Time to achieve remission determines time to be in remission

For this study, three-year follow-up data were used from the Nijmegen RA Inception Cohort of patients included between 1985 and 2005 (N = 753). Patients were included upon diagnosis (ACR criteria), were systematically evaluated at three-monthly visits and treated according to daily practice. Remission was defined according to the Disease Activity Score (DAS) <1.6 and the ACR remission criteria. Remission of at least 6 months duration was regarded as sustained remission. Predictors for time-to-remission were identified by Cox-regression analyses. The relation between time-to-remission and sustained remission was analyzed using longitudinal binary regression.N = 398 (52%) patients achieved remission with a median time-to-remission of 12 months. Male gender, younger age and low DAS at baseline were predictive to reach remission rapidly. There were n = 142 (36%) patients experiencing sustained remission, which was determined by a shorter time-to-remission only. The relationship between time-to-remission and sustained remission was described by a significant odds ratio (1.11) (1.10 to 1.12-95% CI) that was constant over the whole period 1985 to 2005. Results obtained with the ACR remission criteria were similar.A shorter time-to-remission is related to sustainability of remission, supporting striving for early remission in patients with RA.Expectations considering the treatment effect of rheumatoid arthritis (RA) have changed and aiming for clinical remission is currently regarded as an appropriate treatment goal in patients with early RA[1]. However, the number of patients who achieve remission in routine care is small and only a minority of these patients reach sustained remission [2,3]. Rather than complete remission, it is a near-remission disease state that currently is an achievable treatment goal in daily practice. Forthcoming treatment approaches will make the remission aim more realistic.Starting treatment as early as possible after the diagnosis of RA is essent