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An official publication of the ACR and the ARP serving rheumatologists and rheumatology professionals

Target Remission

  |  Issue: March 2007  |  

Among the various continuous disease activity indices, only the SDAI and the CDAI capture all four components: tender and swollen joints as well as physicians’ and patients’ global assessments of disease activity. Moreover, both joint counts (i.e., tender and swollen) have equal weights as do both global assessments. Variables important to the patients and physicians are considered with similar weight in these scores, and the ease in calculating these indices allows doctors and patients to speak the same language. In fact, in our clinics, we educate patients to “know the DAI.”

Make Remission the Goal

Less than a decade ago we would not have considered using the term “remission” but in exceptional circumstances rarely occurring in patients cared for by rheumatologists. With today’s treatment approaches achieving remission has become a reality for a considerable proportion of patients. Further, as new treatments and more innovative therapies are developed, this aim will be far more reachable.

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Getting patients into remission and sustaining remission requires consistent follow-up using individual measures of disease activity and composite scores. Only if we measure the characteristics of the disease consistently can we be sure that we will capture subtle changes of disease activity that may require therapeutic modifications.33,34 This proximity of changes in clinical status and the rheumatologist’s response to these changes is one of the major achievements of rheumatology practice. A variety of sensitive and well-validated tools are available to track disease progression, with these tools providing a platform to promote remission as the goal of care for all patients with rheumatoid arthritis.

Dr. Smolen is professor of medicine and chair of the division of rheumatology at the Medical University of Vienna in Austria and chair of the second department of medicine at the Center for Rheumatic Diseases at Hietzing Hospital in Vienna. Dr. Aletaha is a fellow in rheumatology at the Medical University of Vienna.

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