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Flare in axial spondyloarthritis: investigation of meaningful changes in symptomatic outcome measures
Maxime Dougados1, Emily Wood2, Laure Gossec3
1Paris Descartes University; Department of Rheumatology-Hôpital Cochin, Assistance Publique-Hôpitaux de Paris; INSERM (U1153): Clinical Epidemiology and Biostatistics, PRES Sorbonne Paris-Cité, Paris, France. maxime.dougados@cch.aphp.fr.
Objectives:
To assess symptomatic outcomes associated with flare after discontinuation of non-steroidal anti-inflammatory drugs (NSAIDs) in axial spondyloarthritis (axSpA).
Methods:
Patients with NSAID-refractory axSpA discontinued NSAIDs, restarted if symptoms recurred, and self-recorded Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). 75th percentiles were calculated for changes in BASDAI total and components from NSAID discontinuation to resumption.
Results:
75th percentiles for absolute/relative changes: BASDAI total (0-10)=1.5/28%; fatigue=2.0/25%; spinal pain=2.0/33%; joint pain/swelling=2.0/50%; enthesitis=2.0/43%; morning stiffness=1.5/27%.
Conclusions:
No single score threshold applied but absolute change ≥2 or relative change ≥30% indicated symptomatic deterioration for most BASDAI components.
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