There's no question that arthritis remission is the holy grail for people living with rheumatoid arthritis (RA). With no cure currently available, people living with this progressive autoimmune disease long for remission and relief from pain, inflammation, stiffness, loss of function and joint damage. But what exactly is arthritis remission?

No Standard Definition of Arthritis Remission

While the term arthritis remission generally refers to a period where you don't experience symptoms, you'd probably be surprised to find out that there's currently no medical consensus on the definition of arthritis remission. The term is used differently in study trials around the world, and those may differ from clinical definition of arthritis remission.

The American College of Rheumatology (ACR) organized a committee of international clinical researchers, trialists, and clinical epidemiologists in order to redefine remission in RA. In its first meeting, the committee preferred to develop a strict definition of arthritis remission, implying no or very low disease activity. Such a definition would need to be validated against long-term outcome, for example physical function and damage. The committee decided to consider both a definition for trials and a modified version for clinical practice.

Women Less Likely to Experience Arthritis Remission

Not only are women more at risk for developing RA and to suffer worse symptoms, they're significantly less likely to go into arthritis remission than men. In a study published in the Annals of the Rheumatic Diseases, researchers looked at 698 adults who had rheumatoid arthritis for an average of six months.

Two thirds of the participants were women, and they tended to be younger than the men. The average age of the group was 58 years old. After two years, just under four out of 10 participants had gone into arthritis remission, with a similar percent of 38.5 in remission after five years.

The study revealed that gender was a significant factor in the progress of the disease. At two years, only 32 percent of women were in arthritis remission compared to nearly half, or 48 percent, of the men. The results were even more disparate by the five year mark. Only about 30 percent of women were in remission compared to 52 percent of the men.

The difference in arthritis remission between men and women could not be explained by how long they had suffered from RA, age, or drug treatment.

High Rates of Arthritis Remission Are Possible - Even for Women

Fortunately, some drug research is proving promising for both women and men who are hoping for arthritis remission. Several studies show that combination therapy (the use of two or more drugs) with disease modifying antirheumatic drugs (DMARDs) such as methotrexate and etanercept, or methotrexate, sulfasalazine and prednisolone, can improve remission for people at all stages of arthritis.

But it's not just the drugs that influence arthritis remission; it's when you take them. In the past doctors recommended taking these more advanced medications after a few years of having rheumatoid arthritis, due to concerns about side effects. Increasingly, the focus has been on early intervention. In some studies, early treatment (within the first year of being diagnosed with arthritis) enabled 50 percent of patients to achieve arthritis remission.

While DMARDs pose some risks—such as a higher chance of developing cardiovascular problems or shingles (herpes zoster), and reactivating tuberculosis - there's sufficient evidence that the health benefits outweigh the risks for many people. Speak to your doctor about starting combined DMARD therapy early and improving your chances of arthritis remission.

Study Reference

Journal Name: Arthritis Care & Research, Vol. 61 Issue 5, pp. 704 - 710

Study Date: 29 Apr 2009

Study Name: Defining remission in rheumatoid arthritis: Results of an initial American College of Rheumatology/European League against rheumatism consensus conference


Authors: Lilian H. D. van Tuyl, Steven C. Vlad, David T. Felson, George Wells, Maarten Boers

Journal Name: Annals of the Rheumatic Diseases,  Vol.66 pp.46-52

Study Date: 7 December 2006

Study Name: Sex: a major predictor of remission in early rheumatoid arthritis?


Authors: K Forslind, I Hafström, M Ahlmén, B Svensson