Table 5.
Flare characteristics as classified by patients, MD and patient–MD concordant reports in patients with RA who were previously in remission/low disease activity (n=360)
| Characteristics (mean (SD) or n (%)) | Patient N=58 (16%) |
MD N=71 (20%) |
Patient and MD N=28 (8%) |
|---|---|---|---|
| Patient flare severity (0–10) | 4.4 (2.1) | 4.5 (2.6) | 5.0 (2.3) |
| Duration (days) | |||
| 1–3 | 12 (21%) | 5 (18%) | 5 (18%) |
| 4–7 | 6 (10%) | 4 (14%) | 4 (14%) |
| 8–14 | 12 (21%) | 6 (21%) | 6 (21%) |
| >14 | 28 (48%) | 13 (46%) | 13 (46%) |
| Change in DAS28 | |||
| DAS28 at time of flare | 3.2 (1.4) | 3.0 (1.4) | 3.9 (1.4) |
| DAS28 at previous visit | 2.1 (0.7) | 2.1 (0.6) | 2.1 (0.7) |
| Worsening of DAS28 | 1.1 (1.4) | 0.9 (1.3) | 1.8 (1.2) |
| Change in DMARD# and/or oral steroids use from previous visit | |||
| Reduced (dose or frequency) | 22 (38%) | 29 (41%) | 9 (32%) |
| Stopped (without escalating or adding another therapy) | 19 (33%) | 28 (39%) | 7 (25%) |
| Reduced and/or stopped | 24 (41%) | 34 (48%) | 10 (36%) |
| MD intent to increase treatment* | 25 (45%) | 37 (53%) | 17 (61%) |
| Proposed treatment change* | |||
| Non-methotrexate DMARDS added | 9 (16%) | 10 (14%) | 7 (25%) |
| Methotrexate added or increased† | 2 (6%) | 3 (7%) | 1 (7%) |
| Biologics added/switched (not due to side effect) | 2 (3%) | 3 (4%) | 2 (7%) |
| Steroids added (PO/IM or IA; not used in prior visit) | 7 (12%) | 7 (10%) | 4 (14%) |
| NSAIDs added (not used in the prior visit) | 3 (5%) | 3 (4%) | 2 (7%) |
DMARDs could include biologic and synthetic DMARDs.
*Reported increase in treatment at second or subsequent visit.
†Dose increased or changed from oral to subcutaneous.
DAS, Disease Activity Score; DMARD, disease-modifying antirheumatic drug; IA, intra-articular; IM, intramuscular; NSAIDs, non-steroidal anti-inflammatory drugs; PO, per os.