What Is an Arthritis Remission?

Predicting Who May Achieve Remission

Arthritis remission. Happy patient with doctor.
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Not long after you were diagnosed with arthritis, you probably heard of an "arthritis remission" as the ultimate goal of arthritis treatment. You probably had a few pressing questions. What is a remission? How long can a remission last? Do most arthritis patients achieve a remission? What are your chances?

Rheumatologist Explains Remission

We enlisted the help of rheumatologist, Scott J. Zashin, M.D., to answer our questions about arthritis remission.

His answers help clarify the concept and help you recognize if you have experienced a remission. A clinical remission primarily pertains to rheumatoid arthritis, an inflammatory, autoimmune, disabling type of arthritis which affects about 1.5 million adults in the U.S.

We asked Dr. Zashin what defines a true remission in rheumatoid arthritis patients? Can a doctor predict if a patient will go into a remission or how long a remission will last? Are there statistics on what percentage of rheumatoid arthritis patients ever achieve a remission? What can a rheumatoid arthritis patient do that will give them the best chance to achieve remission?

According to Dr. Zashin, while there is no known cure for rheumatoid arthritis, up to 30% of patients may "feel they are cured" of their disease. What these patients are actually experiencing is a clinical remission. A remission in rheumatoid arthritis had long been defined as the absence of clinical signs of inflammation.

While a very small percentage of patients may be able to discontinue their arthritis medications, more than 95% need to continue on their medication to remain in remission.

The American College of Rheumatology (ACR) classification criteria (1981) for determining clinical remission include:

  • no fatigue
  • no joint pain
  • no joint tenderness or pain on motion
  • no soft tissue swelling in joints or tendon sheaths
  • erythrocyte sedimentation rate (a blood test which measures inflammation) less than or equal to 30 in females and 20 in males

Dr. Zashin further explained that while there is no way to determine who will achieve remission with therapy, patients with a negative rheumatoid factor and CCP antibody, as well as a normal C-reactive protein, appear to have a better outcome. In addition, patients taking combination therapy (for example, methotrexate and a TNF inhibitor) are more likely to achieve remission than those taking either drug alone. However, patients on monotherapy (one drug alone) still may achieve clinical remission. The longer the disease remains in remission, the less likely it is to become active again.

Updated Definition of Remission

In 2011, more than a decade after the first biologic drug was approved for the treatment of rheumatoid arthritis, it was recognized that the definition of remission in rheumatoid arthritis needed to be updated.

The American College of Rheumatology and European League Against Rheumatism analyzed clinical trial data and surveyed committee members, then decided on two definitions for rheumatoid arthritis remission which mostly are applied in clinical trials. The definitions may be considered in clinical practice as well.

It is important to note that remission may not be long-lasting. Stopping your medications can trigger a relapse. Even with continuation of treatment, medications that stop working can trigger a relapse.

(Scott J. Zashin, M.D.,  is a clinical assistant professor at University of Texas Southwestern Medical School, Division of Rheumatology, in Dallas, Texas; an attending physician at Presbyterian Hospitals of Dallas and Plano; a fellow of the American College of Physicians and the American College of Rheumatology and a member of the American Medical Association.)


Rheumatoid Arthritis Researchers Redefine Remission. American College of Rheumatology. February 3, 2011.

Preliminary Criteria for Clinical Remission in Arthritis. Arthritis and Rheumatism. Pinals RS et al., October 1981.

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