{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T16:13:17Z","timestamp":1788624797754,"version":"build-2803163510"},"reference-count":26,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study examined whether adopting the Boolean 2.0 remission criteria results in the inclusion of patients with a higher burden of residual symptoms (RS) in rheumatoid arthritis. It also aimed to characterize differences in RS burden across remission definitions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross-sectional, single-centre study included 400 consecutive patients with rheumatoid arthritis. RSs were assessed using the Okomarigoto Sheet (OS), which evaluates pain, morning stiffness, and fatigue. Clinical remission was defined using the Disease Activity Score in 28 joints with C-reactive protein, Clinical Disease Activity Index, Simplified Disease Activity Index, and Boolean 1.0 and 2.0 criteria. The primary outcome was the proportion of patients achieving OS\u2009=\u20090. Mixed-effects logistic regression and subgroup analyses were conducted to compare RS burden across remission definitions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The proportion of patients achieving a complete absence of RSs differed across remission definitions, with the highest rate observed in Boolean 1.0 remission (52.7%), followed by Boolean 2.0 (45.0%), and the Disease Activity Score in 28 joints with C-reactive protein (37.5%). Compared with Boolean 1.0 remission, patients meeting Boolean 2.0 but not Boolean 1.0 criteria had significantly higher total and domain-specific OS scores (all P\u2009&amp;lt;\u2009.001). Similar findings were observed among patients achieving the Disease Activity Score in 28 joints with C-reactive protein remission but not Boolean 1.0 remission. Mixed-effects logistic regression indicated no significant difference between Boolean 1.0 and Boolean 2.0 remission in achieving OS\u2009=\u20090.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The RS burden in rheumatoid arthritis varies depending on the remission definition. Boolean 2.0 remission expands the classification of remission and is associated with higher multidimensional RS scores than Boolean 1.0 remission.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/mr\/roag069","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T11:36:45Z","timestamp":1787053005000},"source":"Crossref","is-referenced-by-count":0,"title":["Impact of remission definitions on residual symptom burden assessed using the Okomarigoto Sheet in rheumatoid arthritis: A comparison between Boolean 1.0 and Boolean 20"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6680-3445","authenticated-orcid":false,"given":"Kensuke","family":"Koyama","sequence":"first","affiliation":[{"name":"Department of Rheumatology, Nirasaki City Hospital , Nirasaki ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuro","family":"Ohba","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Faculty of Medicine, University of Yamanashi , Chuo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryousuke","family":"Koizumi","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Faculty of Medicine, University of Yamanashi , Chuo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koki","family":"Watabe","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Nirasaki City Hospital , Nirasaki ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirotaka","family":"Haro","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Faculty of Medicine, University of Yamanashi , Chuo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,20]]},"reference":[{"key":"2026090512064724300_ref1","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1136\/annrheumdis-2015-207524","article-title":"Treating rheumatoid arthritis to target: 2014 update of the recommendations of an international task force","volume":"75","author":"Smolen","year":"2016","journal-title":"Ann Rheum Dis"},{"key":"2026090512064724300_ref2","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1136\/ard-2022-223413","article-title":"American College of Rheumatology\/EULAR remission criteria for rheumatoid arthritis: 2022 revision","volume":"82","author":"Studenic","year":"2023","journal-title":"Ann Rheum Dis"},{"key":"2026090512064724300_ref3","doi-asserted-by":"crossref","first-page":"1531","DOI":"10.1007\/s40744-022-00490-5","article-title":"Remission or not remission, that's the question: shedding light on remission and the impact of objective and subjective measures reflecting disease activity in rheumatoid arthritis","volume":"9","author":"Brkic","year":"2022","journal-title":"Rheumatol Ther"},{"key":"2026090512064724300_ref4","doi-asserted-by":"crossref","first-page":"e002034","DOI":"10.1136\/rmdopen-2021-002034","article-title":"Reexamining remission definitions in rheumatoid arthritis: considering the twenty-eight-joint disease activity score, C-reactive protein level and patient global assessment","volume":"7","author":"Felson","year":"2021","journal-title":"RMD Open."},{"key":"2026090512064724300_ref5","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1136\/annrheumdis-2019-216529","article-title":"Testing different thresholds for patient global assessment in defining remission for rheumatoid arthritis: are the current ACR\/EULAR Boolean criteria optimal?","volume":"79","author":"Studenic","year":"2020","journal-title":"Ann Rheum 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assessment in rheumatoid arthritis: a real-life cross-sectional study","volume":"43","author":"Suardi","year":"2023","journal-title":"Rheumatol Int"},{"key":"2026090512064724300_ref9","doi-asserted-by":"crossref","first-page":"e002013","DOI":"10.1136\/rmdopen-2021-002013","article-title":"Inflammation and biologic therapy in patients with rheumatoid arthritis achieving versus not achieving ACR\/EULAR Boolean remission in a treat-to-target study","volume":"8","author":"Paulshus Sundlisaeter","year":"2022","journal-title":"RMD Open"},{"key":"2026090512064724300_ref10","doi-asserted-by":"crossref","first-page":"e002212","DOI":"10.1136\/rmdopen-2022-002212","article-title":"Overtreatment in rheumatoid arthritis: are there reasons for concern?","volume":"8","author":"Ferreira","year":"2022","journal-title":"RMD Open."},{"key":"2026090512064724300_ref11","doi-asserted-by":"crossref","first-page":"2978","DOI":"10.1038\/s41598-022-07046-1","article-title":"Validity and risk of adopting PGA &lt;\/= 2 as a remission criteria of Boolean in clinical practice in patient with rheumatoid arthritis","volume":"12","author":"Yoshii","year":"2022","journal-title":"Sci Rep"},{"key":"2026090512064724300_ref12","doi-asserted-by":"crossref","first-page":"1606","DOI":"10.1002\/acr.24369","article-title":"Systematic literature review of residual symptoms and an unmet need in patients with rheumatoid arthritis","volume":"73","author":"Michaud","year":"2021","journal-title":"Arthritis Care Res"},{"key":"2026090512064724300_ref13","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1093\/mr\/roac152","article-title":"Illustrations of rheumatoid arthritis symptoms to promote communication between patients and physicians","volume":"34","author":"Kaneko","year":"2023","journal-title":"Mod Rheumatol"},{"key":"2026090512064724300_ref14","doi-asserted-by":"crossref","first-page":"3497","DOI":"10.1007\/s10067-025-07592-9","article-title":"Prevalence and predictors of residual symptoms in 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