remission medical logo

New Definition for Remission in RA

There’s newly released guidance for defining remission in rheumatoid arthritis (RA), which will likely increase the number of patients achieving it while retaining its ability to predict objective outcomes.

The revised criteria is from the American College of Rheumatology (ACR) and the European Alliance of Associations for Rheumatology (EULAR), and appeared in joint publications in Arthritis & Rheumatology and the Annals of the Rheumatic Diseases.

As a function of data from four clinical trials comparing biologic RA drugs to methotrexate alone or placebo, the researchers discerned that it was feasible to accept higher scores for patients’ global assessments of disease activity — 2.0 cm on a standard 10-cm rating scale — as part of the definition of remission, which still is adherent with remission as defined by clinician evaluations.

The adjusted definition kept the same correlations with the risk of radiographic progression and functional disability as seen with prior definitions. Further, researchers concluded that discarding the patient assessment altogether “worsened the prediction of good functional outcomes.”

Versus the prior threshold for remission of a 1 cm global assessment score, the choice of 2.0 cm increased the proportion of patients achieving remission from 14.8% to 20.6% in early RA and from 4.2% to 6.0% in patients with chronic RA disease.