Developing a Preliminary Definition and Domains of Flare in Knee and Hip Osteoarthritis (OA): Consensus Building of the Flare-in-OA OMERACT Group

Francis Guillemin; Camille Ricatte; Annica Barcenilla-Wong; Amandine Schoumacker; Marita Cross; Camille Alleyrat; Thomas Buttel; Michel Cembalo; Hakima Manseur; Hema Urban; Bruno Fautrel; Philip G. Conaghan; Gillian Hawker; Claudia Rutherford; Lyn March; Elisabeth Spitz; David J. Hunter

doi:10.3899/jrheum.181085

Abstract

Flare in knee and hip osteoarthritis (OA) is more than just an exacerbation of pain. Unstructured, semistructured, and focus group interviews followed by Delphi surveys with patients and health professionals (HP) generated candidate domains of an OA flare. Content analysis of interviews with 29 patients and 16 HP extracted 180 statements, which were grouped into 9 clusters. Delphi consensus with 50 patients (Australia, Canada, and France) and 116 HP (17 countries on 4 continents) identified 5 flare domains: pain, swelling, stiffness, psychological aspects, and effect of symptoms. Elements for a preliminary definition of an OA flare are proposed. Registered at clinicaltrials.gov NCT02892058.

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Footnotes

This work was supported by a grant from Association Française de Lutte Anti Rhumatisme – France Rhumatisme (France) and the Kolling Foundation (Australia). This work was endorsed by OMERACT and Osteoarthritis Research Society International and by the STPR Group in Rheumatology in France. PGC is supported in part by the UK NIHR Leeds Biomedical Research Centre. The views expressed are those of the authors and not necessarily those of the UK National Health Service, the NIHR, or the Department of Health. GH receives salary support as the Sir John and Lady Eaton Professor and Chair of Medicine at the University of Toronto.