The risk and nature of flares in XXXX : results from the ReACCh-Out cohort.

@entity1 @entity625 @entity4932
OBJECTIVE: To describe probabilities and characteristics of disease flares in @entity1 with @entity4932 ( @entity4932 ) and to identify clinical features associated with an increased risk of flare. METHODS: We studied @entity1 in the Research in @entity625 in Canadian @entity1 emphasizing Outcomes (ReACCh-Out) prospective inception cohort. A flare was defined as a recurrence of disease manifestations after attaining inactive disease and was called significant if it required intensification of treatment. Probability of first flare was calculated with Kaplan-Meier methods, and associated features were identified using Cox regression. RESULTS: 1146 @entity1 were followed up a median of 24   months after attaining inactive disease. We observed 627 first flares (54.7% of @entity1 ) with median active joint count of 1, physician global assessment (PGA) of 12   mm and duration of 27   weeks. Within a year after attaining inactive disease, the probability of flare was 42.5% (95% CI 39% to 46%) for any flare and 26.6% (24% to 30%) for a significant flare. Within a year after stopping treatment, it was 31.7% (28% to 36%) and 25.0% (21% to 29%), respectively. A maximum PGA >30   mm, maximum active joint count >4, rheumatoid factor (RF)-positive @entity625 , antinuclear antibodies (ANA) and receiving disease-modifying antirheumatic drugs (DMARDs) or biological agents before attaining inactive disease were associated with increased risk of flare. Systemic @entity4932 was associated with the lowest risk of flare. CONCLUSIONS: In this real-practice @entity4932 cohort, flares were frequent, usually involved a few swollen joints for an average of 6   months and 60% led to treatment intensification. @entity1 with a severe disease course had an increased risk of flare.
