What are the ACR guidelines on the measurement of disease remission for rheumatoid arthritis (RA)?

Updated: Feb 07, 2020
  • Author: Howard R Smith, MD; Chief Editor: Herbert S Diamond, MD  more...
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Answer

In the 2012 ACR-recommended RA disease activity measures, the following cutoffs indicate disease remission [2] :

  • PAS and PAS-II: 0.00-0.25

  • RAPID-3: 0-1.0

  • CDAI: ≤2.8

  • DAS28 (ESR or CRP): < 2.6

  • SDAI : ≤3.3

In 2011, the ACR and the EULAR jointly released two definitions for evaluating remission of RA in clinical trials, one a Boolean-based definition and the other based on a composite index of RA activity, the SDAI. The Boolean-based definition requires that the patient satisfy all of the following to be considered in remission [3] :

  • Tender joint count of 1 or less
  • Swollen joint count of 1 or less
  • CRP level of 1 mg/dL or lower
  • Patient global assessment of 1 or less (on a 0-10 scale)

To be considered in remission using the traditional index definition, the patient must have an SDAI score of less than 3.3. [3]


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