Wednesday, September 2, 2009

What is Remission of Rheumatoid Arthritis?

Can Rheumatoid Arthritis go into remission?

I always thought that remission was like the Holy Grail – hard to come by. However, I never realized that it was also hard to identify.
When somebody has cancer, he fights for remission. His whole family prays for remission. The remission itself may be elusive, but he knows what it is! It is no more cancer. At least for the time being…

It is not so with Rheumatoid Arthritis. They haven’t really decided what it is. Look at what one rheumatologist said: “To a considerable extent, defining remission in RA is like defining pornography; we have great difficulty agreeing on a definition.”

How many RA’ers go into remission?

That depends upon who you ask.

According to NIH, rates of remission of Rheumatoid Arthritis vary from under 5% to over 16% because of differing definitions. Those ranges are substantiated by much of what I have read. One study reported on Medscape says the remission rate can be up to 20% using certain criteria. Compare that to what one doctor said in Arthritis Today: “If you get treated within two years of the onset of RA symptoms, you have more than a 50 percent chance of achieving remission.”

Is he saying that over half of those who are treated early (during the first 2 years of RA) will get remission?

Alas, I am not a doctor. But, I have read dozens of abstracts and detailed reports on remission. I have never read anything like that, however he qualifies it.

It also depends upon how you ask.

There are various sets of criteria which fulfill various definitions of remission. NIH concluded: “The use of different definitions of RA remission leads to different results with regard to remission rates...”

Two broad definitions with one basic distinction

1) There is a generic understanding of “remission” with a connotation that we all know. One online dictionary defines remission as the “absence of symptoms of the disease and return to good health.” In part, Wikipedia says, “a cure(that) is the end of a medical condition.”

2) There is a big difference between that and what rheumatologists often call “clinical remission.” They are referring to a specific set of criteria which usually does not include the “absence of symptoms” or a “return to good health” or a “cure.”

Hopefully, I did not confuse you. I will leave you today with a link to a wide-ranging set of definitions of remission of Rheumatoid Arthritis. It gives 6 different descriptions of clinical remission with varying criteria. It is at Science Direct.

Next time, we’ll look closer at how the rheumatologists define remission. And we’ll ask why it matters to us.

1 comment:

Living It, Loving It said...

There is just not emphasis or research on this topic. You compared it to the Holy Grail. I compare it to something that is only avaiable to an advantaged few. I am on combination treatment, and the whole idea of combination treatment is a greater chance of remission. When I was first diagnosed, I beleived to be possible, now I just want to make it through the day. I think a big issue is the lack of attention towards RA. We talk about awareness all we want, but there really is not enough resources being put in the research of many chronic pain conditions. That really has to change.