In Part 1, we pointed out that patients and clinicians look at Rheumatoid Arthritis disease activity in different ways. Rheumatologists especially focus on joints, and actually particular kinds of joint activity. Patients face much more with regard to disease activity, as reflected in the post and comments page.
In Part 2, we looked at two specific aspects of RA disease activity that have not been traditionally emphasized. I called the new research “a good sign.” It’s a step in the right direction if investigators realize that there is disease activity earlier than erosions show on x-rays and begin to look for ways to assess it. Patients, of course know this since symptoms of disease activity are obvious to them before being detectable on so-called objective tests.
Three things ought to be considered in RA disease activity, as mentioned:
- The patient’s estimation of his disease activity (more here)
- Appropriate monitoring using available tests (read more here!)
- A more complete paradigm which includes various aspects of the disease
We could achieve the first by using patient outcome measures (asking patients). With researchers thinking outside the x-ray box, we can begin to achieve the third. But what about objective tests for monitoring (number 2)?
The Vectra DA (RA Disease Activity) test
This test actually measures 12 different proteins that have been found to be associated with Rheumatoid Arthritis disease activity, combined into one DA score. The Vectra DA test was developed by considering almost 400 different “protein biomarkers” and refining the list to eventually choose “those 12 with the greatest ability to evaluate RA disease activity.”
Some insurance policies are providing more coverage for the test than others. There is also a patient assistance program. Since it’s new, many doctors don’t know about it yet, but there may be more press about it after next month’s ACR meeting. Meanwhile, you can read more details about the test:
Will the Vectra DA work better for patients?
Will Vectra DA test results be an accurate reflection of what RA patients experience?
It remains to be seen whether the wider patient population will find the test results correlate well with their estimation of disease activity. And it could take time to confirm how well it parallels unseen disease activity like heart or lung damage. Patient outcome measures have long been shown to be the most accurate measure of RA prognosis.
The Vectra DA data look good so far. But this patient has good reason to be skeptical of so-called “objective” tests. Once upon a time, rheumatology told RA patients that prednisone was a cure… Then they called the rheumatoid factor test “The RA test.” Then, we were told that “CRP is the only evidence of disease activity.” But, I’m an optimist, so let’s hope the Vectra provides evidence of what patients often know already – how active the RA monster is.
A handful of the important posts here on this vital topic
- A Paradigm Shift in Rheumatoid Arthritis Disease Activity? Part 2
- Part 1: A Paradigm Shift in Rheumatoid Arthritis Disease Activity
- RA News Headlines: Ibuprofen for Pain, Orencia Shots, New RA test, RA Inflammation Increases CV Risk
- Evidenced-based Medicine or Easy-bake Oven: Tension Between Evidence and Reality
- 2 Reasons Monitoring Rheumatoid Arthritis Matters
- 10 year old efforts to solve this problem: Measuring Rheumatoid Arthritis Disease Activity
- Winter Solstice Lunar Eclipse: Was the Moon Really Red?