STANDARDS - Defining remission in RA: results of an initial ACR/EULAR consensus conference

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Arthritis Rheum. 2009 Apr 29;61(5):704-710.

Defining remission in rheumatoid arthritis: Results of an initial

american college of rheumatology/european league against rheumatism

consensus conference.

Tuyl LH, Vlad SC, Felson DT, Wells G, Boers M.

VU University Medical Center, Amsterdam, The Netherlands.

OBJECTIVE: Due to advances in rheumatoid arthritis (RA) therapies over

the last few years, an increasing proportion of patients are able to

achieve a state of remission. However, the definition of remission is

unclear. Currently, randomized controlled trials around the world use

different remission definitions and consequently measure different

aspects of a patient's disease state. The need for a uniform

definition of remission is vital for research findings to be correctly

interpreted.

METHODS: The American College of Rheumatology (ACR) constituted a

committee that included international clinical researchers, trialists,

and clinical epidemiologists in order to redefine remission in RA.

This group was asked to study current definitions of remission,

explore the theoretical underpinning of the concept of remission, and

develop a research agenda that would inform future work in the

development of an ACR definition of remission.

RESULTS: In its first meeting, the committee preferred to develop a

strict definition, implying no or very low disease activity. Such a

definition would need to be validated against long-term outcome, e.g.,

physical function and damage.

CONCLUSION: The committee decided to consider both a definition for

trials and a modified version for clinical practice. Since the first

meeting, the ACR and the European League Against Rheumatism (EULAR)

have decided to sponsor this initiative as an official ACR/EULAR

collaboration.

PMID: 19405006

http://www.ncbi.nlm.nih.gov/pubmed/19405006

Not an MD