RT Journal Article
SR Electronic
T1 Understanding Differences in Patient Descriptions of RA Flares Using OMERACT Core Domains
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP jrheum.211409
DO 10.3899/jrheum.211409
A1 Gabriela L.  Maica
A1 Christine Iannaccone
A1 Vivi Feathers
A1 Michelle Frits
A1 Vivian Bykerk
A1 Clifton O.  Bingham III
A1 Michael Weinblatt
A1 Nancy A.  Shadick
YR 2023
UL http://www.jrheum.org/content/early/2023/01/25/jrheum.211409.abstract
AB Objective Recently, there has been consensus on domains that constitute flares in Rheumatoid Arthritis (RA); however, variations in patients' flare descriptions continue to be observed. This study evaluates how demographic and clinical characteristics influence these differences. Methods Participants enrolled in a prospective RA registry completed a qualitative survey which included the open-ended question "What does a flare mean to you?". Responses were categorized into OMERACT core and research domains. Univariate analyses evaluated demographic and clinical characteristics. Regression analyses determined independent variables associated with flare description variations. Results Among 645 participants, median (IQR) DAS28-CRP3 was 2.1 (1.6, 2.9); 58% reported at least 1 flare in the past 6 months. Participants reported a median (IQR) of 3 (2, 5) OMERACT domains when describing flares. Fatigue was more commonly noted among females (OR=6.12, p=0.0006) while older participants were less likely to report emotional distress (OR=0.97, p=0.0275), swollen joints (OR=0.99, p=0.0430), physical function decrease (OR=0.98, p=0.0186), and a general increase in RA symptoms (OR=0.98, p=0.0053). Participants with a higher DAS28 score less likely reported symptoms of stiffness (OR=0.70, p=0.0092) and those who experienced a flare within the last 6 months more likely described flares as pain (OR=2.53, p=0.0001) and fatigue (OR=2.0, p=0.0066). Conclusion Variations in patients' flare descriptions can be driven by a patient's disease activity the experience of a recent flare as well as different demographic characteristics such as age and gender. Understanding the interplay of these characteristics can guide a physicians' approach to the management of patients' RA flares.