ACPA-negative RA consists of subgroups: patients with high likelihood of achieving sustained DMARD-free remission can be identified by serological markers at disease presentation

Background: Disease-modifying antirheumatic drug (DMARD)-free remission, the sustained absence of synovitis after DMARD cessation, is increasingly achievable, especially in autoantibody-negative rheumatoid arthritis (RA). However, underlying mechanisms are unknown and patient subgroups that achieve this outcome are insufficiently characterized. We evaluated whether serological biomarkers at disease onset, as measured within the multibiomarker disease activity (MBDA) score, are differently expressed in RA patients who achieve sustained DMARDfree remission. Methods: Two hundred ninety-nine RA patients were evaluated for achievement of sustained DMARD-free remission during a median follow-up of 4.3 years. Twelve biomarkers, as included in the MBDA score, were determined from the serum obtained at disease onset. Patients were categorized as having a low ( 44) score. Analyses were stratified for anti-citrullinated protein antibodies (ACPA) based under the assumption that ACPApositive and ACPA-negative RA are different disease entities. Results: Twenty percent achieved sustai

Biomarkers of Multiple Sclerosis

The search for an ideal multiple sclerosis biomarker with good diagnostic value, prognostic reference and an impact on clinical outcome has yet to be realized and is still ongoing. The aim of this review is to establish an overview of the frequent biomarkers for multiple sclerosis that exist to date. The review summarizes the results obtained from electronic databases, as well as thorough manual searches. In this review the sources and methods of biomarkers extraction are described; in addition to the description of each biomarker, determination of the prognostic, diagnostic, disease monitoring and treatment response values besides clinical impact they might possess. We divided the biomarkers into three categories according to the achievement method: laboratory markers, genetic-immunogenetic markers and imaging markers. We have found two biomarkers at the time being considered the gold standard for MS diagnostics. Unfortunately, there does not exist a single solitary marker being able to present reliable diagnostic value, prognostic value, high sensitivity and specificity as well as clinical impact. We need more studies to find the best biomarker for MS.publishersversionPeer reviewe

Cambios de la irrigación arterial renal durante el tratamiento de la hipertensión arterial esencial; prazosin en comparación con propranolol

Para valorar los cambios hemodinámicos renales durante el tratamiento de la hiperten-sión arterial esencial, en un estudio cruzado se sometió a 12 sujetos con hipertensión arterial esencial a un plan que comprendía un mes de administración de placebo, prazosin y propranolol exclusivamente. Durante la administración de prazosin la presión arterial volvió a cifras normales, y se conservaron filtración glomerular, flujo plasmático renal y flujo sanguíneo renal. Sin embargo, el propranolol normalizó la presión arterial y produjo disminución significativa de la filtración glomerular, flujo plasmático renal y flujo sanguíneo renal. Se explican los posibles mecanismos

Relationship of multi-biomarker disease activity score and other risk factors with radiographic progression in an observational study of patients with rheumatoid arthritis

Pathophysiology and treatment of rheumatic disease

The Multi-Biomarker Disease Activity Test (Vectra (R) DA) Estimates Risk Of Radiographic Progression For Patients With Rheumatoid Arthritis From The Leiden Early Arthritis Clinic

Pathophysiology and treatment of rheumatic disease

A multi-biomarker score measuring disease activity in rheumatoid arthritis patients tapering adalimumab or etanercept: predictive value for clinical and radiographic outcomes

Item does not contain fulltextObjective.: The aim was to evaluate the predictive value of the baseline multi-biomarker disease activity (MBDA) score in long-standing RA patients with low disease activity tapering TNF inhibitors (TNFi) for successful tapering or discontinuation, occurrence of flare and major flare, and radiographic progression. Methods.: Dose REduction Strategies of Subcutaneous TNF inhibitors (Dutch Trial Register, NTR 3216) is an 18-month non-inferiority randomized controlled trial comparing tapering of TNFi until discontinuation or flaring with usual care (UC) in long-standing RA patients with stable low disease activity. Flare was defined as DAS28-CRP increase >1.2 or >0.6 if current DAS 3.2; major flare was a flare lasting >3 months, despite treatment intervention. MBDA scores were measured at baseline. Radiographs were scored at baseline and 18 months using the Sharp-van der Heijde score. The area under the receiver operating characteristic (AUROC) curve was used to analyse the capability of baseline MBDA score to predict the above-mentioned outcomes. Results.: Serum samples and outcomes were available for 171 of 180 patients from Dose REduction Strategies of Subcutaneous TNF inhibitors (115 tapering; 56 UC). AUROC analyses showed that baseline MBDA score was not predictive for the above-mentioned clinical outcomes in the taper group, but did predict major flare in the UC group (AUROC = 0.72, 95% CI: 0.56, 0.88). Radiographic progression was minimal and was not predicted by MDBA score. Conclusion.: In this disease activity-guided strategy study of TNFi tapering in RA patients with low disease activity, baseline MBDA score was not predictive for successful tapering, discontinuation, flare, major flare or radiographic progression in patients who tapered TNFi

High Multi-Biomarker Disease Activity Score Is Associated with High Risk of Radiographic Progression in Six Cohorts

Pathophysiology and treatment of rheumatic disease