Evidence for predictive validity of remission on longterm outcome in rheumatoid arthritis: A systematic review

ObjectiveRemission is rapidly becoming a key end point in rheumatoid arthritis RA clinical trials, but its definition is not satisfactory. Although it is generally believed that achieving a state of remission will lead to better structural outcome, this has not been studied systematically. As part of an undertaking to redefine remission, the current review describes the relationship between remission and longterm structural outcome.MethodsA systematic literature search of PubMed, EMBase, and The Cochrane Library intersected 3 groups of terms: RA, remission, and longterm outcome. The search identified 1,138 records, of which 14 were relevant to the research question.ResultsAll of the studies included in this review showed a relationship between remission and longterm structural damage or disability. Patients that achieved a state of remission, defined in various ways, showed less deterioration of function and radiographic progression compared with patients who did not reach a state of remission.ConclusionPatients who achieved a state of remission were less likely to show deterioration of function and radiographic progression compared with patients who did not reach a state of remission.