title: Remission in rheumatoid arthritis: is it all the same?
abstract: Remission is the key treatment goal in rheumatoid arthritis and should provide the optimal state for patients. Clinical remission criteria are based on composite scores of disease activity and are widely used in clinical practice and trials. With the use of biologic therapies and treat to target strategies, rates of clinical remission have significantly improved. Despite achieving this target, many patients demonstrate structural and functional deterioration. This raises the question regarding the validity of clinical criteria, although they have evolved significantly over the years. Imaging modalities such as ultrasound have been described as more accurate methods of assessing the remission state compared with clinical assessment alone. Furthermore, immuno-pathological assessments are gaining significant interest as this would enable assessment of disease activity at the primary site of pathology. Further research is required to develop accurate biomarkers of remission. We aimed to review the evolution of remission criteria in rheumatoid arthritis to date and to evaluate novel concepts in and the future of defining remission.
authors.affiliation: a 1 Leeds Institute of Rheumatology & Musculoskeletal Medicine, 2nd Floor, Chapel Allerton Hospital, Chapeltown Road, Leeds, LS7 4SA UK.
authors.forename: Hanna L
authors.initials: HL
authors.lastname: Gul
authors.forename: Joana F
authors.initials: JF
authors.lastname: Ferreira
authors.forename: Paul
authors.initials: P
authors.lastname: Emery
mesh_terms: D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000503:physiopathology; D001691:Biological Therapy / Q000379:methods*; D015415:Biomarkers / Q000378:metabolism; D006801:Humans; D012074:Remission Induction / Q000379:methods
chemical_list: D018501:Antirheumatic Agents; D015415:Biomarkers
keywords: T-cell immunology; biomarkers; classification criteria; comprehensive disease control; disease-modifying anti-rheumatic drugs; remission; rheumatoid arthritis; ultrasound