Is remission achievable in most patients with rheumatoid arthritis? Results suggest not

This editorial refers to Prevalence of sustained remission in rheumatoid arthritis: impact of criteria sets and disease duration, a Nationwide Study in Sweden by Einarsson J et al., on pages 227–36. Sustained remission in RA is thought of as a target that is achievable; it is associated with better clinical outcomes, less long term disability, better patient-related outcome measures and less radiographic damage [1, 2]. Recent recommendations have suggested that achieving and maintaining remission is now the goal of treatment in RA [3]. The literature has many examples of the complexities of obtaining sustained remission and has concluded that using different criteria yielded different results. One such example is a recent sub-analysis of a trial of IL-6 inhibition using tociluzimab [4], which showed that patients in DAS28-ESR and DAS28-CRP remission would not satisfy other remission criteria. These data were on carefully selected patients with active disease who might not represent the real world.