analysis for defining predictors of relapse. 

Results 
Moderate-to-high MBDA scores were found in 33% of patients with RA overall. Twice as many patients who relapsed (58%) had moderate/high MBDA compared with patients who remained in remission (21%). Baseline MBDA scores were significantly higher in patients with RA who were relapsing than those remaining in stable remission (N=94; p=0.0001) and those tapering/stopping (N=59; p=0.0001). Multivariate regression analysis identified MBDA scores as independent predictor for relapses in addition to anticitrullinated protein antibody (ACPA) status. Relapse rates were low (13%) in patients who were MBDA-/ACPA-, moderate in patients who were MBDA+/ACPA- (33.3%) and MBDA-ACPA+ (31.8%) and high in patients who were MBDA+/ACPA+ (76.4%). 

Conclusions 
MBDA improved the prediction of relapses in patients with RA in stable remission undergoing DMARD tapering. If combined with ACPA testing, MBDA allowed prediction of relapse in more than 80% of the patients. 

Trial registration number EudraCT 
2009-015740-42.
KW  - Drug-free remission
KW  - Clinical remission
KW  - Validation
KW  - Synovitis
Y1  - 2016
UR  - https://opus.bibliothek.uni-wuerzburg.de/frontdoor/index/index/docId/18751
UR  - https://nbn-resolving.org/urn:nbn:de:bvb:20-opus-187519
VL  - 75
IS  - 9
ER  -