A recent study has published real-world data on RA remission and investigated whether there are predictors that may make remission more likely.
Remission in rheumatoid arthritis
About one third of patients achieve remission with close monitoring of disease activity and treatment.
It took an average of eight months to achieve remission.
Predictive factors for long-term remission were absence of relapse, achievement of remission within six months, age over 60 years, ACPA negativity and baseline DAS28 below 5.1
Remission is realistic for only one third of patients
The current study included people with rheumatoid arthritis who were undergoing escalation therapy with csDMARDs and biologics under close monitoring.
499 patients were included in the long-term study (mean follow-up of 108 months). However, only 157 of them achieved long-term remission, equal to about one third. Long-term remission was defined as:
Meeting the remission criteria of the American Rheumatism Association (ARA).
Taking less than 5 mg prednisolone per day for more than five years.
There are predictive factors
On average, it took eight months to achieve long-term remission. The researchers also investigated whether there might be predictive factors that are associated with a more favourable course and thus make remission more likely.
There was an association between long-term remission and:
Absence of relapse.
Achievement of remission within six months of starting treatment.
Age at first diagnosis over 60 years.
Absence of detection of ACPA antibodies in the blood.
Baseline DAS28 score of less than 5.1
Conclusion for medical practice
The newly published real-world data show that about one-third of RA patients can achieve long-term remission - with appropriate therapy. Moreover, there are predictive factors that could speak for a more positive course of the disease.
Khabbazi A, Gadakchi L, Moslemi M, Khalaji A, Esalatmanesh K, Ziarati Yazdeli A, Hajialilo M, Malek Mahdavi A. Prevalence and predictors of long-term remission in rheumatoid arthritis in real-world practice: a longitudinal study. Clin Rheumatol. 2023 Feb 17. doi: 10.1007/s10067-023-06548-1. Epub ahead of print. PMID: 36800137.