A Multibiomarker Disease Activity Score for Rheumatoid Arthritis Predicts Radiographic Joint Damage in the BeSt Study

From the Department of Rheumatology, Leiden University Medical Center, Leiden; Reinier de Graaf Hospital, Delft; Maasstad Hospital, Rotterdam; Haga Hospital, the Hague; Reade organization; VU Medical Center, Amsterdam, the Netherlands; Crescendo Bioscience, South San Francisco, California, USA. Supported by a government grant from the Dutch Insurance Companies, with additional funding from Schering-Plough B.V. and Janssen B.V. No financial support from Crescendo Bioscience. I.M. Markusse, MD; L. Dirven, PhD; M. van den Broek, MD, PhD, Department of Rheumatology, Leiden University Medical Center; C. Bijkerk, MD, PhD, Department of Rheumatology, Reinier de Graaf Hospital; K.H. Han, MD, Department of Rheumatology, Maasstad Hospital; H.K. Ronday, MD, PhD, Department of Rheumatology, Haga Hospital; R. Bolce, MSN; E.H. Sasso, MD, Crescendo Bioscience; P.J.S.M. Kerstens, MD, PhD, Department of Rheumatology, Reade; W.F. Lems, MD, PhD, Department of Rheumatology, Reade, and VU Medical Center; T.W.J. Huizinga, MD, PhD; C.F. Allaart, MD, PhD, Department of Rheumatology, Leiden University Medical Center. Address correspondence to Dr. I.M. Markusse, Leiden University Medical Center, Department of Rheumatology, PO Box 9600, 2300 RC Leiden, The Netherlands. E-mail: i.m.markusse@lumc.nl. Full Release Article. For details see Reprints/Permissions at jrheum.org. Accepted for publication June 4, 2014.

From the Department of Rheumatology, Leiden University Medical Center, Leiden; Reinier de Graaf Hospital, Delft; Maasstad Hospital, Rotterdam; Haga Hospital, the Hague; Reade organization; VU Medical Center, Amsterdam, the Netherlands; Crescendo Bioscience, South San Francisco, California, USA. Supported by a government grant from the Dutch Insurance Companies, with additional funding from Schering-Plough B.V. and Janssen B.V. No financial support from Crescendo Bioscience. I.M. Markusse, MD; L. Dirven, PhD; M. van den Broek, MD, PhD, Department of Rheumatology, Leiden University Medical Center; C. Bijkerk, MD, PhD, Department of Rheumatology, Reinier de Graaf Hospital; K.H. Han, MD, Department of Rheumatology, Maasstad Hospital; H.K. Ronday, MD, PhD, Department of Rheumatology, Haga Hospital; R. Bolce, MSN; E.H. Sasso, MD, Crescendo Bioscience; P.J.S.M. Kerstens, MD, PhD, Department of Rheumatology, Reade; W.F. Lems, MD, PhD, Department of Rheumatology, Reade, and VU Medical Center; T.W.J. Huizinga, MD, PhD; C.F. Allaart, MD, PhD, Department of Rheumatology, Leiden University Medical Center. Address correspondence to Dr. I.M. Markusse, Leiden University Medical Center, Department of Rheumatology, PO Box 9600, 2300 RC Leiden, The Netherlands. E-mail: i.m.markusse@lumc.nl. Full Release Article. For details see Reprints/Permissions at jrheum.org. Accepted for publication June 4, 2014.

