TY - JOUR T1 - Value of the Multibiomarker Disease Activity Score to Predict Remission in RA: What Does the Evidence Show? JF - The Journal of Rheumatology JO - J Rheumatol SP - 443 LP - 446 DO - 10.3899/jrheum.181061 VL - 46 IS - 5 AU - ROY FLEISCHMANN Y1 - 2019/05/01 UR - http://www.jrheum.org/content/46/5/443.abstract N2 - The achievement of true full clinical remission of rheumatoid arthritis (RA) is the goal of both patients and rheumatologists. There still is much discrepancy, with resulting confusion, in how remission is defined despite the consensus reached by the American College of Rheumatology and the European League Against Rheumatism that the most reliable definition of true remission is either a Boolean definition or a Simplified Disease Activity Index (SDAI) score < 3.31. Other proposed remission cutoffs, including those for Disease Activity Score (DAS), 28-joint DAS (DAS28), and Routine Assessment of Patient Index Data 3 (RAPID-3), are much less stringent, and thus allow far more patients to be considered as having achieved “remission” despite the possibility of continued active disease in the joints with systemic inflammation (Figure 1)2. The accurate measurement of disease activity with a fully validated instrument is a key component of RA management.Figure 1. Relationship between disease measures defining remission in the AMPLE trial (Abatacept Versus Adalimumab Comparison in Biologic-Naive RA Subjects with Background Methotrexate). Each of the diagrams shows the percentage of patients achieving either DAS28-CRP < 2.6 (“remission”) or RAPID-3 “remission,” and of those, the percentage of patients who achieved Boolean, SDAI, or CDAI remission. Panels A–D: SC abatacept + MTX arm. Panels E–H: SC adalimumab + MTX. RA: rheumatoid arthritis; DAS28-CRP: 28-joint Disease Activity Score using C-reactive protein; RAPID-3: Routine Assessment of Patient Index Data 3; Boolean: Boolean remission; SDAI: Simple Disease Activity Index; CDAI: Clinical DAI; SC: subcutaneous; MTX: methotrexate.Over the past decade there has been much interest in the discovery of biomarkers that can identify the complex and heterogeneous biology of RA and have the ability to reliably demonstrate the absolute degree of disease activity, both peripherally and systemically, in all patients. One instrument, which has claimed to be … Address correspondence to Dr. R. Fleischmann, 8144 Walnut Hill Lane, Suite 810, Dallas, Texas 75231, USA. E-mail: rfleischmann{at}arthdocs.com ER -