Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Frequency of Remission, Low Disability in RA Studied

Semin Arthritis Rheum; ePub 2018 Dec 28; Scott, et al

Attaining remission in rheumatoid arthritis (RA) is highly specific for attaining low disability and normal health-related quality of life (HRQOL), although many patients with more active disease also have good function and HRQOL, a recent study found. Furthermore, attaining a Disease Activity Score 28-erythrocyte sedimentation rate (DAS28-ESR) ≤3.2 has a better balance of specificity and sensitivity for attaining these outcomes, with the benefit of being more readily achievable. Researchers studied 571 patients in 2 clinical trials, and 1,693 patients in a 10-year routine care cohort. They found:

  • Point remission and remission/low disease activity (LDA) were common (achieved by 35-58% and 49-74% of patients, respectively), but were rarely sustained (sustained remission and remission/LDA achieved by 5-9% and 9-16% of patients, respectively).
  • Following attaining remission, DAS28-ESR levels varied substantially.
  • Despite this, of those patients attaining point remission, the majority (53-61%) were in remission at study end-points.
  • While remission was highly specific at identifying patients with low disability (85-91%), it lacked sensitivity (51-57%); similar findings were seen for normal HRQOL (specificity 78-86%; sensitivity 52-59%).

Scott IC, Fowzia I, Panayi G, et al. The frequency of remission and low disease activity in patients with rheumatoid arthritis, and their ability to identify people with low disability and normal quality of life. [Published online ahead of print December 28, 2018]. Semin Arthritis Rheum. doi:10.1016/j.semarthrit.2018.12.006.