Going Beyond Signs and Symptoms with Vectra™ DA
High Vectra DA Score Prior to Disease Flare A Vectra DA Case Study †
Visit 1: June 11 A 69 year old woman with a co-morbidity of osteoarthritis comes into clinic. She was referred by her primary care physician. During the visit, the rheumatologist diagnoses her with rheumatoid arthritis (RA). She has low swollen and tender joint counts and morning stiffness of 60 minutes. She is tender in her right 3rd MCP and 2nd and 4th PIPs. There is also swelling in her left knee following hyaluronic acid injection the week prior by her orthopedist. She is currently not on any RA medications.
The physician orders a Vectra DA test to obtain a baseline assessment of her RA disease activity. The Vectra DA score is 71 indicating high disease activity. The physician suggests to the patient that she take methotrexate, but the patient declines. The physician starts her on sulfasalazine 500 mg BID.
Visit 2: June 23The physician brings the patient back 12 days later to assess her disease activity. The patient’s symptoms have increased to 20 swollen and 30 tender joints.
• TJC = 30 • Morning Stiffness = 60 min • Previous Vectra DA score = 71
Action Taken: With the high clinical symptoms, the physician adds methotrexate 10 mg QW immediately and increases it to 15 mg QW over a 3 week time period. Additionally, he increases her sulfasalazine dosage to 1000 mg BID. The high Vectra DA score of 71 twelve days earlier preceded the increased signs and symptoms that followed.
Visit 3-6: July 9, Aug 11, Aug 19, Sept 17On the next several patient visits, the patient’s Vectra DA scores consistently remain high while the tender and swollen joints fluctuate and the CRP and ESR levels decline. The MRI on July 9th show signs of erosions, joint space narrowing, bone edema, synovitis and synovial thickening. The physician adds infliximab 400 mg Q 6w on July 9th.
* The range reflects the precision of the score based on repeat measurements
† Based on information from an actual patient case submitted by a healthcare provider; actual Vectra DA scores;
individual identifiers including actual dates of service have been modified to protect patient privacy.
‡ This CRP level is from a lab other than Crescendo Bioscience. Other CRP values reported are from Vectra DA.
CRP values cannot be used interchangeably with other labs’ CRP.
Going Beyond Signs and Symptoms with Vectra™ DA
The patient’s ESR has increased to 118 mm/hr and the CRP has increased to >25 mg/dL. The physician orders another Vectra DA test and then gives the patient an infusion of abatacept. The Vectra DA score prior to the infusion is 87. Action Taken: The physician will monitor the patient’s progress on abatacept. Visit Date May 25 Jun 11 Jun 23 Jul 9 Aug 11 Aug 19 SJC66/TJC68 1/5 CRP mg/dL ESR mm/hr Vectra DA Score
11 SPECIMEN COLLECTION DATE May 25 Jun 11 Jun 23 Jul 9 Aug 11 Aug 19
Vectra DA was validated in adults with RA. Test results are intended to aid in the assessment of disease activity in RA patients when used in conjunction with standard clinical assessment. This test is not intended or validated to diagnose RA. Vectra, Crescendo Bioscience and the associated logos are trademarks of Crescendo Bioscience, Inc. 2011 Crescendo Bioscience, Inc. All rights reserved. Printed in the USA.
• Missas ofta- finns ofta en tro att det bara är – Mindre aktiva, mer följsamma, mindre aggressiva, förvirrade, glömska, tysta dagdrömmare med läxläsningssvårigheter• Alla presterar sämre än deras begåvning anger• Flickor har ofta ”synlig” sämre funktion hemma—– Ex röker mer o tidigare än pojkar( får tidigare och • Bristsymtom av budbärarsubstanser i • Fli