Flare in axial spondyloarthritis: investigation of meaningful changes in symptomatic outcome measures

Clin Exp Rheumatol. 2017 Mar-Apr;35(2):209-213. Epub 2016 Sep 7.

Abstract

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.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Anti-Inflammatory Agents, Non-Steroidal / administration & dosage*
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects
  • Disease Progression
  • Double-Blind Method
  • Drug Administration Schedule
  • Female
  • Humans
  • Joints / drug effects*
  • Joints / physiopathology
  • Male
  • Middle Aged
  • Recurrence
  • Remission Induction
  • Severity of Illness Index
  • Spine / drug effects*
  • Spine / physiopathology
  • Spondylarthritis / diagnosis
  • Spondylarthritis / drug therapy*
  • Spondylarthritis / physiopathology
  • Time Factors
  • Treatment Outcome

Substances

  • Anti-Inflammatory Agents, Non-Steroidal