Preliminary criteria for clinical remission in rheumatoid arthritis


  • Robert S. Pinals MD,

    1. Chairman, Subcommittee for Criteria of Remission in Rheumatoid Arthritis, Professor of Medicine, University of Tennessee Center for the Health Sciences, Memphis
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  • Alfonse T. Masi MD,

    1. Dr. PH: Chairman, ARA Diagnostic and Therapeutic Criteria Committee, Professor and Head, Department of Medicine, Peoria School of Medicine, University of Illinois College of Medicine, Peoria
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  • Richard A. Larsen MD

    1. Systems Analyst, Health Sciences Computer Center, University of Tennessee, Memphis. Other Subcommittee members: Howard J. Weinberger, MD, former Chairman; John Baum, MD; John Bland, MD; William M. Fosdick, MD; Stanley B. Kaplan, MD, Alfonse T. Masi, MD, Dr. PH; Donald M. Mitchell, MD; Marian W. Ropes, MD; Charles L. Short, MD; John W. Sigler, MD
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A study was conducted to develop criteria for clinical remission in rheumatoid arthritis (RA). Data were provided by 35 rheumatologists on 175 RA patients considered to be in complete remission (with or without antirheumatic therapy) and 169 RA patients in partial remission or with active disease. Six criteria yielded optimal discrimination: morning stiffness absent or not exceeding 15 minutes, no fatigue, no joint pain by history, no joint tenderness, no joint or tendon sheath swelling, and no elevation of erythrocyte sedimentation rate. In this study sample, the presence of five or more of these criteria in an individual patient yielded 72% sensitivity for clinical remission and 100% specificity in discriminating RA patients with active disease. In a population sample, it is estimated that the overall accuracy of these criteria would be more than 90% in RA patients.