Remission

Remission is defined as the partial or complete disappearance of the symptoms and clinical signs of a progressive or malignant disease. Remission may occur on its own or may be the result of treatment.

Remission may occur in people with a number of rheumatic diseases, including rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE or “lupus”). The old definition of remission in RA was the elimination of all disease, but recently, the American College of Rheumatology and the European League Against Rheumatism came up with a new set of guidelines for defining remission in RA. According to one definition, a person is considered to be in remission when the following conditions have been met: 1) He has a maximum of one swollen joint, 2) he has a maximum of one tender joint, 3) he assesses his own arthritis activity as one or less on a scale of zero to 10, and 4) he has little or no inflammation as indicated by a blood test of C-reactive protein, a key marker of inflammation in the body.

A second definition uses a tool called the Simplified Disease Activity Index, which consists of the sum of these same four measures plus a physician assessment. According to the Arthritis Foundation, nearly half of all Americans with RA should be able to achieve remission, and the odds are better the earlier RA is treated.

There is no formally accepted definition of remission in SLE. The most commonly used definition is that the person is doing well on treatment with no evidence of arthritis, rash, lupus-related kidney problems, problems with blood cell count, or other widely recognized manifestations of SLE.

Robert S. Dinsmoor is a medical writer and editor based in Massachusetts.

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