FLARE Questionnaire for PsA Demonstrates Validity

Using the disease flare questionnaire (FLARE), researchers evaluated symptom escalation among patients with psoriatic arthritis (PsA), as well as disease activity and overall patient opinion. 

“The ‘gold standard’ of FLARE was based on patient opinion,” the authors reported. “Test-retest reliability was evaluated by intraclass correlation coefficient (ICC). Disease activity was measured by the Psoriatic Arthritis Disease Activity Score (PASDAS), Group for Research and Assessment of Psoriasis and PsA (GRAPPA) Composite Exercise (GRACE), Composite Psoriatic Disease Activity Index (CPDAI), and Disease Activity Index for Psoriatic Arthritis (DAPSA).”

In this prospective observational study, the FLARE questionnaire was completed by 139 patients and the most common symptom among PsA flares was musculoskeletal. The second most common symptom among patients was fatigue, followed by frustration, function loss, and increase in cutaneous symptoms.

“The test-retest ICC for the FLARE questionnaire was 0.87 (95%), and the optimum cut-off to identify a flare of disease was 4/10. In a new flare, the increase in composite measure score was calculated as follows: 1 for PASDAS and GRACE, 2 for CPDAI, and 7 for DAPSA,” the authors explained.

“A PsA flare displays escalation of symptoms and signs across multiple domains. The FLARE questionnaire has external validity in terms of both composite disease activity and overall patient opinion about the state of their condition,” the authors concluded.

—Angelique Platas

Reference

Helliwell PS,  Tillett W,  Waxman R, et al. Evaluation and validation of a patient-completed psoriatic arthritis flare questionnaire. J Rheumatol. Published August 2021, 48(8)1268-1271 
DOI: https://doi.org/10.3899/jrheum.201317