Abstract

1. Conceptually, remission is thought of as a state where the disease is absent. As we approach a better understanding of the underlying pathophysiological process of a disease, it becomes more and more relevant to include in a definition of remission appropriate biochemical markers of that process.

2. From a practical point of view, definitions of remission in RA have been built upon clinical parameters of disease activity, supplemented in some cases with a single biomarker. However, it is clear that in practice these definitions are insufficiently precise: held against a gold standard of expert opinion, they perform at around 80–90%, misidentifying one or two out of every ten patients. And while there is an understandable and in many ways desiriable development of more patient-reported emphasis in outcomes, it has considerable practical value to be able to objectify an important disease state such as remission.

3. There is convincing evidence to show that biomarkers can be employed succesfully to predict some aspects of RA. In the day-to-day care of patients with this disease, the most important prediction may be whether the effective drug can be tapered or not. Current evidence indicates that biomarkers may be invaluable at helping clinicians and their patients make this important decision.