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Remission in early rheumatoid arthritis
Margaret H Y Ma1, Ian C Scott, Gabrielle H Kingsley
1Department of Rheumatology, GKT School of Medicine, King's College London, London, UK. margaret.ma@nhs.net
The Journal of Rheumatology
|June 3, 2010
Summary
Achieving remission is a feasible goal for early rheumatoid arthritis (RA) patients. Combination therapies, including disease-modifying antirheumatic drugs (DMARDs) and TNF inhibitors, significantly increase remission rates and reduce radiological progression.
Area of Science:
- Rheumatology
- Clinical Trials
- Observational Studies
Background:
- Early rheumatoid arthritis (RA) management aims for remission.
- Assessing remission frequency and treatment impact is crucial.
- Radiological outcomes in remission require further investigation.
Purpose of the Study:
- Systematically review remission as an outcome in early RA.
- Identify remission frequency using different criteria (ACR, DAS).
- Determine treatment strategy influence on remission and radiological outcomes.
Main Methods:
- Systematic review of observational studies and RCTs.
- Searched databases (PubMed, Medline, Embase) for early RA, remission, treatment, anti-TNF, and DMARDs.
- Analyzed remission rates using American College of Rheumatology (ACR) and Disease Activity Score (DAS) criteria.
Main Results:
- Remission observed in 27% of patients in observational studies (17% ACR, 33% DAS).
- RCTs showed higher remission rates with combination therapies (24% ACR, 42% DAS) vs. monotherapy (16% ACR, 26% DAS).
- Radiological progression occurred in remission, but was reduced by combination therapies.
Conclusions:
- Remission is an achievable treatment goal in early RA.
- Combination therapies (DMARDs +/- TNF inhibitors) enhance remission rates.
- Standardization of ACR and DAS criteria is needed for comparability.
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