Background FLARE-RA (FLARE in Rheumatoid Arthritis) is a self-administered questionnaire developed to detect rheumatoid arthritis (RA) flare that has occurred in the meantime since the last visit to the physician1. The questionnaire is based on 11 items or statements exploring both RA patients and physician perceptions of RA flare in the 3-month period before the consultation to the rheumatologist. The respondents are asked to rate their agreement on a 0-10 numerical rating scale (NRS). FLARE-RA score is the mean of the 11 NRS. FLARE-RA has already been shown to be unidimensional, reliable and good correlation with disease activity at the time of questionnaire filling2.
Objectives To assess the ability of the FLARE self-administered questionnaire to identify past flare in RA patients.
Methods Study design was observational prospective 3-month study of patients with RA (satisfaction of 1987 ACR criteria, duration >6 months) and treated with stable doses of DMARDs. Patients were seen at baseline and 3 months (M3). To identify past RA flare, i.e., transient disease activity increase occurring in the 3-month period before the M3 visit, patients were asked to fill in the RAPID3 self-administered questionnaire3 every week between baseline and M3. Spearman correlation coefficients were calculated to assess the association between the FLARE score at M3 and RAPID3-based past disease activity over the 3-month period between baseline and M3. The past disease activity was assessed by 3 different ways: area under the curve of RAPID3 scores (AUC), maximum RAPID3 value (MAX), and maximum delta of RAPID3 scores between 2 consecutive visits (DELTA MAX). The analysis was conducted in the whole population and in the subsample with low disease activity or remission at M3.
Results 132 patients were recruited from 13 centres: 78.7% women, 57.7 years old, 84.4% RF+, 78.7% ACPA+, DAS28 was 2.9, CRP was 5.7 mg/l and 81.2% had erosive disease. Complete RAPID3 data were available for 96, of whom 54 (56%) were in remission or low disease activity at M3 visit. Whatever the method used, FLARE-RA scores were significantly correlated with RA disease activity over the 3-month period preceding the visit to the rheumatologist.
Conclusions The FLARE-RA self-administered questionnaire can detect past RA flare and could represent a potential help to monitor disease activity between rheumatologist consultations and identify patients whose appointment should be anticipated or treatment revised
Berthelot JM et al. Ann Rheum Dis 2012; 71(7): 1110-61.
Morel J et al. Arthritis Rheum 2013; 65(10): S1231.
Pincus T, et al. Rheumatology (Oxford) 2008; 47(3): 345-9.
Acknowledgements We thank Mrs Irawatti Lemonnier for coordination and management of the projet; Mrs Marie Line Epelding for stastistical analysis
Disclosure of Interest None declared
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