Repurposing the Fibrosis-4 Score in Rheumatoid Arthritis: Data from the ESPOIR Cohort

Area of Science:

• Rheumatology
• Hepatology
• Biostatistics

Background:

• Rheumatoid arthritis (RA) is a chronic autoimmune disease requiring prognostic markers.
• The Fibrosis-4 (FIB-4) score, typically used for liver fibrosis, was evaluated for its prognostic value in RA.
• The ESPOIR prospective cohort provided data for this investigation.

Purpose of the Study:

• To assess the prognostic significance of the FIB-4 score in patients with rheumatoid arthritis.
• To determine if FIB-4 score predicts disease progression, structural damage, or adverse events in RA.

Main Methods:

• Prospective cohort study including 647 RA patients meeting ACR/EULAR criteria.
• FIB-4 score calculated using age, AST, ALT, and platelet count.
• Linear mixed-effects models analyzed repeated measures over 10 years.

Main Results:

• FIB-4 score was not independently associated with 10-year Disease Activity Score progression.
• Baseline FIB-4 score did not correlate with modified Sharp scores at 5 years.
• FIB-4 score showed no association with mortality or major adverse cardiovascular events.

Conclusions:

• The FIB-4 score lacks prognostic value in rheumatoid arthritis.
• FIB-4 scores remained stable over time and were not elevated by DMARD treatment.
• Further research may explore other non-invasive markers for RA prognosis.