Remission and radiographic outcome in rheumatoid arthritis: application of the 2011 ACR/EULAR remission criteria in an observational cohort

Abstract

Patients with RA in remission by any established criteria can experience radiographic progression. An increased number of visits in remission was associated with reduced radiographic damage.

Patient-reported Remission in Rheumatoid Arthritis

“…Shahouri, et al reported good agreement between the trial and practice-based criteria, and both Lillegraven and Zhang reported comparable predictive validity of the practice-based criteria in observational datasets as compared to trial datasets from which they were developed 2,3,6 .…”

“…The set of 4 proposed criteria -2 clinical trial criteria and 2 clinical practice criteria -have since been the subject of several validation studies. Rheumatology researchers have shown that clinical trial criteria requiring a tender joint count, swollen joint count, C-reactive protein (CRP) and patient global assessment ≤ 1 or a Simplified Disease Activity Index (SDAI) ≤ 3.3 perform well in both trial and clinical-practice settings 2,3,4,5,6 .…”

Association of the multi-biomarker disease activity score with joint destruction in patients with rheumatoid arthritis receiving tumor necrosis factor-alpha inhibitor treatment in clinical practice

“…Conversely, radiographic progression can sometimes occur among patients who are in clinical remission [10][11][12][13]. Measures that could reliably predict the risk of radiographic progression while tracking disease activity could inform clinicians and patients and support treatment decisions focused on clinical remission and prevention of irreversible joint damage.…”

Rheumatoid Arthritis: Are Current Research-based Guidelines Clinically Relevant?

“…The lack of radiographic progression, then, could be a surrogate for lack of clinical progression or preservation of function over the longer term. However, a number of studies concluded that radiologic progression continues despite attaining clinical remission, regardless of the criteria used to define this remission 3,4 . Additionally, the timepoint at which radiographic progression is examined appears to be significant.…”