Definition of Remission in Rheumatoid Arthritis & Likelihood with Advanced Therapies

Join Stacey Johnson, NP-C, as she explains the two primary remission criteria for rheumatoid arthritis (RA) recommended by the American College of Rheumatology (ACR) and the European Alliance of Associations for Rheumatology (EULAR). These guidelines define remission using two key approaches: the Boolean-based definition and the Index-based definition.

The Boolean 2.0 criteria evaluate four key factors: tender joint count, swollen joint count, patient global assessment, and CRP levels. Meanwhile, the Index-based definitions rely on the Simplified Disease Activity Index (SDAI) at ≤ 3.3 and the Clinical Disease Activity Index (CDAI) at ≤ 2.8 to determine remission status.

Recent updates to the Boolean criteria in 2022 aimed to improve agreement with the index-based definitions while maintaining accuracy in predicting functional and radiographic outcomes. A study of 248 patients found that remission rates were slightly higher under the new Boolean 2.0 criteria compared to the original 1.0 version. However, overall remission rates remain low, underscoring the continued need for advanced therapies and optimized treatment strategies.

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