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Rheumatology (Oxford). 2010 May;49(5):929-32. doi: 10.1093/rheumatology/kep435. Epub 2010 Feb 1.

Frequency and characteristics of disease flares in ankylosing spondylitis.

Author information

1
School of Medicine, Swansea University, Swansea, UK.

Abstract

OBJECTIVE:

To examine the characteristics and frequency of disease flares in a cohort of people with AS.

METHODS:

A prospective data set from a randomized controlled trial (RCT) of a probiotic treatment/placebo was utilized to examine disease flares in 134 people with AS. Disease flares were defined as either minor/localized flares (pain/swelling localized to one area with fatigue and stiffness) or major/generalized flares (generalized pain, hot burning joints, muscle spasm, fever, sweating, extreme fatigue and stiffness). Results. One hundred and thirty-four people were followed up for 1216 person follow-up weeks and there were 71.4 flares per 100 person-weeks. Of these, 12 were major/generalized flares and 59.4 were minor/localized flares. People who experienced at least one major/generalized flare during the study period had worse disease during flare-free periods in terms of disease activity, impaired function, self-reported night pain and iritis compared with those who did not experience any major/generalized flares during the study. Major/generalized flares lasted for an average of 2.4 weeks (s.d. 2.7), and were preceded by and followed by a minor/localized flare in 92% (55/60) of cases.

CONCLUSION:

Seventy per cent of people with AS felt they had a flare in any given week. Those who experienced major/generalized flares appear to have more severe and active disease even during periods when not in flare, compared with those who do not experience major/generalized flares. These results have implications for the timing of assessments prior to starting anti-TNF therapy and suggest that the presence of major flares may be helpful in identifying patients with severe disease.

PMID:
20123954
PMCID:
PMC2853701
DOI:
10.1093/rheumatology/kep435
[Indexed for MEDLINE]
Free PMC Article

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