1 ML-ACR2014ITSlides-01 11/14 unauthorized changes not permitted Vectra ® DA: A Better Measure for Predicting Radiographic Progression in Rheumatoid Arthritis? Ronald F. van Vollenhoven, MD, PhD Jonathan Kay, MD Andrew Laster MD, FACR Eric Sasso, MD Crescendo Bioscience ® is the sponsor of the presentation.
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Vectra® DA: A Better Measure for
Predicting Radiographic Progression in
Rheumatoid Arthritis?
Ronald F. van Vollenhoven, MD, PhD
Jonathan Kay, MD
Andrew Laster MD, FACR
Eric Sasso, MD
Crescendo Bioscience® is the sponsor of the presentation.
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Agenda • Introduction:
- Eric Sasso, MD, Crescendo Bioscience
• The Role of CRP and ESR in Assessing RA Disease Activity:
- Jonathan Kay, MD, UMass Medical School
• Vectra® DA and Radiographic Progression:
- Eric Sasso, MD, Crescendo Bioscience
- Ronald van Vollenhoven, MD, PhD, Karolinska Institute
• Clinical Applications of Vectra DA:
- Andrew Laster, MD, FACR, Arthritis & Osteoporosis Consultants of the
Carolinas
• Q&A
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Vectra® DA Intended Use
• Vectra DA, a multi-biomarker blood test, was validated to
measure disease activity in adults diagnosed with
rheumatoid arthritis
• Test results are intended to
– Aid in the assessment of disease activity in RA patients
– Help inform patient management decisions when used in
conjunction with standard clinical assessment
• This test is not intended or validated to:
– Diagnose RA
– Guide therapy selection
• Interpretation of individual biomarker results has not
been validated
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Vectra® DA Biomarkers: Twelve biomarkers reflect the
heterogeneity of RA
Biomarker Biomarker Category Primary Role
VCAM-1 Adhesion Molecules Cellular influx and tissue expansion
EGF
VEGF-A
Growth Factors
IL-6
TNF-RI
Cytokine-related Proteins Local inflammation and destruction
MMP-1
MMP-3
Matrix Metalloproteinases Cartilage degradation and joint
• Community based independent rheumatology practice in
Charlotte, NC (pop.1.5 x 106)
• 6 rheumatologists / 2 NPs / 41 total staff
• Single office
• Full capability with X ray and U/S
• MRI not available in office without CON in NC
Arthritis & Osteoporosis Consultants of the
Carolinas
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Use of Vectra® DA in My Practice
• Number of RA patients in practice: 456
• Tested with Vectra DA in Last 12 Months: 322 (71%)
– Single test 52%
– > 1 test 48%
Score Composite for Last
12 Months Score Distribution for
Last 12 Months
10 20 30 40 50 60 70 80 90 100 0%
5% 10%
15%
20% 25%
30%
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• 12-30% of patients with apparent clinical remission have
evidence of radiographic progression 1,2,3
– Advanced imaging with U/S or MRI:
• has superior sensitivity compared to clinical evaluation for
detecting synovitis
• correlates with subsequent X ray damage and functional
outcome
• ~ 60% of patients not in clinical remission do not progress
radiographically 2
1Brown et al Arthritis Rheum 2008; 58(10):2958-2967. 2Lillegraven et al Ann Rheum Dis 2012; 71(50):681-686. 3van der Helm-van Mil et al Rheumatology 2013; 52 (5):839-846.
– Assessment of disease activity in single joint instead of
MRI
* Change in Vectra DA score during tocilizumab treatment may underestimate the
change in clinical response
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Summary: Clinical Utility of Vectra® DA in My Practice
• Vectra DA has had a significant impact on my ability to better
assess disease activity in RA patients with a variety of
presentations (there is not one ideal patient type where Vectra
DA is best suited):
– Identify patients with sub-clinical synovitis
– Exclude active RA in setting of co-morbidities
– Assess early in disease course, likelihood of progression with
radiographic damage
• Vectra DA has resulted in more selective utilization of advanced
diagnostic imaging in my practice
• Vectra DA has allowed me to more confidently manage drug
therapy in a treat-to-target approach
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Q&A
Crescendo Bioscience® is the sponsor of the presentation.
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Oral Presentations Wednesday, Nov. 19; Room 258B
9:30–9:45 AM
2973 The Multi-Biomarker Disease Activity Score as a Predictor of Radiographic Progression in a Registry of
Patients with Rheumatoid Arthritis; E.H. Sasso, G. Wu, C.C. Hwang, M.E. Weinblatt, N.A. Shadick,C. Alexander, O.G.
Segurado
9:45–10:00 AM
2974 Multi-Biomarker Disease Activity Score is Associated with Power Doppler Ultrasound in Patients with
Rheumatoid Arthritis in Low Disease Activity State; M.H. Ma, T. Garrood, W. Li, N.A. Defranoux, G.H. Kingsley, A.P.
Cope, D. Scott
Poster Presentations
Sunday, Nov 16, 9:00–11:00 AM; Exhibit Hall B
364 In Early Rheumatoid Arthritis, the Multi-Biomarker Disease Activity Score at Different Time-Points is
Predictive of Subsequent Radiographic Progression; K. Hambardzumyan R.J. Bolce, S. Saevarsdottir, K. Forslind,
I.F. Petersson, P. Geborek, E.H. Sasso, D. Chernoff, S. Cruickshank, R.F. van Vollenhoven
367 In Early Rheumatoid Arthritis Patients with Non-Response to Methotrexate Monotherapy the Change in Multi-
Biomarker Disease Activity Score is Differentially Associated with Subsequent Response to Non-Biological
Versus Biological Therapy; K. Hambardzumyan, R.J. Bolce, S. Saevarsdottir, K. Forslind, I.F. Petersson, P. Geborek,
E.H. Sasso, D. Chernoff, S. Cruickshank, R.F. van Vollenhoven
376 Using the Multi-Biomarker Disease Activity Score as a Complementary Inclusion Criterion for Clinical Trials
in Rheumatoid Arthritis May Enhance Recruitment; R.F. van Vollenhoven, R. Bolce, K. Hambardzumyan, S.
Saevarsdottir, K. Forslind, I.F. Petersson, E.H. Sasso, C.C Hwang, O.G. Segurado, P. Geborek
Tuesday, Nov. 18; 9:00–11:00 AM Exhibit Hall B
2615 Preliminary Assessment of a Multi-Biomarker Disease Activity Test for Axial Spondyloarthritis; W.P. Maksymowych, S. Wichuk, P.S. Eastman, E.H. Sasso