Objectives To assess the prevalence of persistent remission and factors associated with persistent remission in a large cohort of RA patients in remission.

Methods RA patients in remission according to the ACR/Pinals criteria were evaluated every 3 months for disease activity during 2 years. Factors measured at baseline and possibly associated with persistent remission were evaluated.

Results Of the 180 RA patients included 93 (52%) experienced persistent remission. Those patients had significantly (p < 0.05) less tender joints, lower Ritchie score, lower VAS score, lower serum IgM-RF and IgA-RF levels, lower HAQ score at baseline when compared to patients suffering an exacerbation. DMARD use was not associated with persistent remission. In a multivariate analysis, the following variables were independently associated with persistent remission: DAS < 1.6 (odds ratio with 95% CI: 3.7, 1.5–9.5) and VAS < 12 (1.1, 1.0–1.2). The area under the curve of the DAS < 1.6 in the first year was associated with remission in the second year (9.9, 4.1–24).

Conclusion Persistent remission occurs frequently and is associated with a low disease activity score (DAS), in particular with a low cumulative DAS. The use of a cumulative DAS may be a tool in taking therapeutic decisions.