Management of Rheumatoid Arthritis Flares

Characteristics of Flares

• Rheumatoid arthritis flares represent a worsening of disease activity that is outside the patient's usual day-to-day variation, characterized by increased joint inflammation, pain, morning stiffness, and possible functional deterioration 1

Evaluation of Flares

• The American College of Rheumatology recommends identifying flares based on an increase in the number of inflamed and painful joints, worsening of pain and morning stiffness, and deterioration of physical function 1
• The European League Against Rheumatism suggests using composite measures of disease activity, such as DAS28, SDAI, and CDAI, to objectively quantify disease activity and identify flares 3

Management of Flares

• The American College of Rheumatology recommends adjusting therapy with disease-modifying antirheumatic drugs (DMARDs) as needed to manage flares 1
• The Mayo Clinic suggests considering intra-articular corticosteroid injections for localized flares in specific joints 2
• The goal of treatment during a flare is to regain a state of low disease activity or remission, with regular evaluation of disease activity every 1-3 months in patients with active rheumatoid arthritis 4

Importance of Controlling Flares

• The European League Against Rheumatism emphasizes the importance of preventing flares to establish ideal control of rheumatoid arthritis, as frequent flares can increase the risk of progressive joint damage and disability 2
• Controlling flares contributes to improving patient quality of life and functionality 3