Different types of flares in people with rheumatoid arthritis

What is it about?

People with rheumatoid arthritis (RA) often experience flare-ups (flares) of their condition. Flares can cause loss of day to day function and can lead to a lot of worry for some people. Many doctors believe that inflammation is the cause of flares, leading to worse swelling; but pain is also common during a flare (as is fatigue). In this study we looked at whether the inflammation and the pain of flares could be separated. Are their different flares of pain and flares of inflammation (swelling) in people with RA? Data given by people from the Early RA Network (ERAN) study were analysed. Data had been previously collected annually up to 11 years after their diagnosis with RA. There were 719 people who had data analysed. We defined a pain flare and an inflammation flare using the measurements taken from these people. We also did extra analysis to try and find possible other types of flares. The inflammation flares (45% of people) and pain flares (52%) were quite common, but they did not always happen together. Our findings also lead us to believe that people were more disabled after their flare had finished. Other factors did not seem to stay worse after a flare. We used our analysis to try and find different types of flare. One type (‘Observed’) was characterised by people having more swelling and tender joints (hands/wrists, knees, elbows, shoulder, hips). Another type (‘Self-report’) showed much worse pain and fatigue. A final type (‘Moderate) was less severe than the others.

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Photo by Em bé khóc nhè on Unsplash

Photo by Em bé khóc nhè on Unsplash

Why is it important?

Flares are both common and varied in people with RA. The different types of flare could be examined further in other research studies. It is possible that they might need different types of treatment.