Association between rheumatoid arthritis flares and joint structural changes at 24 months: using FLARE-RA questionnaire - 08/01/26
, Lisa Bialé d, Marion Couderc e, f, André Basch g, Frédérique Gandjbakhch a, c, Francis Guillemin h, iHighlights |
• | What is already known on this topic: (i) the self-reported Flare Assessment in Rheumatoid Arthritis (FLARE-RA) questionnaire is a valid measure to detect flares in patients with rheumatoid arthritis (RA) before or between medical visits; using the FLARE-RA could help clinicians with therapeutic decision-making. |
• | What this study adds: (i) FLARE-RA scores were associated with objective and perceived assessments of RA during follow-up (DAS28-CRP, PGA, HAQ-DI, PASS, MCID) and with RA treatment intensification; (ii) RA flares detected by the FLARE-RA were not associated with 24-month structural damage progression seen on X-rays. |
• | How this study might affect research, practice or policy: our study confirms the value of the self-reported FLARE-RA questionnaire for monitoring RA disease activity and enabling a closer therapeutic adjustment of the disease in routine medical practice. |
Abstract |
Objective |
To describe whether rheumatoid arthritis (RA) flares detected by the self-administered Flare Assessment in Rheumatoid Arthritis (FLARE-RA) questionnaire can predict joint structural damage progression at 2 years and to explore the association between the FLARE-RA score and RA outcome measures.
Methods |
Adults with RA for less than 10 years and Health Assessment Questionnaire-Disability Index (HAQ-DI) score < 1 were included in this prospective observational study. Patients were followed clinically every 6 months and completed the FLARE-RA questionnaire every 3 months at home, for 24 months. Wrist and foot X-rays were taken at inclusion and month 24 (M24). Logistic regressions and generalized linear mixed-effects models were used.
Results |
The median (IQR) age of the 221 analyzed patients was 58.0 years (48.0–66.0), 67.4% were female, and the median time from RA diagnosis was 1.4 years (0.5–2.8). Most patients (84.6%) received ongoing treatment for RA, and 46.0% were in remission according to the Disease Activity Score in 28 joints (DAS28) at inclusion. Flare assessment between visits to the rheumatologist, as assessed with the FLARE-RA global score, was not associated with structural changes (OR: 1.00, 95% CI 0.99–1.01) or progression of erosions (OR = 1.00, 95% CI 0.99–1.01) at month 24 but was significantly associated with DAS28, Physician Global Assessment, HAQ-DI, Patient Acceptable Symptom State, Minimal Clinically Important Difference, and intensification of treatment for RA during follow-up (all P < 0.0001).
Conclusions |
The FLARE-RA score was associated with physician-based disease activity measures, suggesting its value as a patient-reported disease-activity measure in routine care, including remote consultation.
Le texte complet de cet article est disponible en PDF.Keywords : Rheumatoid arthritis, Disease activity, Structural, Damage, Flare, Patient reported outcomes, Prognosis
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Vol 93 - N° 1
Article 105957- janvier 2026 Retour au numéro
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