Exagen Diagnostics and Medco Research Institute have started a pilot program to assess the ability of the former’s test to optimize low-dose methotrexate (MTX) therapy for rheumatoid arthritis (RA). Called Nimble (novel interventions in methotrexate boosts levels of effectiveness), the study aims to understand how MTX is being absorbed, retained, and metabolized by a patient.
Exagen's lab test, called Avise PG, will be used to measure whether patients are receiving an appropriate dose of MTX. Avise PG measures MTX polyglutamate levels, the active metabolites of MTX. Medco Research Institute will work with Medco clients to recruit patients to take part in the Nimble pilot program.
When a volunteer receives an initial MTX prescription for RA, Medco will provide the prescribing physician with the Avise PG test, and patients will be alerted that a blood-draw for the Avise PG test will be performed at their next office visit.
Once the physician's office has collected the blood sample, it will be sent to Exagen Diagnostics' CLIA-certified laboratory for testing. Exagen will provide the test results to the prescribing physician to make dose changes accordingly and to Medco Research Institute.
It is anticipated that up to 400 Medco members who are new to MTX therapy will have the Avise PG testing performed. The downstream medical and pharmacy claims data from these patients will be compared to a similar number of Medco members who did not receive Avise PG testing as part of their care in order to determine the clinical utility and cost effectiveness of this intervention.
"The findings we observe through the Nimble pilot will be an important step in understanding the value of testing like this and may bring us closer to making this testing standard practice for RA patients," notes Felix Frueh, Ph.D., president, Medco Research Institute.