Active not recruitingOBSERVATIONAL

The REFLECT Study- Flares in axSpA

The REFLECT study is looking into a condition called axial spondyloarthritis (axSpA), which causes long-term pain and stiffness in the spine and joints. People with axSpA often have times when their symptoms suddenly get worse, known as "flares." These flares can be very difficult and unpredictable. This study aims to better understand what flares are like for people, what triggers them, and how they affect daily life. Participants will use a digital diary for 12 months to record their symptoms, diet, and daily activities, and how flares impact their work and well-being. They will also attend two hospital appointments for blood tests. The goal is to help doctors and patients identify and manage flares more effectively in the future, improving long-term care.

At a glance

Status

Active not recruiting

Sponsor

Royal United Hospitals Bath NHS Foundation Trust

Enrolment target

Start

01 Jun 2026

Estimated completion

31 Aug 2026

Axial Spondyloarthritis (AxSpA)Axial Spondyloarthritis, Non-Radiographic Axial Spondyloarthritis, Radiographic Axial Spondylarthritis (r-axSpA)

What is this study about?

If you have a condition called axial spondyloarthritis (axSpA), you might know that it causes long-term pain and stiffness, mainly in your spine and the joints at the base of your back. Sometimes, your symptoms can suddenly get much worse; these periods are called "flares." Flares can be really painful, come on unexpectedly, and make it hard to do everyday things, go to work, and can even affect your mood and relationships. Because they are so unpredictable, flares can leave people feeling anxious about when the next one might hit.

Doctors and researchers know that having lots of severe flares can lead to more problems with axSpA over time. However, it's actually quite tricky for them to agree on exactly what a flare is, or to predict when one will happen. This means there's a big need to learn more about flares so that doctors can step in earlier and give more effective help, which could lead to better health for people with axSpA in the long run.

This study, called REFLECT, wants to hear directly from people living with axSpA about their experiences with flares. By gathering information over a year using a digital diary, we hope to build a clearer picture of what flares are like for different individuals. This information will help us understand why flares happen and how they affect different parts of your life, from your symptoms and diet to your mental well-being and relationships. We also hope to find potential "windows of opportunity" where an early action might help reduce the impact of a flare. Ultimately, this research aims to create new tools and ways for patients and doctors to work together to spot and manage flares more effectively in the future. The study is taking place at two specialist hospitals in the UK: The Royal National Hospital for Rheumatic Diseases in Bath and King's College Hospital in London.

Key takeaways

The REFLECT study aims to understand axSpA 'flares'.
Flares are when axSpA symptoms suddenly worsen.
Participation involves a digital diary for 12 months.
You'll have two hospital visits for blood tests.
The goal is to improve flare management for future patients.
Your contribution could help develop new patient tools.

Who may be eligible?

This study is looking for adults aged 18 or over who have been diagnosed with axial spondyloarthritis (either non-radiographic or radiographic axSpA). To join, you need to be able to use an electronic device, like a smartphone or computer, and have an email address so you can take part in the digital parts of the study.

You also need to be able to understand the study information and give your permission to take part (this is called informed consent). It’s important that you can communicate in English, as that's the language the research is conducted in. Lastly, you must have experienced at least one flare in the 12 months before you express interest in joining the study.

There are a few reasons why someone might not be able to join. For example, if you are under 18 or have another type of inflammatory arthritis that isn’t axSpA. Also, if you have a significant mental health condition or if taking part might cause you too much stress, you wouldn't be able to join. If you’ve previously participated in a study called Project Nightingale (at the Royal United Hospitals, Bath, between 2018-2022), you also won't be eligible to join REFLECT.

Could this study suit you?

Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.

Are you 18 years old or older?
Do you have a diagnosis of axial spondyloarthritis (axSpA)?
Do you have access to email and a device to use for data collection?
Can you communicate in English?
Have you had at least one axSpA flare in the past 12 months?
Have you *not* participated in Project Nightingale (at RUH, Bath)?

Answer every question to see your result.

What does participation involve?

If you decide to take part in the REFLECT study, you'll be involved for a total of 12 months. The main way you'll contribute is by using a digital diary to record information regularly. This diary will ask about your symptoms, everyday activities, diet, lifestyle choices, self-management strategies, and how flares affect your work, well-being, and relationships.

Over the 12 months, you will attend two in-person clinic appointments at one of the study hospitals. One of these appointments will happen when you are experiencing a flare, and the other will be when you are not in a flare. At both of these appointments, a small blood sample will be taken to check for certain markers in your blood that might give us clues about inflammation during flares.

Potential risks and benefits

Taking part in this study could help future patients with axSpA by improving our understanding of flares and leading to better ways to manage them. While there are no direct personal benefits for you, your input is invaluable. The potential risks are minimal, mainly involving the minor discomfort from blood tests. We will ensure your personal information is kept private throughout the study. Remember, your participation is voluntary, and you have the right to withdraw from the study at any time without giving a reason, and this will not affect your usual medical care.

Locations (2)

Some site locations are approximate. We're improving this — please verify with the trial team before travelling.

Royal United Hospitals Bath NHS Foundation Trust
Verified postcode
Bath, United Kingdom
King's College Hospital NHS Foundation Trust
Verified postcode
London, United Kingdom

Common questions

What is axial spondyloarthritis (axSpA)?

AxSpA is a long-term condition that causes inflammation, pain, and stiffness, mainly in the spine and the joints at the bottom of your back.

What is a 'flare' in axSpA?

A flare is when your axSpA symptoms, like pain and stiffness, suddenly get much worse than usual for a period of time.

How often do I need to go to the hospital?

You'll only need to visit the hospital twice over the whole 12 months – once during a flare and once when you're not having a flare.

What will I do with the digital diary?

You'll use the digital diary to regularly record your symptoms, diet, lifestyle, and how flares affect your daily life, work, and feelings.

Can I stop taking part if I change my mind?

Yes, you can choose to leave the study at any time, for any reason, and it won't affect your medical care.