What is the criteria for remissions.

How do they/you judge it? If you are sero negative how to do they know it's remission? Do you still get other symptoms?

[Hidden]

Hi Julie, I can only speak of my RA experiences and that is in all my 17years of RA have never experienced a remission. Although my RA is well controlled at the moment, well to me it is, my consultant would like it to be better controlled but it seems to be the best it will ever get they feel as there is always disease activity. From what I understand to be in a remission there as to be no clinical signs of the disease, then again I think there may be such a thing as a partial remission which is when there is reduced disease activity.

I also think if the disease is caught early enough and the treatment is successful there is more chance of remission.

Good question this Julie you may hear some interesting answers.

mand xx

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I was also told that remission is when there are no clinical signs of the disease.

I am beginning to think remission is just make believe, cos nonody ever seems to get there!!!

Sue x

[Hidden]

Hi Julie,

I cut/pasted followingthis onto my desktop ages ago as I'm determined I'll get there! Can't remember what site this was on.....

Achieving Remission in Rheumatoid Arthritis

What is ‘remission?’

In general terms, remission describes the point when the symptoms of a disease are either greatly reduced or

no longer evident. For people with rheumatoid arthritis (RA), this means that all or most symptoms of the

disease, such as inflammation, pain, and fatigue, have gone away and further damage to the joints has

stopped.

Measuring disease activity and remission

One of the most widely accepted methods of defining disease activity in RA is the Disease Activity Score 28,

known as the ‘DAS28’ scoring system.1

The DAS28 scoring system takes into account several measures:

• The number of tender and swollen joints (this can be between 0 and 28)

• A blood test to measure the level of inflammation in the body, with either the erythrocyte

sedimentation rate (ESR) or C-reactive protein(CRP)

• The patient’s own assessment of their general health which they are asked to rate on a visual scale

(this can range from ‘very good’ to ‘very bad’)

The results of the above measures are used to calculate a DAS28 score between 0 and 10. A patient is

considered to be in remission when they have a score of DAS28 <2.6 out of 10.i

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 (another measure of inflammation in the blood) 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. Nevertheless, 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.

It's a bit gobbodleegoop to me,

Good luck, I would love to know if you get there

[Hidden in reply to Hidden]

very informative thanks

[Hidden]

Forgot to add, I have met recently 4 people with RA, 2 of them have achieved remission for long periods! maybe our consultant up here in the highlands is a magician!!

[Hidden]

Remission is more common these days because the drugs are so much more effective and started much earlier in the disease process. Generally remission is regarded as being free from clinical symptoms with a DAS of less than 2.6.

However, there are varying thoughts on what is true remission and what is controlled disease; it's a close call. If you continue on with your medication and the disease is well controlled with no symptoms are you in remission? I would say not because if you stop the drugs the likelihood is the disease will rear it's ugly head once more. Is that remission or controlled? If however you are weaned off the cocktail therapy and symptoms do not re-appear that to me is true remission.

I have two friends diagnosed with poly inflammatory arthritis within two years of my diagnosis (my GP described my symptoms similarly although I was diagnosed by the rheumatologist as having sero-negative RA). All three of us were told that the disease could burn itself out within two years. Both of my friends 'disease' did just that, mine didn't. Did they have RA? Was it something different? Did they simply go into remission?

Are some people misdiagnosed at the outset? So many questions, so I guess I haven't answered the question!!

Lyn x

[Pheno3 in reply to Hidden]

Hi Lyn ,

I know it’s an old post but just wanted to see how you were doing ? Did you achieve remission at all ? Best wishes x

[Hidden]

Phew! Thanks everyone... it's just as I thought really.... Lots of Ifs and Buts and maybes......so no-one really knows, except possibly the victim?!

Once again, all important and useful information.

Julie x

[Gina_K]

Good question Julie, and interesting replies. I am going to ask my consultant when I see her in June. Also I have never discussed DAS scores with her, am going to ask her about mine. I think I might be in a bit of remission although I am afraid to hope. My bloods are normal now for few months crp & esr. I only get achy ankle & foot when I'm on them a long time. After what I have been thru its a bit of a miracle, I have read (here & other places) that meds can stop working etc. My index finger bit stiff today (forget I said that)

[Hidden in reply to Gina_K]

Seeing what Cathie says below, you two (and me) seem to be in the same boat?? Do you think? I am just waiting for an opinion on mybloods. Has your cons not said whether you are in remission or not. I wonder if some of them dare to say considering the volatility of the disease? So curious... good feeback, thanks.

Julie x

[cathie]

Yes my consultant tells me I'm in remission (anti-TNF + Methotrexate) but I still have some pain, slow mornings, fatigue. But I dont have the inflammation unless I overdo things. Not very specific is it!

[Hidden in reply to cathie]

Thanks Cathie, I believe this is how I am at the moment. So I think I am really really lucky that I have been able to get where I am on 20 mg dose of Methotrexate alone. I am just awaiting the results of my last blood test and to see my cons in May to get his opinion. I know like you say it's not specific but I think it is a recognisable condition isn't it?

Many thanks. Julie x