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JOINTstat (Rheumatoid Arthritis (RA) Test)

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JOINTstat™ test is used to help diagnose people with rheumatoid arthritis (RA). Combined with Rheumatoid Factor (RF) and Anti-CCP, JOINTstat is able to detect significantly up to 78% of RA patients compared to 57% detected by RF alone. JOINTstat also helps detect patients with a progressive form of the disease.

Test at a glance

Clinical Utility

​Used in early detection of RA. The addition of JOINTstat (to RF and anti-CCP) increases the sensitivity for early diagnosis in RA to 78%.[1]
Studies have shown that JOINTstat blood levels change over time which corresponds with joint damage risk and therapy response. [2-6]

Ordering

​In BC healthcare providers must indicate JOINTstat under the section “Other tests” of the standard requisition form. In Ontario, JOINTstat requires a separate requisition form.

Patient instructions

​Patient must bring the completed requisition form to a LifeLabs Patient Service Centre.

Turnaround Time

​Test results will be available within 2 weeks.

Cost

​This test is not currently covered by provincial health plans, but may be covered by the patient’s private insurance.

Healthcare Professional Information

What is Being Tested?

The 14-3-3η (eta) protein is an emerging biomarker for RA and erosive psoriatic arthritis diagnosis. It is produced by joints and it may play a biologic role in the joint erosive process. Blood levels appear to be elevated in patients with RA, but not in other diseases including psoriasis, osteoporosis, gout, ulcerative colitis, type 1 diabetes, systemic lupus erythematosus, Crohn disease, primary Sjögren syndrome, scleroderma, and multiple sclerosis.

A positive test indicates that the patient should be considered for referral to a rheumatologist, prior to the onset of significant joint damage. [7,8] A positive JOINTstat test early in disease also marks high joint damage risk, and therefore, along with other clinical indicators, would signal to a rheumatologist how aggressively to treat and monitor the patient.

Studies to date have shown that 14-3-3η:

  • Is positive in patients with joint pain who develop RA within 5 years of symptom onset.
  • At high levels (>0.80 ug/L) is an indicator of RA that will lead to more joint damage over 3 years.
  • At lower levels (<0.40 ug/L or negative in RA diagnosed patients) is an indicator of a higher likelihood of response to RA therapy.
  • Decreasing levels with treatment or over time indicate a better disease outcome.
  • Overall, RA patients who are negative or who have low levels (<0.40 ug/L) have a more favourable outcome.

 

Patient Frequently Asked Questions(FAQs)

​How is it used?

The JOINTstat test measures the levels of the 14-3-3η (eta) protein in the blood to assist with the diagnosis of rheumatoid arthritis (RA).

The 14-3-3η protein, measured by JOINTstat, is not normally present in the blood of healthy individuals. 96% of healthy people tested do not have detectable levels in blood. In the healthy state, 14-3-3η is present only inside of cells where it is involved in important normal biological processes. In patients with RA, through a disease-driven process, 14-3-3η is pushed outside the cells where it causes harmful effects and where it is measurable in blood. In particular, 14-3-3η stimulates the production of factors that cause inflammation and joint damage.

When is it ordered?

People who experience symptoms such as fatigue and morning stiffness of the small joints of hands and feet should consider getting tested with JOINTstat.

Particular care should be taken by those with family history of RA and women, as they are 2 to 3 times more likely to develop rheumatoid arthritis than men.

What does the test result mean?

Unlike anti-CCP and RF, JOINTstat (14-3-3η) is not a by-product of the disease but is actually involved in the joint damage process. JOINTstat provides biological-level information in regards to active joint damage processes underway. When 14-3-3η is present in blood, it activates immune cells causing them to release factors that are involved in promoting inflammation and joint damage.

This test complements other tests for RA such as rheumatoid factor (RF) and anti-CCP, and when measured in combination with those tests, it significantly improves diagnosis of early RA.

Also, unlike anti-CCP and RF, the levels of the 14-3-3η protein in the blood change during the disease course and studies show that low or decreasing levels correspond with a better outcome. Anti-CCP and RF levels stay relatively constant after diagnosis and are not retested.

Is there a charge for the test?

This test is not covered by provincial health insurance plans, but it may be covered by your extended private health insurance plan. Contact us to find out about the current fee for the test.

Is there anything else I should know?

Rheumatoid arthritis is one of the most common autoimmune diseases. In about 1% of people it affects the lining of joints, causing painful inflammation and swelling. If not adequately treated, rheumatoid arthritis can turn into a debilitating condition which can eventually result in bone erosion and joint deformity. This is why early diagnosis is critical; the earlier the disease is caught, the more effective the treatment.

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Additional Resources

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Do you reside outside of BC or ON?

You can still order JOINTstat by obtaining a JOINTstat kit and approaching your local laboratory service provider for a sample draw.

Did you know that you can book your appointment online?

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