Skip to main content


Table 1 Definition of remission as treatment outcome/disease state in RA

From: Aspects of early arthritis. Definition of disease states in early arthritis: remission versus minimal disease activity

Remission criteria Definition
ACR criteria For clinical remission, a minimum of five of the following items must be present for at least two subsequent months:
     Morning stiffness <15 minutes
     No fatigue
     No joint pain by history
     No joint tenderness or pain on motion
     No soft-tissue swelling in joints or tender sheats
     ESR < 30 mm/1st hour in women or < 20 mm/1st hour in men
Disease activity score criteria DAS remission defined as a score <1.6 using a compound index of the following measures:
     Ritchie articular index of tender joints
     44 swollen joint count
     Patient's assessment of general health (measured on a 100 mm visual analogue scale)
  DAS28 remission defined as a score <2.6 using a compound index of the following measures:
     28-joint count for tender and swollen joints
     Patient's assessment of general health
FDA criteria Remission
     Requires achieving ACR clinical remission and absence of radiological progression (Larsen or Sharp-van der Heijde method) over a continuous 6 month period in the absence of DMARDs
  Complete clinical remission
     Same as remission, but while continuing DMARD therapy
  Major clinical response
     Requires achieving ACR70 response for at least 6 subsequent months (ACR70 response means 70% improvement of tender and swollen joint count coupled with improvement in 3 of 5 of the following: patient's assessment, physician's assessment, ESR or CRP, pain scale, Health Assessment Questionnaire)
  1. The formula to calculate the DAS is: 0.54 × √ Ritchie articular index + 0.065 × 44 swollen joint count + 0.33 × ln ESR + 0.0072 × general health. The formula to calculate the DAS28 score is: 0.56 × √ 28 tender joint count + 0.28 × √ 28 swollen joint count + 0.7 × lnESR = 0.014 × general health.