From the Department of Rheumatology, Leiden University Medical Center, Leiden; Reinier de Graaf Hospital, Delft; Maasstad Hospital, Rotterdam; Haga Hospital, the Hague; Reade organization; VU Medical Center, Amsterdam, the Netherlands; Crescendo Bioscience, South San Francisco, California, USA. Supported by a government grant from the Dutch Insurance Companies, with additional funding from Schering-Plough B.V. and Janssen B.V. No financial support from Crescendo Bioscience. I.M. Markusse, MD; L. Dirven, PhD; M. van den Broek, MD, PhD, Department of Rheumatology, Leiden University Medical Center; C. Bijkerk, MD, PhD, Department of Rheumatology, Reinier de Graaf Hospital; K.H. Han, MD, Department of Rheumatology, Maasstad Hospital; H.K. Ronday, MD, PhD, Department of Rheumatology, Haga Hospital; R. Bolce, MSN; E.H. Sasso, MD, Crescendo Bioscience; P.J.S.M. Kerstens, MD, PhD, Department of Rheumatology, Reade; W.F. Lems, MD, PhD, Department of Rheumatology, Reade, and VU Medical Center; T.W.J. Huizinga, MD, PhD; C.F. Allaart, MD, PhD, Department of Rheumatology, Leiden University Medical Center. Address correspondence to Dr. I.M. Markusse, Leiden University Medical Center, Department of Rheumatology, PO Box 9600, 2300 RC Leiden, The Netherlands. E-mail: i.m.markusse@lumc.nl. Full Release Article. For details see Reprints/Permissions at jrheum.org. Accepted for publication June 4, 2014.

From the Department of Rheumatology, Leiden University Medical Center, Leiden; Reinier de Graaf Hospital, Delft; Maasstad Hospital, Rotterdam; Haga Hospital, the Hague; Reade organization; VU Medical Center, Amsterdam, the Netherlands; Crescendo Bioscience, South San Francisco, California, USA. Supported by a government grant from the Dutch Insurance Companies, with additional funding from Schering-Plough B.V. and Janssen B.V. No financial support from Crescendo Bioscience. I.M. Markusse, MD; L. Dirven, PhD; M. van den Broek, MD, PhD, Department of Rheumatology, Leiden University Medical Center; C. Bijkerk, MD, PhD, Department of Rheumatology, Reinier de Graaf Hospital; K.H. Han, MD, Department of Rheumatology, Maasstad Hospital; H.K. Ronday, MD, PhD, Department of Rheumatology, Haga Hospital; R. Bolce, MSN; E.H. Sasso, MD, Crescendo Bioscience; P.J.S.M. Kerstens, MD, PhD, Department of Rheumatology, Reade; W.F. Lems, MD, PhD, Department of Rheumatology, Reade, and VU Medical Center; T.W.J. Huizinga, MD, PhD; C.F. Allaart, MD, PhD, Department of Rheumatology, Leiden University Medical Center. Address correspondence to Dr. I.M. Markusse, Leiden University Medical Center, Department of Rheumatology, PO Box 9600, 2300 RC Leiden, The Netherlands. E-mail: i.m.markusse@lumc.nl. Full Release Article. For details see Reprints/Permissions at jrheum.org. Accepted for publication June 4, 2014.

From the Department of Rheumatology, Leiden University Medical Center, Leiden; Reinier de Graaf Hospital, Delft; Maasstad Hospital, Rotterdam; Haga Hospital, the Hague; Reade organization; VU Medical Center, Amsterdam, the Netherlands; Crescendo Bioscience, South San Francisco, California, USA. Supported by a government grant from the Dutch Insurance Companies, with additional funding from Schering-Plough B.V. and Janssen B.V. No financial support from Crescendo Bioscience. I.M. Markusse, MD; L. Dirven, PhD; M. van den Broek, MD, PhD, Department of Rheumatology, Leiden University Medical Center; C. Bijkerk, MD, PhD, Department of Rheumatology, Reinier de Graaf Hospital; K.H. Han, MD, Department of Rheumatology, Maasstad Hospital; H.K. Ronday, MD, PhD, Department of Rheumatology, Haga Hospital; R. Bolce, MSN; E.H. Sasso, MD, Crescendo Bioscience; P.J.S.M. Kerstens, MD, PhD, Department of Rheumatology, Reade; W.F. Lems, MD, PhD, Department of Rheumatology, Reade, and VU Medical Center; T.W.J. Huizinga, MD, PhD; C.F. Allaart, MD, PhD, Department of Rheumatology, Leiden University Medical Center. Address correspondence to Dr. I.M. Markusse, Leiden University Medical Center, Department of Rheumatology, PO Box 9600, 2300 RC Leiden, The Netherlands. E-mail: i.m.markusse@lumc.nl. Full Release Article. For details see Reprints/Permissions at jrheum.org. Accepted for publication June 4, 2014.

