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Assessing remission in clinical practice.

M Mierau1, M Schoels, G Gonda

  • 12nd Department of Medicine, Hietzing Hospital, Vienna, Austria.

Rheumatology (Oxford, England)
|March 8, 2007
PubMed
Summary
This summary is machine-generated.

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Sustained remission in rheumatoid arthritis is achievable in 17-20% of patients. The Clinical Disease Activity Index (CDAI) and Simplified Disease Activity Index (SDAI) offer more stringent remission criteria than DAS28 and mACR, indicating less residual disease activity.

Area of Science:

  • Rheumatology
  • Clinical Practice
  • Disease Activity Assessment

Background:

  • Rheumatoid arthritis (RA) remission is the optimal patient outcome.
  • Evaluating sustained remission and assessment tools is crucial for RA management.

Purpose of the Study:

  • To assess sustained remission rates in a large, prospective RA cohort.
  • To compare the stringency of various remission-defining instruments in clinical practice.

Main Methods:

  • Prospective analysis of 621 RA patients with two consecutive visits (average 92 days apart).
  • Remission assessed using modified ACR (mACR), DAS28, SDAI, and CDAI criteria.
  • Sustained remission defined as remission at both visits; patients treated with conventional or biologic DMARDs.

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Main Results:

  • Sustained remission rates varied by instrument: 16.7-19.6%.
  • CDAI and SDAI showed higher agreement (very good) compared to DAS28 and mACR (moderate).
  • CDAI/SDAI remission had significantly less residual disease activity (approx. 5% swollen joints) than DAS28 (15%) or mACR (6%).

Conclusions:

  • Sustained remission is achievable in 17-20% of RA patients in clinical settings.
  • CDAI and SDAI are more stringent remission criteria, reflecting lower residual disease activity.
  • These findings support the use of CDAI and SDAI for a more rigorous assessment of sustained remission in RA.