title: Flare in axial spondyloarthritis: investigation of meaningful changes in symptomatic outcome measures.
abstract: OBJECTIVE
  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.
authors.affiliation: 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. maxime.dougados@cch.aphp.fr.
authors.forename: Maxime
authors.initials: M
authors.lastname: Dougados
authors.affiliation: Statistical Consultancy, Quanticate Ltd, Hertfordshire, UK.
authors.forename: Emily
authors.initials: E
authors.lastname: Wood
authors.affiliation: 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.
authors.forename: Laure
authors.initials: L
authors.lastname: Gossec
authors.affiliation: Leiden University Medical Center, Department of Rheumatology, Leiden, The Netherlands.
authors.forename: Désirée
authors.initials: D
authors.lastname: van der Heijde
authors.affiliation: Pfizer, Paris, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Logeart
mesh_terms: D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage* / Q000009:adverse effects; D018450:Disease Progression; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007596:Joints / Q000187:drug effects* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012074:Remission Induction; D012720:Severity of Illness Index; D013131:Spine / Q000187:drug effects* / Q000503:physiopathology; D025241:Spondylarthritis / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal