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ASAS consensus identifies preliminary definitions of ‘flare’ in axSpA
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Researchers of an Assessment of Spondyloarthritis initiative have identified 12 preliminary definitions of flare among patients with axial spondyloarthritis using common, validated outcome measures.
The researchers analyzed 27 different definitions of flare across 38 different studies. According to research by the group, bath ankylosing spondylitis disease activity index (BASDAI) and pain were the most common outcome measures used in the studies to assess flare. The researchers also participated in 140 vignette exercises to determine whether axial spondyloarthritis (axSpA) patients had experienced a flare between two follow-up visits using outcomes such as the BASDAI, pain, BASDAI plus C-reactive protein (CRP) and ankylosing spondylitis disease activity score (ASDAS)-CRP, according to the abstract.
“This data-driven consensus process has led to 12 preliminary definitions of ‘flare’ in axSpA, based on widely used indices,” Laure Gossec, MD, PhD, and colleagues wrote in their study.
Laure Gossec
Overall, 121 Assessment of Spondyloarthritis (ASAS) experts assessed 4,999 flare cases, which had a high area under the ROC curve (range = 0.88 to 0.89), according to the abstract. There was a cut-off of three articles concerning pain, four articles concerning ASDAS-CRP and five articles concerning BASDAI against the ASAS expert opinions (sensitivity range = 0.60 to 0.99; specificity range = 0.40 to 0.94).
“Further steps will allow the assessment of these preliminary definitions on real patient data in order to select the most relevant definition(s),” Gossec and colleagues wrote in their study. “This work is important in the context of clinical trial design, for example, for designing tapering trials, to better define ‘flares’ in future clinical studies.” – by Jeff Craven
Disclosure: The researchers report no relevant financial disclosures.
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