Disease activity level, remission and response in established rheumatoid arthritis: Performance of various criteria sets in an observational cohort, treated with anti-TNF agents | Semantic Scholar (2025)

Patients with active RA despite DMARD treatment and even after inadequate response to TNFα inhibitors, receiving TCZ showed signs of remission, when clinical practice criteria, not inclusive of acute phase reactants, were used.

Patients with active RA despite DMARD treatment and even after inadequate response to TNFα inhibitors, receiving TCZ showed signs of remission, when clinical practice criteria, not inclusive of acute phase reactants, were used.

The present study revealed that DAS28-ESR may not be sufficient to estimate RA disease activity treated by TCZ, probably due to the significant effect toward inhibition of acute phase reactants byTCZ.

It is concluded that achieving a good EULAR response with DMARDs and biologic agents in active RA results in substantially improved mean HAQ and EQ5D scores and patients who achieve such responses should continue on treatment.

Current smoking, female sex, longer symptom duration, cigarette smoking habits, autoantibody status, Health Assessment Questionnaire (HAQ) score, concurrent prednisolone and treatment with non-steroidal anti-inflammatory drugs predict a worse response to MTX in patients with new-onset RA.

MDA and DAS-28 <2.6 are reachable treatment targets in RA with anti-TNF, although residual disease activity might still be present, but ACR/EULAR remission criteria might be too stringent for use in daily clinical practice due to the strict cut-point in the patient-reported outcome.

Overall, patients achieving LDA or ACR50 responses reported less improvement in PROs (HAQ-DI, pain and patient global assessment) compared with clinical measures compared withclinical measures.

In patients with established RA, physical function measured by the Health Assessment Questionnaire improves in patients reaching SR compared with patients who only occasionally reach remission, which supports that maintaining remission should be a treatment goal.

While the CDAI and SDAI assigned disease activity states that were largely similar, the DAS28-ESR was often discordant across the two populations.

Patients with early RA are more likely to reach SR than patients with established RA, and lower age, male sex and milder disease characteristics were associated with SR.

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New criteria for levels of RA disease activity were determined and internally validated based on current and explicit expert judgment, which are valuable in this era of rapidly advancing therapeutic approaches.

In this observational study of patients with established RA, gender did not predict response to anti-TNF therapy, whereas treatment with concomitant DMARDs, especially MTX and low disability were associated with good response.

Remission remains uncommon in RA, and the prevalence of new remission in community practice is substantially lower than noted in published trials of biologic therapy.

For individual patients, agreement is good at the level of ACR 20 response, when EULAR overall, SDAI overall, or HAQ 0.22 criteria are applied, which should be considered when response criteria are used for clinical decisions.

The SDAI is a valid and sensitive assessment of disease activity and treatment response that is comparable with the DAS 28 and ACR response criteria; it is easy to calculate and therefore a viable tool for day-to-day clinical assessment of RA treatment.

Data support an improved outcome among patients receiving MTX in combination with anti-TNF-therapies, however, the most disabled patients were less likely to respond, despite concurrent MTX, and the benefits of NSAIDs may reflect the relative absence of comorbidities in patients who …

The goal was to redefine response in RA in a manner that corresponds to a clinical impression of response, maximizes sensitivity to change, correlates well with rheumatologists' impressions of improvement, and preserves the ACR20.

The Simplified Disease Activity Index (SDAI) and the Clinical Disease activity Index (CDAI), developed to provide physicians and patients with simple and more comprehensible instruments, are the only composite index that does not incorporate an acute phase response and can be used to conduct a disease activity evaluation essentially anytime and anywhere.

EULAR response criteria showed better construct and discriminant validity than did the ACR and the WHO/ILAR response criteria for RA and the World Health Organization and International League Against Rheumatism criteria.

Despite the smaller relative improvement achieved in these patients with longstanding, severe RA who would not fulfill the inclusion criteria of a major trial, the majority of such patients would nevertheless benefit from biologic therapy.

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