ArticleBMC rheumatology2019
Disease activity flares and pain flares in an early rheumatoid arthritis inception cohort; characteristics, antecedents and sequelae.
Article in BMC rheumatology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- Co-designing interventions for patients with inflammatory arthritis: a systematic review.Systematic reviews · 2026Pooled it
- Performance of the Rheumatoid Arthritis Impact of Disease (RAID) score in relation to flares in disease activity.RMD open · 2024Trial
- Rheumatoid arthritis in crisis: investigating the impact of stress on RA flares during the COVID-19 pandemic.Clinical rheumatology · 2026Article
- Effectiveness and Safety of Upadacitinib in Treating Oligoarticular and Polyarticular Psoriatic Arthritis: Primary Analysis from the UPJOINT-Study.Rheumatology and therapy · 2026Article
- Central Sensitization and Nociplastic Pain: Shared Mechanisms in Fibromyalgia, Osteoarthritis, and Inflammatory Arthritis.Journal of pain research · 2026Review
- Associations Between Daily Symptoms and Pain Flares in Rheumatoid Arthritis: Case-Crossover mHealth Study.JMIR mHealth and uHealth · 2025Article
- Article
- Synovial fibroblast gene expression is associated with sensory nerve growth and pain in rheumatoid arthritis.Science translational medicine · 2024Article
- Review
- Central sensitization in osteoarthritic knee pain: A cross-sectional study.Turkish journal of physical medicine and rehabilitation · 2023Article
- Insights Into the Concept of Rheumatoid Arthritis Flare.Frontiers in medicine · 2022Review
- Review
- Pain Mechanism in Rheumatoid Arthritis: From Cytokines to Central Sensitization.Mediators of inflammation · 2020Review
- Cannabis Use in Arthritis: Impact on Health-Related Quality of Life.Medical cannabis and cannabinoidsArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRA flares are common and disabling. They are described in terms of worsening inflammation but pain and inflammation are often discordant. To inform treatment decisions, we investigated whether inflammatory and pain flares are discrete entities.
methodsPeople from the Early RA Network (ERAN) cohort were assessed annually up to 11 years after presentation (
resultsDAS28 (45%) and Pain Flares (52%) were each common but usually discordant, with 60% of participants in DAS28 Flare not concurrently in Pain Flare, and 64% of those in Pain Flare not concurrently in DAS28 Flare. Three discrete DAS28 Flare subgroups were identified. One was characterised by increases in tender/swollen joint counts (14.4%), a second by increases in symptoms (13.1%), and a third displayed lower flare severity (72.5%). Two discrete Pain Flare subgroups were identified. One occurred following low disease activity and symptoms (88.6%), and the other occurred on the background of ongoing active disease and pain (11.4%). Despite the observed differences between DAS28 and Pain Flares, each was associated with increased disability which persisted beyond the flare episode.
conclusionFlares are both common and heterogeneous in people with RA. Furthermore our findings indicate that for some patients there is a discordance between inflammation and pain in flare events. This discrete flare subgroups might reflect different underlying inflammation and pain mechanisms. Treatments addressing different mechanisms might be required to reduce persistent disability after DAS28 and Pain Flares.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.