PT  - JOURNAL ARTICLE
AU  - Charlotte Jacquemin
AU  - Walter P. Maksymowych
AU  - Annelies Boonen
AU  - Laure Gossec
TI  - Patient-reported Flares in Ankylosing Spondylitis: A Cross-sectional Analysis of 234 Patients
AID  - 10.3899/jrheum.160838
DP  - 2017 Apr 01
TA  - The Journal of Rheumatology
PG  - 425--430
VI  - 44
IP  - 4
4099  - http://www.jrheum.org/content/44/4/425.short
4100  - http://www.jrheum.org/content/44/4/425.full
SO  - J Rheumatol2017 Apr 01; 44
AB  - Objective. Ankylosing spondylitis (AS) is characterized by periodic flares. The objective of this study was to assess the frequency of patient-reported flares and their related factors.Methods. This cross-sectional study analyzed the 2004 data of a Canadian cohort. Participants had AS according to the modified New York criteria. Current flare status (“Are you experiencing a current flare”?), number of flares over the past 3 months, their average duration, the Bath Ankylosing Spondylitis Disease Activity and Functional Index (BASDAI and BASFI, respectively), and the AS Quality of Life questionnaire were assessed by self-report. Univariate and multivariate regressions analyzed the factors associated with current flare.Results. Among 234 analyzed patients, 169 (73.5%) were men, mean age was 45.5 (± 11.8) years, mean disease duration of 21.7 (± 11.7) years, and mean BASDAI and BASFI (0–10) of 4.4 (± 2.3) and 3.4 (± 2.6), respectively; 18 (7.7%) received antitumor necrosis factor (anti-TNF). Overall, 175 patients (74.8%) reported flares and 117 (50%) were currently in flare. Patients reporting flares had a median of 3 flares in 3 months, with a median duration of 2 weeks. Overall, the 234 patients spent a median of 25% of their time in flare. In multivariate analyses, current flare was significantly associated with higher BASDAI (OR 2.01, p = 0.01), worse quality of life (OR 1.37, p = 0.004), shorter AS duration (OR 1.19, p = 0.04), and less anti-TNF (OR 7.14, p = 0.03).Conclusion. In this population, before the wide use of biologics, flares were frequent and long. As expected, flare was associated with higher disease activity, suggesting the validity of the concept of patient-reported flares.