From the Department of Rheumatology, Leiden University Medical Center, Leiden; Reinier de Graaf Hospital, Delft; Maasstad Hospital, Rotterdam; Haga Hospital, the Hague; Reade organization; VU Medical Center, Amsterdam, the Netherlands; Crescendo Bioscience, South San Francisco, California, USA. Supported by a government grant from the Dutch Insurance Companies, with additional funding from Schering-Plough B.V. and Janssen B.V. No financial support from Crescendo Bioscience. I.M. Markusse, MD; L. Dirven, PhD; M. van den Broek, MD, PhD, Department of Rheumatology, Leiden University Medical Center; C. Bijkerk, MD, PhD, Department of Rheumatology, Reinier de Graaf Hospital; K.H. Han, MD, Department of Rheumatology, Maasstad Hospital; H.K. Ronday, MD, PhD, Department of Rheumatology, Haga Hospital; R. Bolce, MSN; E.H. Sasso, MD, Crescendo Bioscience; P.J.S.M. Kerstens, MD, PhD, Department of Rheumatology, Reade; W.F. Lems, MD, PhD, Department of Rheumatology, Reade, and VU Medical Center; T.W.J. Huizinga, MD, PhD; C.F. Allaart, MD, PhD, Department of Rheumatology, Leiden University Medical Center. Address correspondence to Dr. I.M. Markusse, Leiden University Medical Center, Department of Rheumatology, PO Box 9600, 2300 RC Leiden, The Netherlands. E-mail: i.m.markusse@lumc.nl. Full Release Article. For details see Reprints/Permissions at jrheum.org. Accepted for publication June 4, 2014.

From the Department of Rheumatology, Leiden University Medical Center, Leiden; Reinier de Graaf Hospital, Delft; Maasstad Hospital, Rotterdam; Haga Hospital, the Hague; Reade organization; VU Medical Center, Amsterdam, the Netherlands; Crescendo Bioscience, South San Francisco, California, USA. Supported by a government grant from the Dutch Insurance Companies, with additional funding from Schering-Plough B.V. and Janssen B.V. No financial support from Crescendo Bioscience. I.M. Markusse, MD; L. Dirven, PhD; M. van den Broek, MD, PhD, Department of Rheumatology, Leiden University Medical Center; C. Bijkerk, MD, PhD, Department of Rheumatology, Reinier de Graaf Hospital; K.H. Han, MD, Department of Rheumatology, Maasstad Hospital; H.K. Ronday, MD, PhD, Department of Rheumatology, Haga Hospital; R. Bolce, MSN; E.H. Sasso, MD, Crescendo Bioscience; P.J.S.M. Kerstens, MD, PhD, Department of Rheumatology, Reade; W.F. Lems, MD, PhD, Department of Rheumatology, Reade, and VU Medical Center; T.W.J. Huizinga, MD, PhD; C.F. Allaart, MD, PhD, Department of Rheumatology, Leiden University Medical Center. Address correspondence to Dr. I.M. Markusse, Leiden University Medical Center, Department of Rheumatology, PO Box 9600, 2300 RC Leiden, The Netherlands. E-mail: i.m.markusse@lumc.nl. Full Release Article. For details see Reprints/Permissions at jrheum.org. Accepted for publication June 4, 2014.

