How I Have Used VECTRA Testing to Guide RA Diagnosis and Treatment
What happens when I have a strong suspicion of rheumatoid arthritis (RA) but the 2 traditional lab markers (rheumatoid factor and anti-CCP antibodies) are not coming back positive? I have found that VECTRA testing can be helpful to determine whether a person might have seronegative RA.
Judging the possibility of seronegative RA
The VECTRA gives a score between 0 and 100:1
- A score between 1 and 29 indicates low disease activity level.
- 30 to 44 indicates moderate disease activity level.
- 45 to 100 indicates high disease activity level.
Someone with a high VECTRA score is more likely to have RA despite negative rheumatoid factor and anti-CCP antibodies. This helps me decide whether to start treatment for seronegative RA in people who have had vague lab results.1
The VECTRA also tests for a panel of inflammatory markers that can be linked to rheumatoid arthritis. This includes TNF-alpha levels and interleukin-6 levels. Both of these have been found to be much higher in the serum of people with RA compared to the general population. A person with raised TNF-alpha or interleukin-6 levels is more likely to have RA even if they have negative rheumatoid factor and anti-CCP antibodies.2,3
Determining disease activity level
Do you ever wonder why some people with RA have mild symptoms with few flares per year, while other people seem to have severe disease that causes early destruction of the joints with flares every week or month?
It may be that there are different types of RA and ways it shows up in the body that current testing cannot detect. The VECTRA can be helpful in determining a person’s disease activity level at various points in their disease process.4,5
Likelihood of developing erosions
The VECTRA report also estimates the likelihood of developing spots of bone loss (erosions) on X-rays within the next year or so. A higher VECTRA score points to more severe disease progression with early development of erosions and more frequent flares.5
Higher VECTRA scores also have been linked with stroke and heart attack in people with RA. This is due to too much inflammation in the body.6
Choosing a biologic therapy
Since the VECTRA testing also measures TNF-alpha levels and interleukin-6 levels, it can help me select a biologic drug. I can choose a therapy that is tailored for each individual.4
People with elevated TNF-alpha levels should respond well to biologics that are TNF inhibitors. People with elevated interleukin-6 levels should respond well to biologics that block that specific protein in the body.7
Monitoring response to therapy
Another use for VECTRA testing is to track disease activity levels over time. Maintaining a VECTRA score between 1 and 29 likely means that the condition is under better control with less inflammation. If disease activity levels remain high despite treatment, more treatment or a change in therapy may be needed.8
Other measures of disease activity level include joint pain and swelling, quality of life, and the ability to perform daily tasks such as getting dressed or cooking.9
Did you have difficulty receiving a RA diagnosis?