Rheumatoid Arthritis Testing Services & Comprehensive RA Portfolio (2024)

Rheumatoid Arthritis Testing

Rheumatoid arthritis affects an estimated 1.5 million people in the United States.¹ For most people with RA, early diagnosis and treatment can control joint pain and swelling and lessen joint damage.

Labcorp is your trusted single-source solution for RA testing,from RA diagnosis to disease activity monitoring and treatment management.

RA Related Testing(Opens in a new window)

RA Diagnosis

Early RA diagnosis and initiation of disease-suppressing therapy may improve clinical outcomes and reduce the accrual of joint damage and disability.² Labcorp offers several RA-specific markers that, when used in combination, provide industry-leading sensitivity and help support an early diagnosis of RA. Prognosis is dependent on early, accurate diagnosis and establishing an effective treatment plan.³ Diagnosis and classification of RA has relied heavily on anti-cyclic citrullinated peptide (Anti-CCP) and rheumatoid factor (RF) IgM.² New markers are available to better identify patients with RA, stratify patients for risk of joint destruction and/or radiographic progression, and monitor disease activity and effectiveness of treatment.

Learn More About RA Novel Markers

Disease Activity Monitor and Prognostic Tool

Vectra® by Labcorp

Achieving a state of disease remission in rheumatoid arthritis (RA) is a primary treatment goal. Until the desired treatment target is reached, drug therapy should be adjusted at least every three to six months. The desired treatment target should be maintained throughout the remaining course of the disease. Vectra provides an objective measure of RA inflammation and can be used to complement other disease activity measures.

RA Treatment Monitoring

Although RA treatment is multifaceted, medications play an important role in patient management. Newly developed laboratory assays aid physicians in monitoring use and maximizing effectiveness of both disease-modifying anti-rheumatic drugs (DMARDs) and biologics.

Monitoring Biologics

Labcorp offers serum measurement of drug and anti-drug antibodies for patients on biologic drug therapy. Drug and anti-drug antibody levels provide the pharmaco*kinetic and immunogenic assessment that discerns the underlying mechanism of an inadequate response to biologic drug. Testing may be ordered at any time during therapy, though sample collection before the next infusion or injection is recommended.

• Patient on Biologic*
  • Inadequate Response
    • Free drug trough levels are undetectable or low to intermediate and
      • Anti-drug antibody is undetectable to low
        • Pharmaco*kinetic insufficiency:Increase dose
      • Anti-drug antibody is low to intermediate
        • "Reversible" immunogenicity: Increase dose +/-
          Consider adding MTX or Thiopurine
      • Anti-drug antibody is high
        • "Late refractory" immunogenicity: Consider switching biologics within class (or to a different mechanism)
    • Free drug trough level is therapeutic and
      • Anti-drug antibody is undetectable to low
        • Pharmacodynamic (mechanistic) response failure: Consider switching biologics out-of-class (after confirming active inflammation
  • Good Response
    • Free drug trough level is sub-therapeutic and
      • Anti-drug antibody is undetectable to low
        • Dose optimize to maximally beneficial drug trough concentration
    • Free drug trough level is persistently at or above targetat 12 months and
      • Anti-drug antibody is undetectable to low
        • Adequate dose: Maintain dose or consider tapering down

* Proposed algorithm for RA patients. A consensus has yet to be reached about target ranges and maximally effective concentrations.³Optimal drug concentration is patient-specific and depends on disease and desired therapeutic endpoint.

References

1. Handout on Health: Rheumatoid Arthritis. National Institute of Arthritis and Musculoskeletal and Skin Diseases Website http://www.niams.nih.gov/health_info/Rheumatic_Disease/default.asp#ra_2 . Accessed February 25, 2014.
2. Aletha D, Neogi T, Silman AJ. 2010 rheumatoid arthritis classification criteria. Arthritis Rheum. 2010;62(9):2569-2581.
3. Maksymowych WP, Naides SJ, Bykerk V, Siminovitch KA, et al. Serum 14-3-3η is a novel marker that complements current serological measurements to enhance detection of patients with rheumatoid arthritis. J Rheumatol. 2014 Nov;41(11):2104-13. doi: 10.3899/jrheum.131446. Epub 2014 Aug 15. PMID: 25128504.
4. Maksymowych WP, Boire G, van Schaardenburg D, et al. 14-3-3η Autoantibodies: Diagnostic Use in Early Rheumatoid Arthritis. J Rheumatol. 2015 Sep;42(9):1587-94. doi: 10.3899/jrheum.141385. Epub 2015 Jul 15. PMID: 26178283.
5. Curtis, J.R., Weinblatt, M.E., Shadick, N.A. et al. Validation of the adjusted multi-biomarker disease activity score as a prognostic test for radiographic progression in rheumatoid arthritis: a combined analysis of multiple studies. Arthritis Res Ther 23, 1 (2021). https://doi.org/10.1186/s13075-020-02389-4 .
6. Curtis, J.R., Xie, F., Crowson, C.S. et al. Derivation and internal validation of a multi-biomarker based cardiovascular disease risk prediction score for rheumatoid arthritis patients. Arthritis Res Ther 22, 282 (2020). https://doi.org/10.1186/s13075-020-02355-0 .
7. Goodman S. Measuring methotrexate polyglutamates. Clin Exp Rheumatol. 2010 Sep-Oct; 28 (5 Suppl 61): S24-S26.
8. De Rotte MCFJ, den Boer E, de Jong PHP, et al. Methotrexate polyglutamates in erythrocytes are associated with lower disease activity in patients with rheumatoid arthritis. Ann Rheum Dis. 2013;0:1-7.
9. Chevaux JB, Peyrin-Biroulet L, Sparrow MP. Optimizing thiopurine therapy in inflammatory bowel disease. Inflamm Bowel Dis. 2011 Jun; 17(6): 1428-1435.