Insights Into the Concept of Rheumatoid Arthritis Flare
Emanuele Bozzalla Cassione, Silvia Grignaschi, Blerina Xoxi, Terenzj Luvaro, Maria Immacolata Greco, Iolanda Mazzucchelli, Serena Bugatti, Carlomaurizio Montecucco, Antonio Manzo
Abstract
Identification of a pathological change in the course of systemic chronic immune-inflammatory diseases is key to delivering effective treatment strategies. In this context, one of the most compelling issues is the concept of flare. The multifaceted expression of disease activity in rheumatoid arthritis (RA) makes it challenging to provide an omni-comprehensive definition of flare, encompassing the pathology's different objective and subjective domains. Our incomplete understanding of the pathophysiological mechanisms underlying this process contributes to the partial comprehension of its potential clinical expression. This review focuses on the proposed pathophysiological processes underlying disease recrudescence in RA and the variable definitions adopted to capture flare in clinical practice through its objective, subjective, and temporal domains. Overall, what emerges is a complex landscape far from being unraveled.