Remission in early rheumatoid arthritis: Predictors, definitions and treatment

• Published in: Rheumatology
• Main Author: Sundlisæter, Nina Paulshus
• Format: Doctoral or Postdoctoral Thesis
• Language: English
• Published: 2020
• Subjects: Arctic
• Online Access: http://hdl.handle.net/10852/77487; http://urn.nb.no/URN:NBN:no-80594

In this thesis Nina Paulshus Sundlisæter assessed achievement and prediction of different remission definitions in rheumatoid arthritis (RA). She also studied the association between definitions of remission and long-term outcomes, and how to treat RA patients in sustained remission. The thesis is based on data from two randomized controlled trials, ARCTIC and ARCTIC REWIND. Paulshus Sundlisæter showed that sustained remission was achievable in RA patients treated according to current recommendations, even if negative prognostic factors were present. Less joint tenderness and short symptom duration at time of disease-modifying antirheumatic drug (DMARD) initiation predicted remission. Attainment of ACR/EULAR Boolean remission had the strongest association with both a good radiographic and functional outcome. Patients in sustained remission on conventional synthetic DMARDs were randomized to either continued stable therapy or half-dose. Patients in the stable group experienced less flares and less frequent radiographic joint damage progression the next year. Thus, continued stable therapy should be the preferred choice for RA patients in sustained remission.