impact factor

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

1, 2, 3, 4, 5


  1. Paris Descartes University; Department of Rheumatology-Hôpital Cochin, Assistance Publique-Hôpitaux de Paris; INSERM (U1153): Clinical Epidemiology and Biostatistics, PRES Sorbonne Paris-Cité, Paris, France.
  2. Statistical Consultancy, Quanticate Ltd, Hertfordshire, UK.
  3. Sorbonne Universités, UPMC University Paris 06, Institut Pierre Louis d’Epidémiologie et de Santé Publique; AP-HP, Pitié Salpêtrière Hospital, Department of Rheumatology, Paris, France.
  4. Leiden University Medical Center, Department of Rheumatology, Leiden, The Netherlands.
  5. Pfizer, Paris, France.

2017 Vol.35, N°2
PI 0209, PF 0213
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PMID: 27749225 [PubMed]

Received: 07/04/2016
Accepted : 25/07/2016
In Press: 07/09/2016
Published: 15/03/2017


To assess symptomatic outcomes associated with flare after discontinuation of non-steroidal anti-inflammatory drugs (NSAIDs) in axial spondyloarthritis (axSpA).
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.
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%.
No single score threshold applied but absolute change ≥2 or relative change ≥30% indicated symptomatic deterioration for most BASDAI components.

Rheumatology Article