{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T00:05:30Z","timestamp":1793837130219,"version":"4.6.1"},"reference-count":48,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2018,1,30]],"date-time":"2018-01-30T00:00:00Z","timestamp":1517270400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis Care &amp; Research"],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>In current management paradigms of rheumatoid arthritis (<jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content>), patient global assessment (<jats:styled-content style=\"fixed-case\">PGA<\/jats:styled-content>) is crucial to decide whether a patient has attained remission (target) or needs reinforced therapy. We investigated whether the clinical and psychological determinants of <jats:styled-content style=\"fixed-case\">PGA<\/jats:styled-content> are appropriate to support this important role.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a cross\u2010sectional, single\u2010center study including consecutive ambulatory <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content> patients. Data collection comprised swollen 28\u2010joint count (<jats:styled-content style=\"fixed-case\">SJC<\/jats:styled-content>28), tender 28\u2010joint count (<jats:styled-content style=\"fixed-case\">TJC<\/jats:styled-content>28), C\u2010reactive protein (<jats:styled-content style=\"fixed-case\">CRP<\/jats:styled-content>) level, <jats:styled-content style=\"fixed-case\">PGA<\/jats:styled-content>, pain, fatigue, function, anxiety, depression, happiness, personality traits, and comorbidities. Remission was categorized using American College of Rheumatology\/European League Against Rheumatism Boolean\u2010based criteria: remission, near\u2010remission (only <jats:styled-content style=\"fixed-case\">PGA<\/jats:styled-content> &gt;1), and nonremission. A binary definition without <jats:styled-content style=\"fixed-case\">PGA<\/jats:styled-content> (3v\u2010remission) was also studied. Univariable and multivariable analyses were used to identify explanatory variables of <jats:styled-content style=\"fixed-case\">PGA<\/jats:styled-content> in each remission state.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 309 patients were included (remission 9.4%, near\u2010remission 37.2%, and nonremission 53.4%). Patients in near\u2010remission were indistinguishable from remission regarding disease activity, but described a disease impact similar to those in nonremission. In multivariable analyses, <jats:styled-content style=\"fixed-case\">PGA<\/jats:styled-content> in near\u2010remission was explained (R<jats:sup>2<\/jats:sup><jats:sub>adjusted<\/jats:sub> = 0.50) by fatigue, pain, anxiety, and function. Fatigue and pain had no relationship with disease activity measures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content>, a consensually acceptable level of disease activity (<jats:styled-content style=\"fixed-case\">SJC<\/jats:styled-content>28, <jats:styled-content style=\"fixed-case\">TJC<\/jats:styled-content>28, and <jats:styled-content style=\"fixed-case\">CRP<\/jats:styled-content> level \u22641) does not equate to low disease impact: a large proportion of these patients are considered in nonremission solely due to <jats:styled-content style=\"fixed-case\">PGA<\/jats:styled-content>. <jats:styled-content style=\"fixed-case\">PGA<\/jats:styled-content> mainly reflects fatigue, pain, function, and psychological domains, which are inadequate to define the target for immunosuppressive therapy. This consideration suggests that clinical practice should be guided by 2 separate remission targets: inflammation (3v\u2010remission) and disease impact.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.23284","type":"journal-article","created":{"date-parts":[[2017,5,23]],"date-time":"2017-05-23T21:11:21Z","timestamp":1495573881000},"page":"369-378","source":"Crossref","is-referenced-by-count":102,"title":["Suppressing Inflammation in Rheumatoid Arthritis: Does Patient Global Assessment Blur the Target? A Practice\u2010Based Call for a Paradigm Change"],"prefix":"10.1002","volume":"70","author":[{"given":"Ricardo J. 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