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Correlation of the Multi-Biomarker Disease Activity Score with Rheumatoid ArthritisDisease Activity Measures: A Systematic Review and Meta-Analysis

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Johnson TM1,2, Register KA3, Schmidt CM4, O'Dell JR1,2, Mikuls TR1,2, Michaud K1,5, England BR1,2. Arthritis Care Res (Hoboken). 2018 Oct 15. doi: 10.1002/acr.23785. [Epub ahead of print]

Abstract

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1 Division of Rheumatology & Immunology, University of Nebraska Medical Center (UNMC), Omaha, NE.

2 Veterans Affairs Nebraska-Western Iowa Health Care System, Omaha, NE.

3 Division of Rheumatology, University of Utah, Salt Lake City, UT.

4 McGoogan Library of Medicine, University of Nebraska Medical Center, Omaha, NE.

5 FORWARD, The National Databank for Rheumatic Diseases, Wichita, KS.

Abstract

OBJECTIVE: There are conflicting reports on the validity of the multi-biomarker disease activity (MBDA) score to assess RA disease activity. We performed a systematic review of the MBDA and meta-analysis of the correlation between the MBDA and other RA disease activity measures.

METHODS: A systematic review was performed, searching MEDLINE, EMBASE, Scopus, Google Scholar, and the Cochrane Library from inception to March 7, 2017. Study details, MBDA performance, and study quality were assessed by independent reviewers. Correlations of the MBDA with composite RA disease activity measures were pooled using random-effects meta-analyses.

RESULTS: Twenty-two studies were identified in the systematic review, of which 8 (n=3,242 assays) reported correlations of the MBDA with RA disease activity measures. Pooling results from these eight studies in the meta-analysis, the MBDA demonstrated modest correlations with DAS28-CRP (r = 0.41, 95% CI 0.36-0.46) and DAS28-ESR (r = 0.48, 95% CI 0.38-0.58) with weaker correlations observed with SDAI (r = 0.35, 95% CI 0.26-0.43), CDAI (r = 0.26, 95% CI 0.19-0.33), and RAPID3 (r = 0.23, 95% CI 0.19-0.27). Correlations between change in MBDA and change in disease activity measures ranged from r = 0.53 (DAS28-ESR) to r = 0.26 (CDAI).

CONCLUSION: The MBDA demonstrates moderate convergent validity with DAS28-CRP and DAS28-ESR, but weaker correlations with SDAI, CDAI, and RAPID3. While it appears to complement existing RA disease activity measures, further assessment of the MBDA's performance characteristics is warranted.