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Remission in rheumatoid arthritis.

Rania M Shammas1, Veena K Ranganath, Harold E Paulus

  • 1Division of Rheumatology, University of California Los Angeles, Veterans Association Greater Los Angeles Health System, Los Angeles, CA, USA. rshammas@mednet.ucla.edu

Current Rheumatology Reports
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PubMed
Summary

Achieving remission is the goal in rheumatoid arthritis treatment, but defining and measuring it remains challenging. A consensus on remission criteria is needed for clinical trials and practice, as complete disease absence may not be realistic.

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Area of Science:

  • Rheumatology
  • Clinical Immunology
  • Medical Therapeutics

Background:

  • Advancing therapeutic options have shifted rheumatoid arthritis (RA) treatment goals towards achieving remission.
  • Defining and consistently measuring remission in RA remains a significant clinical challenge.
  • Current treatment strategies aim for remission, but a unified definition is lacking.

Purpose of the Study:

  • To highlight the challenges in defining and assessing remission in rheumatoid arthritis.
  • To emphasize the need for a consensus definition of remission for RA.
  • To discuss the implications of current remission criteria for clinical trials and practice.

Main Methods:

  • Review of existing literature on rheumatoid arthritis remission criteria.
  • Analysis of the strengths and limitations of multiple devised and modified remission criteria.
  • Discussion on the necessity of a consensus definition for evaluating clinical trial outcomes and setting treatment targets.

Main Results:

  • Multiple, varied remission criteria for rheumatoid arthritis exist, each with distinct advantages and disadvantages.
  • Disagreement persists regarding the precise definition of remission and the appropriate measures for assessing disease activity.
  • The complete absence of disease as a remission definition may not be an achievable therapeutic objective in current RA management.

Conclusions:

  • A consensus definition for rheumatoid arthritis remission is crucial for standardizing clinical trial evaluations and establishing practical treatment targets.
  • The development of a unified remission criterion is essential for advancing RA patient care.
  • Current therapeutic goals in RA may need re-evaluation considering the feasibility of complete disease eradication.