title: Characteristics of patients with rheumatoid arthritis in clinical remission: the many aspects of DAS28 remission.
abstract: OBJECTIVE
  The aim of this study was to observe the clinical characteristics, including the extent of foot and ankle involvement, of Korean patients with rheumatoid arthritis (RA) in remission, defined as Disease Activity Score in 28 joints (DAS28) <2.6.
  
  
  METHODS
  Data from a registry of RA patients who visited a rheumatology clinic of a university-affiliated hospital and who were regularly evaluated with DAS28, including the ankle and foot metatarsophalangeal (MTP) joints were enrolled. Patients who were treated with disease-modifying anti-rheumatic drugs for at least three months and who were in DAS28 remission were included in this study.
  
  
  RESULTS
  Two hundred and thirteen episodes of DAS28 remission were observed in 147 patients. The mean DAS28 value at the time of remission was 1.84 (range, 0.14-2.59). The mean numbers of swollen joints and tender joints (of the 28 joints examined for DAS28) at the time of remission was 0.4 (range, 0-6) and 1.5 (range, 0-13), respectively. Overall, 11.7% and 38% of the patients in clinical remission had foot MTP/ankle swollen and tender joints, respectively. Additionally, 7% and 8.9%, respectively, of the patients in clinical remission had foot MTP/ankle swollen and tender joints without any involvement of the 28 joints included in the DAS28.
  
  
  CONCLUSIONS
  Our results show that RA patients in DAS28 remission frequently have residual disease activity in the ankle and foot joints. Given that fore-foot disease activity can lead to joint damage and disability with respect to weight-bearing activities, these joints should be included in the clinical examination.
authors.affiliation: Division of Rheumatology, Department of Internal medicine, Hallym University Sacred Heart Hospital, Anyang Kyunggi, Korea. jollyfox@hanmail.net
authors.forename: Kyeong Min
authors.initials: KM
authors.lastname: Son
authors.forename: Su Hee
authors.initials: SH
authors.lastname: Song
authors.forename: Soo Kyung
authors.initials: SK
authors.lastname: Lim
authors.forename: Young Il
authors.initials: YI
authors.lastname: Seo
authors.forename: Hyun Ah
authors.initials: HA
authors.lastname: Kim
mesh_terms: D000328:Adult; D000843:Ankle Joint / Q000187:drug effects / Q000473:pathology; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D018771:Arthralgia / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy* / Q000208:ethnology; D044466:Asian People; D005260:Female; D033023:Foot Joints / Q000187:drug effects* / Q000473:pathology; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008683:Metatarsophalangeal Joint / Q000187:drug effects / Q000473:pathology; D008875:Middle Aged; D010147:Pain Measurement; D011237:Predictive Value of Tests; D012042:Registries; D012074:Remission Induction; D056910:Republic of Korea; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents