FRI0111 Defining Flare in Spondyloarthritis: Thresholds of Disease Activity Variations. (10th June 2014)

• Record Type: Journal Article
• Authors: Godfrin-Valnet, M.; Puyraveau, M.; Wendling, D.
• Is Part Of: Annals of the rheumatic diseases. Volume 73:Supplement 2(2014)
• Page Start: 421
• Page End: 422
• Publication Date: 2014-06-10
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2014-eular.4866
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: Spondyloarthritis (SpA) activity varies with time and treatment, but to date no clear definition of a flare of the disease is available. Objectives: The aim of this study was to evaluate thresholds of disease activity variations using validated composite indexes Methods: SpA patients fulfilling ASAS criteria and prospectively followed with at least two visits were evaluated using BASDAI, ASDAS-CRP and ASDAS-ESR. Patients and physician answered at each visit the question: "do you consider your SpA in a state of flare ?". Variations of BASDAI and ASDAS between visits were assessed and associated to the change of perception of a flare (yes/no). ROC curves were built to assess thresholds of variation in BASDAI end ASDAS associated with the change Flare: no to yes between visits. Results: The patients were issued from a prospective series of 250 SpA. 99 situations with at least 2 visits were analyzed. The main characteristics of this cohort were: 67% men, mean age 45±12 years; disease duration: 16±10 y; 84% HLA-B27 positive; purely axial SpA: 81%; PASS at baseline: 56%; mean CRP: 8.6±13.5 mg/l. Mean BASDAI and ASDAS-CRP at baseline were 4.3±2.2 and 2.5±1.1 respectively. The kappa coefficient of agreement between patient and physician for considering a flare was 0.68. The main results of the ROC curves are reported in the table: Conclusions: According to these results, an increase from a non-flare state of at least 2.1 units in BASDAI, 0.8 units in ASDAS-ESR or 1.3 units in ASDA-CRP is associated to (and may define) a flare, as considered by the patient and the physician. This is the first study assessing, in current practice, thresholds of variation of activity score associated with a flare in SpA. This may help physicians in the evaluation and management of the patients with SpA. Disclosure of Interest: None declared DOI: 10.1136/annrheumdis-2014-eular.4866