From the Department of Rheumatology, Leiden University Medical Center, Leiden; Reinier de Graaf Hospital, Delft; Maasstad Hospital, Rotterdam; Haga Hospital, the Hague; Reade organization; VU Medical Center, Amsterdam, the Netherlands; Crescendo Bioscience, South San Francisco, California, USA. Supported by a government grant from the Dutch Insurance Companies, with additional funding from Schering-Plough B.V. and Janssen B.V. No financial support from Crescendo Bioscience. I.M. Markusse, MD; L. Dirven, PhD; M. van den Broek, MD, PhD, Department of Rheumatology, Leiden University Medical Center; C. Bijkerk, MD, PhD, Department of Rheumatology, Reinier de Graaf Hospital; K.H. Han, MD, Department of Rheumatology, Maasstad Hospital; H.K. Ronday, MD, PhD, Department of Rheumatology, Haga Hospital; R. Bolce, MSN; E.H. Sasso, MD, Crescendo Bioscience; P.J.S.M. Kerstens, MD, PhD, Department of Rheumatology, Reade; W.F. Lems, MD, PhD, Department of Rheumatology, Reade, and VU Medical Center; T.W.J. Huizinga, MD, PhD; C.F. Allaart, MD, PhD, Department of Rheumatology, Leiden University Medical Center. Address correspondence to Dr. I.M. Markusse, Leiden University Medical Center, Department of Rheumatology, PO Box 9600, 2300 RC Leiden, The Netherlands. E-mail: i.m.markusse@lumc.nl. Full Release Article. For details see Reprints/Permissions at jrheum.org. Accepted for publication June 4, 2014.

From the Department of Rheumatology, Leiden University Medical Center, Leiden; Reinier de Graaf Hospital, Delft; Maasstad Hospital, Rotterdam; Haga Hospital, the Hague; Reade organization; VU Medical Center, Amsterdam, the Netherlands; Crescendo Bioscience, South San Francisco, California, USA. Supported by a government grant from the Dutch Insurance Companies, with additional funding from Schering-Plough B.V. and Janssen B.V. No financial support from Crescendo Bioscience. I.M. Markusse, MD; L. Dirven, PhD; M. van den Broek, MD, PhD, Department of Rheumatology, Leiden University Medical Center; C. Bijkerk, MD, PhD, Department of Rheumatology, Reinier de Graaf Hospital; K.H. Han, MD, Department of Rheumatology, Maasstad Hospital; H.K. Ronday, MD, PhD, Department of Rheumatology, Haga Hospital; R. Bolce, MSN; E.H. Sasso, MD, Crescendo Bioscience; P.J.S.M. Kerstens, MD, PhD, Department of Rheumatology, Reade; W.F. Lems, MD, PhD, Department of Rheumatology, Reade, and VU Medical Center; T.W.J. Huizinga, MD, PhD; C.F. Allaart, MD, PhD, Department of Rheumatology, Leiden University Medical Center. Address correspondence to Dr. I.M. Markusse, Leiden University Medical Center, Department of Rheumatology, PO Box 9600, 2300 RC Leiden, The Netherlands. E-mail: i.m.markusse@lumc.nl. Full Release Article. For details see Reprints/Permissions at jrheum.org. Accepted for publication June 4, 2014.

From the Department of Rheumatology, Leiden University Medical Center, Leiden; Reinier de Graaf Hospital, Delft; Maasstad Hospital, Rotterdam; Haga Hospital, the Hague; Reade organization; VU Medical Center, Amsterdam, the Netherlands; Crescendo Bioscience, South San Francisco, California, USA. Supported by a government grant from the Dutch Insurance Companies, with additional funding from Schering-Plough B.V. and Janssen B.V. No financial support from Crescendo Bioscience. I.M. Markusse, MD; L. Dirven, PhD; M. van den Broek, MD, PhD, Department of Rheumatology, Leiden University Medical Center; C. Bijkerk, MD, PhD, Department of Rheumatology, Reinier de Graaf Hospital; K.H. Han, MD, Department of Rheumatology, Maasstad Hospital; H.K. Ronday, MD, PhD, Department of Rheumatology, Haga Hospital; R. Bolce, MSN; E.H. Sasso, MD, Crescendo Bioscience; P.J.S.M. Kerstens, MD, PhD, Department of Rheumatology, Reade; W.F. Lems, MD, PhD, Department of Rheumatology, Reade, and VU Medical Center; T.W.J. Huizinga, MD, PhD; C.F. Allaart, MD, PhD, Department of Rheumatology, Leiden University Medical Center. Address correspondence to Dr. I.M. Markusse, Leiden University Medical Center, Department of Rheumatology, PO Box 9600, 2300 RC Leiden, The Netherlands. E-mail: i.m.markusse@lumc.nl. Full Release Article. For details see Reprints/Permissions at jrheum.org. Accepted for publication June 4, 2014.

