Agreement between patient-reported flares and clinically significant flare status in patients with rheumatoid arthritis in sustained remission: data from the ARCTIC REWIND trials
Authors' conclusion
Among patients in sustained remission, patient-reported flare status was accurate in ruling out a clinically significant flare. About half of the patient-reported flares were assessed to be clinically significant.
Study context
- Population
- Patients with rheumatoid arthritis (RA) in remission for ≥12 months on stable treatment (64% women; age 56.1 (11.8) years; Disease Activity Score (DAS) 0.8 (0.3))
- Participants
- 248 patients682 visits
- Comparison
- Patient-reported flare status vs clinically significant flare status
- Outcome
- Agreement, sensitivity, specificity and predictive values of patient-reported flare status vs clinically significant flare status
- Follow-up
- 12 months
Methodological detailspooled 12-month data from the ARCTIC REWIND tapering trials
- Pooled 12-month data from the ARCTIC REWIND tapering trials
Performance
As reported in the abstract
Agreement with clinically significant flare status
| Test or model | Visits in agreement | Agreement coefficient | Sensitivity | Specificity | PPV | NPV |
|---|---|---|---|---|---|---|
| Patient-reported flare status | 621/682 (91%) | 0.89 | 91% | 91% | 46% | 99% |
Patient-reported flare status
Visits in agreement621/682 (91%)
Agreement coefficient0.89
Sensitivity91%
Specificity91%
PPV46%
NPV99%
Further findings
Flare frequency
- Patients reporting a flare at least once
- 35%
- Patients with clinically significant flares
- 21%
- Clinically significant flares leading to DMARD intensification
- 48/53 (91%)
Original publication
Agreement between patient-reported flares and clinically significant flare status in patients with rheumatoid arthritis in sustained remission: data from the ARCTIC REWIND trials. RMD Open. Published 5 September 2024. doi:10.
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