REVIEW - Induction of remission in RA: criteria and opportunities

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Rheumatol Int. 2008 Dec;29(2):131-9. Epub 2008 Sep 21.

Induction of remission in rheumatoid arthritis: criteria and opportunities.

Valesini G, Di Franco M, Spinelli FR, Scrivo R.

Dipartimento di Clinica e Terapia Medica, Reumatologia, Sapienza,

Università di Roma, Policlinico Umberto I, 00161, Rome, Italy.

The concept of remission in rheumatology is complicated by the lack of

a single gold standard measurement, spontaneous remissions and the

usage of several sets of remission criteria. Feasibility is reduced by

traditional clinical practice, which does not include remission

criteria monitoring. The " window of opportunity " to prevent joint

damage with DMARD therapy lasts only a few months. The perspective of

the physician and patient differ, as the former gives importance to

signs of disease activity, whereas the latter to disability and

quality of life. All patients with rheumatoid arthritis are candidates

for combination DMARD-based therapy, which should be instituted

without delay. Remission is important to prevent joint destruction,

preserve adequate quality of life and prevent disability. The

introduction of biological agents has made this objective feasible,

but the failure rate is still high (about 50%), on account of lack of

response, contraindications and intolerance.

PMID: 18807254

http://www.ncbi.nlm.nih.gov/pubmed/18807254

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