Response levels in clinical trials of rheumatoid arthritis (RA), such as ACR20, may be useful for evaluating the efficacy of new treatments but are inappropriate in clinical practice where the goals should be set higher. Much higher. We ‘operate in the window of opportunity’1 with early aggressive intervention, ‘aim at remission’ for our patients2 and apply ‘tight control’ and ‘treat to target’ strategies3 4 backed by research data that support these concepts of early therapeutic interventions.2 3 5

With modern treatment ambitions it has become increasingly clear that ‘old time’ definitions do not fit modern treatment opportunities and goals. New ACR-EULAR classification criteria for RA have therefore been developed which were published earlier this year,6 7 with the new criteria focusing on patients with short disease duration with unspecified inflammatory arthritis. The goal is to prevent chronic and erosive disease by identifying patients who are at high risk and should receive disease-modifying treatment.

With the new classification criteria and ambitious treatment strategies leading to improved clinical and radiographic outcomes, long-term and drug-free remission has become a realistic goal in many patients and a great need has emerged for consensus on how to (re)define remission.

In this issue of Annals of the Rheumatic Diseases, preliminary new criteria for remission in patients with RA—another merit of the new times—are published by Felson et al. 8 This paper is also the result of an ACR-EULAR collaboration, underlining globalisation of the world of rheumatology.

The old remission criteria were like silent films—with disease potentially progressing silently under a cover of remission that allowed substantial disease activity to be present. The new criteria are more like a 3D movie—requiring no or minimal activity based on three dimensions: clinician's (swollen and tender joint counts) and patient's (global health score) …