How should rheumatoid arthritis disease activity be measured today and in the future in clinical care?

Quantitative clinical monitoring of musculoskeletal conditions and inflammatory joint diseases is challenging. Traditional measures to assess rheumatoid arthritis (RA), such as joint assessment, laboratory, imaging, and patient self-report measures, have limitations and provide only a reflection of the underlying inflammatory process. A gold standard to define disease activity in RA does not exist and various indices of disease activity must be used. Standard quantitative monitoring with a treatment goal has been shown to be beneficial to patient outcomes in randomized clinical trials. Quantitative monitoring has also contributed to improved long-term outcomes for RA in clinical care. Challenges of the measures need to be recognized and hurdles identified that prevent quantitative monitoring in every-day clinical care concerning disease activity and beyond. These aspects are discussed in this article.