From the Department of Rheumatology, Leiden University Medical Center, Leiden; Reinier de Graaf Hospital, Delft; Maasstad Hospital, Rotterdam; Haga Hospital, the Hague; Reade organization; VU Medical Center, Amsterdam, the Netherlands; Crescendo Bioscience, South San Francisco, California, USA. Supported by a government grant from the Dutch Insurance Companies, with additional funding from Schering-Plough B.V. and Janssen B.V. No financial support from Crescendo Bioscience. I.M. Markusse, MD; L. Dirven, PhD; M. van den Broek, MD, PhD, Department of Rheumatology, Leiden University Medical Center; C. Bijkerk, MD, PhD, Department of Rheumatology, Reinier de Graaf Hospital; K.H. Han, MD, Department of Rheumatology, Maasstad Hospital; H.K. Ronday, MD, PhD, Department of Rheumatology, Haga Hospital; R. Bolce, MSN; E.H. Sasso, MD, Crescendo Bioscience; P.J.S.M. Kerstens, MD, PhD, Department of Rheumatology, Reade; W.F. Lems, MD, PhD, Department of Rheumatology, Reade, and VU Medical Center; T.W.J. Huizinga, MD, PhD; C.F. Allaart, MD, PhD, Department of Rheumatology, Leiden University Medical Center. Address correspondence to Dr. I.M. Markusse, Leiden University Medical Center, Department of Rheumatology, PO Box 9600, 2300 RC Leiden, The Netherlands. E-mail: i.m.markusse@lumc.nl. Full Release Article. For details see Reprints/Permissions at jrheum.org. Accepted for publication June 4, 2014.

From the Department of Rheumatology, Leiden University Medical Center, Leiden; Reinier de Graaf Hospital, Delft; Maasstad Hospital, Rotterdam; Haga Hospital, the Hague; Reade organization; VU Medical Center, Amsterdam, the Netherlands; Crescendo Bioscience, South San Francisco, California, USA. Supported by a government grant from the Dutch Insurance Companies, with additional funding from Schering-Plough B.V. and Janssen B.V. No financial support from Crescendo Bioscience. I.M. Markusse, MD; L. Dirven, PhD; M. van den Broek, MD, PhD, Department of Rheumatology, Leiden University Medical Center; C. Bijkerk, MD, PhD, Department of Rheumatology, Reinier de Graaf Hospital; K.H. Han, MD, Department of Rheumatology, Maasstad Hospital; H.K. Ronday, MD, PhD, Department of Rheumatology, Haga Hospital; R. Bolce, MSN; E.H. Sasso, MD, Crescendo Bioscience; P.J.S.M. Kerstens, MD, PhD, Department of Rheumatology, Reade; W.F. Lems, MD, PhD, Department of Rheumatology, Reade, and VU Medical Center; T.W.J. Huizinga, MD, PhD; C.F. Allaart, MD, PhD, Department of Rheumatology, Leiden University Medical Center. Address correspondence to Dr. I.M. Markusse, Leiden University Medical Center, Department of Rheumatology, PO Box 9600, 2300 RC Leiden, The Netherlands. E-mail: i.m.markusse@lumc.nl. Full Release Article. For details see Reprints/Permissions at jrheum.org. Accepted for publication June 4, 2014.