Jeffrey Curtis, MD: Vectra Test Predicts Radiographic Progression, CV Risk

A simple blood test could provide rheumatologists and clinicians with the ability to predict radiographic progression and the risk of cardiovascular events in people with rheumatoid arthritis (RA).

Two studies presented at the 2019 American College of Rheumatology annual meeting in Atlanta, GA revealed Vectra, a multi-biomarker molecular blood test, was able to predict risk of radiographic progression within one year and, in combination with other clinical measures, could predict risk of first cardiovascular events in RA patients.

In the first study, which pertained to the Vectra test’s ability to predict radiographic progression, investigators analyzed data from 973 patients across 4 cohorts. Results of this analysis revealed adjusted Vectra score was a superior predictor of radiographic progression at 1 year compared to common disease activity assessments including DAS28-CRP, CRP, CDAI, and swollen joint count.

Investigators also noted patients with a low adjusted Vectra score had a 1% to 3% risk of radiographic progression in 1 year. In comparison, patients with a moderate to high Vectra score had between a 7% and 47% increased risk.

To assess the test’s ability to determine risk of a cardiovascular event, investigators evaluated a cohort of 30,751 Medicare patients with RA. For the purpose of this study, the primary endpoint was a composite of heart attack, stroke, and death occurring within 3 years of testing.

Upon analyses, the Vectra CVD score was compared to 4 other prediction models. Results of the comparisons revealed Vectra was a significant predictor of cardiovascular risk and was superior to the other prediction models.

Investigators noted when risk scores were converted into 3-year percentage risk for cardiovascular events 80% of patients were found to have a moderate or high risk of a cardiovascular event.

To learn more about how implementation of Vectra could improve and streamline clinical practices, MD Magazine® sat down with lead investigator Jeffrey Curtis, MD, MPH, rheumatologist and Professor of medicine at the University of Alabama at Birmingham, at ACR 2019.

MD Mag: How can utilization of the Vectra test improve rheumatology practices in a real-world setting?

So, the Vectra test is a simple blood test. It's ordered in a doctor's office, typically a rheumatologist office. It's designed to assess inflammation related to rheumatoid arthritis disease activity. So inflammation and rheumatoid arthritis doesn't just stay in people's joints, it spills out and it can be measured in the blood. So this is a simple blood test. The research that's being presented at this meeting based on Myriad's Vectra test allows you not just to assess disease activity and inflammation today, but to predict future irreversible joint damage. That's one aspect of it.

The second aspect of it is to predict the future risk for cardiovascular event—so, a heart attack or a stroke—and the reason that that's so critical, is we can assess, as clinicians, how people are doing today with their RA, but we want them to live well for a lifetime not just feel better today.

To do that, we don't want irreversible joint damage to progress and cardiovascular disease kills our patients with a 50% increased risk in rheumatoid arthritis. The problem is, it's a puzzle to know who's going to have that joint damage that we can never undo. We don't know who's going to be at highest risk for a heart attack, but now with a Vectra test, based on the results of the research presented at this meeting, we now have keys to unlock that puzzle.