WASHINGTON, D.C.—The American College of Rheumatology (ACR) annual meeting held recently in Washington, D.C., served as the venue for Crescendo Bioscience, a wholly owned subsidiary of Myriad Genetics Inc., to highlight four poster presentations regarding Crescendo’s multi-biomarker blood test Vectra DA.
Two of the posters showcased recent studies showing new ways in which the test can improve risk stratification in populations of patients with rheumatoid arthritis (RA), specifically regarding the development of heart disease and other infections, and in the development of radiographic progression. The other two described studies exploring how the test can help physicians improve treatment for RA patients.
Vectra DA integrates the concentrations of 12 serum proteins associated with RA disease activity into a single objective score, on a scale of one to 100, to help physicians make more informed decisions about treatment. The score generated by Vectra DA classifies RA into low, moderate and high disease activity.
Two of Crescendo’s presentations at the ACR meeting highlighted the use of Vectra DA to help physicians with two common issues in the treatment of RA: the question of whether testing needs to be done outside of normal office hours, and the likelihood that patients may experience a flare-up of symptoms after the withdrawal of therapy.
In one of those presentations, “Examination of Diurnal and Daily Variation of the Multi-biomarker Disease Activity (MBDA) Score in RA to Establish a Minimally Important Difference,” the research evaluated the biological variability in Vectra DA scores over a 24-hour period and day-to-day in 28 patients suffering from RA, with the goals of determining a minimally important difference (MID) and establishing a cut point for a meaningful change in Vectra DA scores over time. The results showed that, based on the short-term variability in the Vectra DA score among stable RA patients tested serially over time, the MID in the score was nine units. Changes exceeding this threshold are unlikely due to diurnal and daily biological variations alone and, based on these data, blood samples for Vectra DA testing taken during normal office hours would not be expected to be impacted by a diurnal variation in the Vectra DA score in clinically stable patients.
The other physician/treatment-focused poster was titled “Predicting Flare and Sustained Clinical Remission After Adalimumab Withdrawal Using the Multi-Biomarker Disease Activity (MBDA) Score.” This study evaluated the Vectra DA score as a predictor of flare or sustained clinical remission after discontinuation of adalimumab in patients with established RA from the HONOR study. Vectra DA scores were measured at adalimumab discontinuation, and the ability of Vectra DA to predict flare or remission was assessed at six months and one year. The findings suggest that the Vectra DA score could predict flare and biologic-free remission in patients in stable remission undergoing adalimumab withdrawal while maintaining methotrexate treatment. The results point to the potential clinical utility of Vectra DA for guiding treatment decisions in patients with RA.
As noted earlier, the other two presentations detailed studies regarding the utility of Vectra DA in predicting the occurrence of heart disease and other infections among RA patients, as well as the likelihood of radiographic progression.
The first, “Biomarker-Related Risk for Myocardial Infarction and Serious Infections in Patients with Rheumatoid Arthritis: A Population-Based Study,” evaluated the utility of Vectra DA in assessing the risk of cardiovascular outcomes and serious infections in a large U.S. Medicare claims database of patients with RA (approximately 17,000 patients). Researchers examined the relationship between the Vectra DA score and the risk of developing infections requiring hospitalization, myocardial infarction (MI) and a composite of coronary heart disease (CHD), including percutaneous coronary intervention and coronary artery bypass graft. The results showed that high Vectra DA scores were associated with an increased risk for infections requiring hospitalization, MI, CHD and CHD events. These findings indicate that the use of the Vectra DA score to risk-stratify patients for these serious adverse events may help clinicians identify those at highest risk.
The other poster was titled “Multi-Biomarker Disease Activity (MBDA) Score and Prediction of Radiographic Progression in a Randomized Study of Patients with Early RA Treated with Methotrexate Alone or with Adalimumab.” The objectives of this study were to evaluate 180 early RA patients from the OPERA trial for associations between the baseline Vectra DA score and 12-month radiographic outcomes, and to assess the value of adding the Vectra DA score to the anticyclic citrullinated peptide (anti-CCP) status for predicting radiographic progression. The results showed that a high baseline Vectra DA score was a strong, independent predictor of radiographic progression and it added value to anti-CCP status.
“Crescendo is pioneering a personalized medicine approach for autoimmune disorders and is committed to helping all patients with rheumatoid arthritis achieve their treatment goals,” said Dr. Elena Hitraya, chief medical officer of Crescendo Bioscience. “We are excited about the new data being presented at ACR that advances the science for Vectra DA and will help rheumatologists improve care for their patients with rheumatoid arthritis.”