New provisional ACR/EULAR definition of remission in clinical trials for rheumatoid arthritis

The new American College of Rheumatoid Arthritis (ACR)/European League Against of Rheumatism (EULAR) provisional definition for rheumatoid arthritis (RA) has been published by Felson, et al., in the January 2011 issue of Arthritis and Rheumatism.

With advances in treatment for RA, there is a greater feasibility of attaining remission.

Two definitions have emerged:  1) Boolean ; 2) Index-based.

Boolean-based definition:

The patient must satisfy all of the following, at any point in time:

Tender joint count less than or = 1

Swollen joint count less than or = 1

C-reactive protein less than or =1 mg/ml

Patient global assessment less than or =1 (on a 0 to 10 scale)

Index-based definition:

At any time point, patient must have:

Simlified Disease Activity Index score of less than or =3.3

 While these remission criteria have not yet been validated, it is hoped that they will form a common basis for defining remission in clincal trials and perhaps in clinical practice.

Rheumatoid Arthritis