Remission in rheumatoid arthritis

Abstract

Four hundred and fifty-eight patients whose clinical data had been prospectively entered into a rheumatic disease databank were studied for remission utilizing remission criteria of the American Rheumatism Association and criteria modified for chart review. During the period of observation 86 of 458 or 18.8% had at least one remission by investigators' assessment on chart review and 18.1% by application of ARA criteria. Patients were followed for 1131 patient years and remission occupied 97 patient years. For patients achieving remission this period represented 34.5% of their followup duration. The median length of remission was 10 months. Nineteen (18.6) percent of gold treatment courses and 16.7% of penicillamine courses resulted in remission. Fourteen (13.6) percent of patients who never received remittive therapy also had remissions. The ARA Preliminary Criteria for Clinical Remission in Rheumatoid Arthritis displayed a sensitivity of 80.2% and a specificity of 96.2% in this population. In patients receiving remittive therapy, female sex, disease onset before age 60, and early development of erosions were associated with decreased proportion of remission.