From Carol & Richard Eustice,
Your Guide to Arthritis.
FREE Newsletter. Sign Up Now!

About.com Health's Disease and Condition content is reviewed by Kate Grossman, MD

What defines a true remission in rheumatoid arthritis patients? Can a doctor predict if a patient will go into a remission or how long a remission will last? Are there statistics on what percentage of rheumatoid arthritis patients ever achieve a remission? What can an RA patient do that will give them the best chance at achieving remission?

A. While there is no known cure for rheumatoid arthritis, up to 30% of patients may feel they are "cured" of their disease. What these patients are actually experiencing is a clinical remission. A remission in rheumatoid arthritis is defined as the absence of clinical signs of inflammation. While a very small percentage of patients may be able discontinue their arthritis medications, over 95% need to continue on the medication to remain in remission. The American College of Rheumatology (ACR) classification criteria for determining clinical remission include:

morning stiffness less than or equal to 15 minutes

no fatigue

no joint pain

no joint tenderness or pain on motion

no soft tissue swelling in joints or tendon sheaths

erythrocyte sedimentation rate -(a blood test which measures inflammation) less than or equal to 30 in females and 20 in males

While there is no way to determine who will achieve remission with therapy, patients with a negative rheumatoid factor and CCP antibody as well as a normal C-reactive protein (another measure of inflammation in the blood) appear to have a better outcome. In addition, patients taking combination therapy (e.g. methotrexate and a TNF inhibitor) are more likely to achieve remission than those taking either drug alone. Nevertheless, patients on monotherapy (eg. methotrexate only) still may achieve clinical remission. The longer the disease remains in remission, the less likey it is to become active again.

Answer provided by Scott J. Zashin, M.D., clinical assistant professor at University of Texas Southwestern Medical School, Division of Rheumatology, in Dallas, Texas. Dr. Zashin is also an attending physician at Presbyterian Hospitals of Dallas and Plano. He is a fellow of the American College of Physicians and the American College of Rheumatology and a member of the American Medical Association. Dr. Zashin is author of Arthritis Without Pain - The Miracle Of Anti-TNF Blockers. The book is a must-have for anyone on one of the biologic drugs (Enbrel, Remicade, Humira) or considering the biologic drugs. Read my review of the book.