Active — Not RecruitingNot Applicable

The REFLECT Study- Flares in axSpA

United Kingdom40 participantsStarted 2026-06-01

Plain-language summary

Axial spondyloarthritis (axSpA) is a long-term inflammatory condition that affects the spine and sacroiliac joints. People living with axSpA often experience periods when their symptoms suddenly worsen, known as disease "flares." These flares can be painful, unpredictable, and significantly affect daily life, work and psychological wellbeing. Their unpredictable nature can leave people feeling helpless and anxious about when symptoms will return. Research has shown that severe or frequent flares are linked to worse long-term outcomes in axSpA. However, it is difficult for researchers and clinicians to clearly define what a flare is, or to predict when one will happen. There is an unmet, urgent need to improve our understanding and recognition of flares, to enable earlier and more effective intervention, and improve long-term outcomes. This study will explore people's experiences of flares, through a real-time digital flare and symptom diary. Data will be captured digitally from people living with axSpA over 12 months, including symptoms, diet, and lifestyle, self-management strategies and impact of flare on life, work, psychological wellbeing and relationships. Participants will attend clinic at two time points only (once when in flare, once when not in flare), to collect blood (serum) samples for investigation of inflammatory markers. Findings will enable us to define and "map" different flare experiences of people living with axSpA and identify windows of opportunity for intervention and effective management. The results will inform the development of a novel, patient-initiated digital pathway for flare identification and management, which will be discussed and refined in a series of workshops with patients and healthcare professionals. This project will take place in two UK NHS hospitals (specialist rheumatology care settings): The Royal National Hospital for Rheumatic Diseases, Bath and King's College Hospital, London. We anticipate future work to pilot test the pathway and inform potential wider NHS implementation

Who can participate

Age range

18 Years

Sex

ALL

See this in plain English?

AI-rewrites the medical criteria so a patient or caregiver can understand them. Always confirm with the trial site.

Inclusion Criteria: * Adult patients (≥18 years) with a diagnosis of axSpA (non-radiographic or radiographic axSpA). * Access to an email address and electronic device, to participate in data collection. * Capacity to provide informed consent. * Sufficient communicative ability to participate in the research study (must be able to communicate in English). * Patient has experienced at least one (self-reported) flare in the 12-months prior to enrolment. Exclusion Criteria: * Patients \<18 years of age. * Patients with another diagnosis of inflammatory arthritis that is not axial spondyloarthritis. * Living with significant psychiatric morbidity, or if participation may cause distress. * Patient has participated in Project Nightingale (RUH only, 2018 - 2022).

Questions worth asking your doctor

Bring these to your next appointment. They're a starting point for a shared conversation — not a sign you qualify or a recommendation to enrol.

1Since this study is focused on self-reported flares in axial spondyloarthritis, how would tracking and reporting my own flare-ups actually work in practice, and would it fit into my daily routine?
2This trial is listed as 'active but not recruiting' — does that mean there's no chance of me joining now, and are there similar observational studies I could look into instead?
3Since this is a Phase NA observational study measuring flare patterns rather than testing a treatment, would participating in any way change or delay the therapy I'm currently receiving or being considered for?
4This study covers both radiographic and non-radiographic axSpA — given my specific diagnosis, would my type of axSpA make my data particularly relevant to what this study is trying to learn?
5If my doctor thinks this kind of flare tracking would be useful for my care, is there a way to do something similar outside of this trial, such as keeping a structured symptom diary, while we wait to see if enrollment reopens?

Generated to help you prepare — always confirm anything about your own eligibility and care with the study team and your doctor.

Questions for the trial coordinator

The trial coordinator is the person who runs the study day to day. These cover the practical side — logistics, costs, and what taking part would actually mean for your life. The study team confirms whether you meet the criteria; these are questions to ask, not a sign you qualify.

1What does taking part actually involve week to week — how many visits, where, and how long does each one take?
2What costs are covered by the study, and what might I have to pay for myself, including travel, parking, or time off work?
3What happens during screening, and what happens if the study team confirms I don't meet the criteria after those tests?
4Who pays for the scans, blood work, and other tests the trial requires — the study, my insurance, or me?
5How will being in the trial affect my regular care, and will my own doctor stay informed and involved?
6Can I leave the trial at any point if I change my mind, and what would happen to my care if I do?

A starting point for the conversation — always confirm anything about your own eligibility, costs, and care with the study team and your doctor.

What they're measuring

Self-reported flares

Timeframe: From enrollment to end of 12 months

Trial details

NCT IDNCT07688174

SponsorRoyal United Hospitals Bath NHS Foundation Trust

Sponsor typeOTHER

Study typeOBSERVATIONAL

Primary completion2026-06-01

View on ClinicalTrials.gov More Axial Spondyloarthritis (AxSpA) trials