The Subcommittee for Criteria of Remission in Rheumatoid Arthritis (RA) of the American Rheumatism Association (ARA) Diagnostic and Therapeutic Criteria Committee proposed preliminary criteria for complete clinical remission of rheumatoid arthritis. The remission may be either spontaneous or represent drug-induced disease suppression.
Patient selection: The patient must have met the ARA criteria for definite or classic rheumatoid arthritis at some time in the past.
For complete remission, 5 or 6 of the following requirements must be present for >= 2 consecutive months:
(1) duration of morning stiffness not exceeding 15 minutes
(2) no fatigue
(3) no joint pain (by history)
(4) no joint tenderness or pain on motion
(5) no soft tissue swelling in joints or tendon sheaths
(6) erythrocyte sedimentation rate (ESR, Westergren method) < 30 mm/h in women or < 20 mm/h in men
No alternative explanations may be invoked to account for the failure to meet a particular requirement (i.e., a person with knee pain felt clinically to be due to degenerative arthritis is still considered to have knee pain).
The presence of one or more of the following conditions prevents a designation of complete remission:
(1) manifestations of active vasculitis
(2) pericarditis
(3) pleuritis
(4) myositis
(5) unexplained recent weight loss
(6) unexplained recent fever
Performance of criteria:
• The sensitivity is 72% and specificity 100%.
• The estimated overall accuracy is over 90%.
