Evidence for predictive validity of remission on long-term outcome in rheumatoid arthritis: a systematic review.
OBJECTIVE
Remission is rapidly becoming a key end point in rheumatoid arthritis (RA) clinical trials, but its definition is not satisfactory. Although it is generally believed that achieving a state of remission will lead to better structural outcome, this has not been studied systematically. As part of an undertaking to redefine remission, the current review describes the relationship between remission and long-term structural outcome.


METHODS
A systematic literature search of PubMed, EMBase, and The Cochrane Library intersected 3 groups of terms: RA, remission, and long-term outcome. The search identified 1,138 records, of which 14 were relevant to the research question.


RESULTS
All of the studies included in this review showed a relationship between remission and long-term structural damage or disability. Patients that achieved a state of remission, defined in various ways, showed less deterioration of function and radiographic progression compared with patients who did not reach a state of remission.


CONCLUSIONS
Patients who achieved a state of remission were less likely to show deterioration of function and radiographic progression compared with patients who did not reach a state of remission.
van Tuyl
Lilian H D
LH
Department of Rheumatology, VU University Medical Center, Amsterdam, The Netherlands. L.vanTuyl@vumc.nl
Felson
David T
DT
Wells
George
G
Smolen
Josef
J
Zhang
Bin
B
Boers
Maarten
M
D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D004359:Drug Therapy, Combination; D005060:Europe / Q000453:epidemiology; D019317:Evidence-Based Medicine / Q000379:methods* / Q000639:trends*; D006801:Humans; D011237:Predictive Value of Tests; D011859:Radiography; D016032:Randomized Controlled Trials as Topic / Q000379:methods / Q000592:standards / Q000639:trends; D012074:Remission Induction; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology