Histological disease activity in patients with microscopic colitis is not related to clinical disease activity or long‐term prognosis

2021 ◽  
Author(s):  
Lærke Müller Olsen ◽  
Peter Johan Heiberg Engel ◽  
Danny Goudkade ◽  
Vincenzo Villanacci ◽  
Jeppe Thagaard ◽  
...  
Keyword(s):  
Disease Activity ◽  
Microscopic Colitis ◽  
Clinical Disease ◽  
Clinical Disease Activity ◽  
Long Term Prognosis

scholarly journals AB0105 A SYSTEMATIC REVIEW OF THE MULTI-BIOMARKER DISEASE ACTIVITY SCORE FOR THE DIAGNOSIS AND TREATMENT IN RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1081.1-1081
Author(s):  
D. Abdelhafiz ◽  
M. Bukhari
Keyword(s):  
Rheumatoid Arthritis ◽  
Systematic Review ◽  
Prospective Study ◽  
Disease Activity ◽  
Literature Search ◽  
Clinical Disease ◽  
Diagnosis And Treatment ◽  
Response To Treatment ◽  
Clinical Disease Activity

Background:Biomarkers are important tools that can be used in the diagnosis and monitoring of rheumatoid arthritis (RA). The multi-biomarker disease activity (MBDA) score has shown a clinical value in the overall management of patients with RA.Objectives:To systematically explore the role of MBDA score for diagnosis and treatment of RA.Methods:A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. Key words used included: ‘Rheumatoid Arthritis’, ‘Biomarkers’, ‘Diagnosis’, ‘Treatment’, ‘Outcome’, ‘Response to treatment’, ‘Disease Activity’, and ‘MBDA’. The literature search included papers published in 2020 and in the English language.Results:This literature search has yielded 5 studies that investigated the impact of MBDA score on the diagnosis, treatment or disease progression of RA and have reported clear and clinically validated diagnostic or therapeutic effects. The first study prospectively investigated 130 patients with RA, and has shown that the MBDA score moderately correlated with disease activity at baseline (r = 0.36 for adjusted MBDA score, r = 0.44 for unadjusted MBDA score) and at 16 weeks follow up (r = 0.20 for adjusted MBDA, r = 0.30 unadjusted MBDA) but did not predict treatment response to methotrexate. There was also moderate correlation between MBDA scores and erythrocyte sedimentation rate (ESR) at baseline (r = 0.54 and 0.59) and week 16 (r = 0.42 and 0.51). The second was a cross-sectional study, which included 104 patients (50% female) and demonstrated that adjusted and unadjusted MBDA score correlated similarly with clinical disease activity. Adjustment for leptin reduced the influence of adiposity, particularly among women but significantly estimated higher disease activity in thin men and women. However, MBDA score predicted disease activity and response to tofacitinib treatment, measured by musculoskeletal ultrasound score (MSUS), in RA patients as demonstrated by the third prospective study that included 25 patients (all p< 0.05). Correlation was found between baseline MSUS and MBDA score, and with 12-week changes in clinical disease activity (r = 0.45–0.62, p < 0.05). Regression analysis showed associations between baseline MBDA score and 6-week (all p< 0.05) and 12-week change in change in clinical disease activity (p= 0.03). The fourth prospective study which included 92 patients with RA, showed that MBDA could predict response to treatment of methotrexate with or without prednisolone. The improvement was faster in the first month of treatment followed by gradual improvement over the following 6 months. Changes from baseline to 12 months for disease activity and MBDA score showed a significant correlation for methotrexate and prednisolone (r= 0.57, p= 0.002), methotrexate and placebo (r= 0.57, p= 0.001) and for all groups (r= 0.56, p< 0.001). The final prospective study which included 148 patients, showed that MBDA predicted remission in RA and could differentiate between small differences in disease activity (low disease activity vs remission states). Baseline MBDA score discriminated baseline remission, area under the curve (AUC) 0.68-0.75, and intermittent/sustained remission (AUC 0.65-0.74). MBDA also predicted long term remission after one year.Conclusion:MBDA appears to be a useful tool in day-to-day clinical practice that can be used in the diagnosis, monitoring of treatment and prediction of outcomes of patients with RA. MBDA correlated well with disease activity and response to treatment. It is also a good predictor of long-term disease remission.Disclosure of Interests:None declared

Body Mass Index Impact on Disease Activity, Clinical and Sonographic Remission Rates in Patients with Rheumatoid Arthritis

2019 ◽  
Vol 15 (3) ◽  
pp. 215-223
Author(s):  
Tanya Sapundzhieva ◽  
Rositsa Karalilova ◽  
Anastas Batalov
Keyword(s):  
Rheumatoid Arthritis ◽  
Body Mass Index ◽  
Disease Activity ◽  
Body Mass ◽  
Normal Weight ◽  
Clinical Disease ◽  
Clinical Disease Activity ◽  
Das 28 ◽  
Remission Rates ◽  
Activity Indices

Aim: To investigate the impact of body mass index (BMI) on clinical disease activity indices and clinical and sonographic remission rates in patients with rheumatoid arthritis (RA). Patients and Methods: Sixty-three patients with RA were categorized according to BMI score into three groups: normal (BMI<25), overweight (BMI 25-30) and obese (BMI≥30). Thirty-three of them were treated with conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs), and 30 with biologic DMARDs (bDMARDs). Patients underwent clinical and laboratory assessment and musculoskeletal ultrasound examination (MSUS) at baseline and at 6 months after initiation of therapy. We evaluated the rate of clinical and sonographic remission (defined as Power Doppler score (PD) = 0) and its correlation with BMI score. Results: In the csDMARDs group, 60% of the normal weight patients reached DAS28 remission; 33.3% of the overweight; and 0% of the obese patients. In the bDMARDs group, the percentage of remission was as follows: 60% in the normal weight subgroup, 33.3% in the overweight; and 15.8% in the obese. Within the csDMARDs treatment group, two significant correlations were found: BMI score–DAS 28 at 6th month, rs = .372, p = .033; BMI score–DAS 28 categories, rs = .447, p = .014. Within the bDMARDs group, three significant correlations were identified: BMI score–PDUS at sixth month, rs = .506, p =.004; BMI score–DAS 28, rs = .511, p = .004; BMI score–DAS 28 categories, rs = .592, p = .001. Sonographic remission rates at 6 months were significantly higher in the normal BMI category in both treatment groups. Conclusion: BMI influences the treatment response, clinical disease activity indices and the rates of clinical and sonographic remission in patients with RA. Obesity and overweight are associated with lower remission rates regardless of the type of treatment.

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