Abstract Background/Aims A characteristic of systemic autoimmune rheumatic diseases (SARDs) is unpredictable worsening of symptoms or disease activity after a period of stability, commonly known as “flares”, that significantly impact patients’ quality of life. Despite clinical advances, the factors that trigger or prevent flares remain poorly understood, and patients’ perspectives are seldom incorporated into research in the area. Emerging evidence suggests that psychosocial, environmental, and lifestyle factors play a significant role in flare dynamics, yet these are underrepresented in clinical assessments. The primary aim of the study was to explore and compare perceptions of flare triggers and preventers among patients with different SARD diagnoses (e.g., systemic lupus erythematosus, rheumatoid arthritis, Sjögren’s syndrome, etc.). Further, we examined how patients acquire and use knowledge to manage flares. Methods Extensive co-production preliminary work with groups of people living with SARDs resulted in an initial exploratory survey completed by N = 812 patients, which included open-text questions about which factors triggered and prevented their flares. These data were then incorporated into the “INSPIRE-trigger” survey made available internationally online from April to July 2025. Patients first indicated whether they believed factors within grouped categories (e.g., hormonal, dietary, environmental, pharmacological, and psychosocial) affected their flares (yes, maybe, no). They were then asked to rate a series of potential flare-related factors within each category using a co-created scale ranging from −2 (triggers a flare) to 0 (no effect) to + 2 (prevents a flare). Additional items assessed flare trigger consistency and sources of knowledge of triggers (e.g., symptom tracking, medical advice). Chi-square tests and ANOVA/Kruskal-Wallis will be used to compare flare perceptions between disease groups and sociodemographic variables including gender and ethnicity (analysis ongoing at time of submission). Results Completed surveys were received from individuals diagnosed with SARDs (N = 1,798). Data analysis is currently underway, and the results will be presented at the conference. Patient responses will be compared across 11 SARD types (systemic lupus erythematosus, rheumatoid arthritis, Sjögren’s syndrome, scleroderma, undifferentiated/mixed connective tissue disease, vasculitis, polymyalgia rheumatica, Behcet’s syndrome, antiphospholipid syndrome, and inflammatory muscle disease). Preliminary analysis suggests that, when all SARD groups are combined, patients most commonly identified physical activity (62%), life stressors (62%), change/onset of psychiatric symptoms (59%), and medical/treatment related factors (including alterations to/skipping medication) (56%) as variables influencing flares (triggers/prevents). Conclusion Findings from this large-scale, co-produced survey will offer critical insight into patients’ perspectives on the triggers and preventers of flares across SARDs. By quantifying these perspectives, the study will reveal shared and condition-specific flare triggers and preventers, better equipping clinicians with knowledge to support effective SARD management. The results may also inform the development of tailored educational resources and flare management strategies that reflect patient experience, advancing the goal of truly patient-centred rheumatology care. Disclosure A. Arunasalam: None. M. Piper: None. D. D’Cruz: Consultancies; D.D’C reports consultancy/speaker fees from GSK, Eli Lilly and UCB. Grants/research support; D.D’C. reports grants from MRC, NIHR, LUPUS UK and The Lupus Trust. Other; D.D’C report a leadership role on the board of APS support UK. J.A. Bourgeois: Royalties; JAB receives royalties from American Psychiatric Publishing, Springer International, Lippincott Williams JAB has received speaking fees from Psychiatric Times and Oakstone. F. Naughton: None. A. Bortoluzzi: None. P. Saha: None. A. Kaul: None. G. Leschziner: None. T. Pollak: Grants/research support; T.A.P. was supported by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley National Health Service Foundation Trust and King’s College London. L. Calderwood: None. M. Pitkanen: None. P. Hamilton-Conaty: None. M. Yates: None. E. Dalby: None. X. Yan: None. M. Sloan: Grants/research support; M.S. is funded by The Lupus Trust and LUPUS UKMP.
Arunasalam et al. (Wed,) studied this question.