British Journal of Rheumatology 1996;35:1039-1042 EDITORIALS PREDICTING AND DECIDING ON REMISSION IN RHEUMATOID ARTHRITIS

greatest at the onset of disease with the number of swollen joints maximal at this time and a high probability of developing joint damage or erosions within 2 yr of the onset of disease [1-3]. Early aggressive treatment of RA may alter the disease course [4-6]. Thus, initiation of disease-modifying anti-rheumatic drug (DMARD) therapy should not be delayed beyond 3 months [1,7]. However, the diagnosis of RA may be difficult in early disease [8] and the prognosis varies within wide limits: some cases have a tendency to spontaneous (natural) remission, while others result in chronic inflammation with destruction of joints, functional disability, morbidity and mortality. Also, conventional therapies have significant adverse side-effects. Ideally