Achieving Remission in Rheumatoid Arthritis What is ‘remission?’

In general terms, remission describes the point when the symptoms of a disease are either greatly reduced or no longer evident. For people with rheumatoid arthritis (RA), this means that all or most symptoms of the disease, such as inflammation, pain, and fatigue, have gone away and further damage to the joints has stopped. Measuring disease activity and remission One of the most widely accepted methods of defining disease activity in RA is the Disease Activity Score 28, known as the ‘DAS28 ’ scoring system.1 The DAS28 scoring system takes into account several measures: • The number of tender and swollen joints (this can be between 0 and 28) • A blood test to measure the level of inflammation in the body, with either the erythrocyte sedimentation rate (ESR) or C-reactive protein(CRP) • The patient’s own assessment of their general health which they are asked to rate on a visual scale (this can range from ‘very good ’ to ‘very bad’) The results of the above measures are used to calculate a DAS28 score between 0 and 10. A patient is considered to be in remission when they have a score of DAS28 <2.6 out of 10.i Achieving remission: Treating RA early People with RA suffer permanent joint damage early on in the disease, and this occurs most rapidly within the first six months.ii Therefore, a major goal of disease management is to begin treatment as soon as possible after diagnosis in order to prevent this damage from occurring in the first place and to give people with RA the best chance of achieving a rapid and long-lasting remission