Comprising physicians, researchers and patients, the Outcome Measures in Rheumatology (OMERACT) Flares in RA workgroup is addressing gaps in the assessment of RA flares. These gaps include a definition of what constitutes a flare, as well as a way to measure its severity.
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Explore This IssueDecember 2015
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“What we are attempting—as an international group—is to come together to first systematically define what is meant by a flare representing an increase in inflammatory RA disease activity that patients and providers agree on, and then find a way to measure it,” says Dr. Bartlett. Until now, she says, there has been no reliable way to identify and quantify flares.
The need to better identify and measure flares has gained importance “in this new era of treatment favoring lowering or withdrawing medications [because] this places patients with RA at greater risk of flare.
“The reason we think it is important to identify flares is because there is now evidence to show that flares are associated with damage,” says Dr. Bartlett. “It is really important for patients to get evaluated if they are in a flare, because it may mean their treatment is not working as well as it should be.”
Amye L. Leong, MBA, a patient research partner and member of the Steering Committee for the OMERACT Flares in RA group, emphasized the importance of a uniform method for identifying flares, particularly now that treatment can make living with the disease more manageable.
Having lived with RA for 35 years, five of which confined her to a wheelchair because of ineffective treatment, Ms. Leong stressed that RA today does not need to be the crippling disease that she first struggled with—if it is diagnosed and treated early.
“Early on as a new patient, [I heard] the doctors … talking about flares, but it was only 28 years later while working with the OMERACT flare group that I learned there is no standard patient-centered definition of a flare,” Ms. Leong says. “I find that startling!”
Findings of the OMERACT Group In 2012, the OMERACT group published the results of its initial studies on patients with RA who reported what they experienced during flares.5 This work was undertaken to understand the symptoms and impact of flares that both patients and physicians thought were important in understanding flares.
“One of our first findings was that flares are, indeed, a universal experience and far more common than any of us realized,” says Dr. Bartlett. “We thought maybe 15% of patients in a given year would flare, but now our data suggest flare is much more common.” Emerging data suggest that up to one-third or more of patients who come in for their regular office visit are in a flare.5