At the annual meeting of the American College of Rheumatology (ACR), Myriad Genetics, Salt Lake City, shared new data further demonstrating that Vectra testing and three additional biomarkers, combined with traditional risk factors, can predict the risk of cardiovascular (CV) events in patients with rheumatoid arthritis (RA). Also, presented at the meeting was a study showing that Vectra is a significant predictor for joint damage and is a better predictor than several tested subjective measures. Vectra is an advanced blood test that objectively measures inflammation caused by RA.
“Due to inflammatory processes, patients with RA have approximately 50% greater risk for cardiovascular disease (CVD), the leading cause of mortality among patients with RA, which accounts for 30% to 40% of deaths.” says Elena Hitraya, MD, PhD, rheumatologist and chief medical officer at Myriad Autoimmune. “The data shows that a newly developed Multi-Biomarker Based CVD Risk Score can accurately predict the risk of major cardiovascular events over the next three years across various subgroups of RA patients. Knowing a patient’s future risk of potential joint damage and cardiovascular events, clinicians can make more informed treatment decisions with the goal of achieving better health outcomes.”
Vectra Posters at ACR
External Validation of a Multi-Biomarker-Based Cardiovascular Disease Risk Prediction Score for Rheumatoid Arthritis Patients
This validation study assessed the performance of the Multi-Biomarker-Based Cardiovascular Disease Risk Prediction Score in a non-Medicare patient population. The goal of the study was to validate the risk score in a cohort (N=44,379) with median age of 54 (46-60) years that was younger than, and independent of, the Medicare cohort used for test development. The study found that the Vectra-based CVD risk score (mean 3.3, IQR 2.8-3.8) was a significant predictor of CVD risk, with hazard ratio (HR) = 3.99 (95% CI: 3.52-4.51, p=4.4×10-95); i.e., for every 1-unit increase in the score, the CVD event rate was ~4 times higher.
Performance of the MBDA-based CVD risk score in RA patient groups of clinical interest
The purpose of this study was to evaluate the ability of a risk score that combines Vectra, TNF-R1, MMP-3, leptin, age and traditional risk factors (diabetes, hypertension, smoking, history of CVD) to predict 3-year risk for myocardial infarction (MI), stroke, or fatal CVD for RA patients in subgroups of interest. The study found that, in a cohort of 10,275 Medicare patients, with high prevalence of comorbidities, such as diabetes (40%) and hypertension (79%), the Vectra-based CVD risk prediction score had good accuracy overall and in subgroups based on level of a Vectra score, sex, and statin use.
Comparison of MBDA Score, Patient Global Assessment, and Evaluator Global Assessment for Predicting Risk of Radiographic Progression
In a cohort of 766 patients from one registry and two clinical trials, this study compared Vectra, patient global assessment (PGA), and evaluator global assessment (EGA) in terms of their abilities to predict risk of radiographic progression (RP) (i.e. new joint damage). The study found Vectra significantly predicted risk for RP (Figure 1A in the poster), with univariate OR=1.53, p=5.3×10-8. In contrast, neither PGA nor EGA predicted RP (p=0.38 and 0.47, respectively). Vectra predicted RP regardless of whether PGA and EGA were concordant or discordant.
RA affects more than one million people in the United States. Lost productivity associated with RA is substantial, with approximately 20-70% of individuals working at the time of their RA diagnosis being disabled after seven to 10 years. RA is an inflammatory autoimmune disease that attacks a patient’s joints and often affects other organ systems, contributing to increased disability, significant morbidity, increased mortality and financial burden. The risk of RP, defined as change in total Sharp score >5 units per year, is a function of Vectra score. Increased risk of RP means greater irreversible joint damage.
Three out of four rheumatologists have used Vectra and have ordered more than one million tests for their RA patients. The ACR includes Multi-Biomarker Disease Activity Score (Vectra) as a disease activity measure that meets the minimum standard for regular use for patients with rheumatoid arthritis. Those recommendations were published in the journal Arthritis Care & Research.1
- England BR, Tiong BK, Bergman MJ, et al. 2019 Update of the American College of Rheumatology Recommended Rheumatoid Arthritis Disease Activity Measures. Arthritis Care Res (Hoboken).2019;71(12):1540-1555. doi:10.1002/acr.24042