Disease flares in rheumatoid arthritis are associated with joint damage progression and disability: 10-year results from the BeSt study

Arthritis Research & Therapy
Iris M MarkusseCornelia F Allaart

Abstract

Flares in patients with rheumatoid arthritis are suggested to sometimes spontaneously resolve. Targeted therapy could then entail possible overtreatment. We aimed to determine the flare prevalence in patients who are treated-to-target and to evaluate associations between flares and patient-reported outcomes and radiographic progression. In the BeSt study, 508 patients were treated-to-target for 10 years. After initial treatment adjustments to achieve disease activity score ≤2.4, a flare was defined from the second year of follow-up onwards, according to three definitions. The first definition is a disease activity score >2.4 with an increase of ≥0.6 regardless of the previous disease activity score. The other definitions will be described in the manuscript. The flare prevalence was 4-11 % per visit; 67 % of the patients experienced ≥1 flare during 9 years of treatment (median 0 per patient per year). During a flare, functional ability decreased with a mean difference of 0.25 in health assessment questionnaire (p < 0.001), and the odds ratios (95 % confidence intervals) for an increase in patients' assessment of disease activity, pain and morning stiffness of ≥20 mm on a visual analogue scale were 8.5 (7.3-9.8), 8.4 (7.2-9.7) an...Continue Reading

References

Sep 1, 1984·Clinical Rheumatology·C E SiegertA Cats
Jan 22, 2009·Annals of the Rheumatic Diseases·Y P M Goekoop-RuitermanB A C Dijkmans
Mar 11, 2010·Annals of the Rheumatic Diseases·Josef S SmolenUNKNOWN T2T Expert Committee
Aug 3, 2011·The Journal of Rheumatology·Rieke AltenUNKNOWN OMERACT RA Flare Definition Working Group
Aug 3, 2011·The Journal of Rheumatology·Clifton O BinghamUNKNOWN OMERACT RA Flare Definition Working Group
Jul 10, 2012·Annals of the Rheumatic Diseases·Susan J BartlettUNKNOWN OMERACT RA Flare Working Group
Jul 16, 2013·Annals of the Rheumatic Diseases·Elisabeth LieUNKNOWN OMERACT RA Flare Working Group
Dec 18, 2013·The Journal of Rheumatology·Vivian P BykerkDaniel H Solomon

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Citations

Mar 13, 2016·Autoimmunity Reviews·Christopher K Y ChanChristopher J Edwards
Jul 25, 2017·Health Services Research·Pengxiang LiJalpa A Doshi
Oct 5, 2017·Therapeutic Advances in Musculoskeletal Disease·Sofia Ajeganova, Tom Huizinga
Jul 21, 2017·Scientific Reports·Hideaki TsujiChikashi Terao
Feb 6, 2021·Clinical Rheumatology·Tommaso SchioppoRoberto Caporali
Jun 25, 2021·Journal of Inflammation Research·Lene Terslev, Mikkel Ostergaard
Aug 28, 2021·International Journal of Environmental Research and Public Health·Francesca IngegnoliRoberto Caporali

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Software Mentioned

BeSt

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