{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T16:22:47Z","timestamp":1759422167909},"reference-count":18,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2013,6,8]],"date-time":"2013-06-08T00:00:00Z","timestamp":1370649600000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Pfizer India Ltd"},{"name":"IARET"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Rheum Dis"],"published-print":{"date-parts":[[2013,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Remission is an ideal target in the management of rheumatoid arthritis (<jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content>). We compared <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>merican <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>ollege of <jats:styled-content style=\"fixed-case\">R<\/jats:styled-content>heumatology (<jats:styled-content style=\"fixed-case\">ACR<\/jats:styled-content>) 1981 preliminary definition of remission, <jats:styled-content style=\"fixed-case\">E<\/jats:styled-content>uropean <jats:styled-content style=\"fixed-case\">L<\/jats:styled-content>eague <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>gainst <jats:styled-content style=\"fixed-case\">R<\/jats:styled-content>heumatism (<jats:styled-content style=\"fixed-case\">EULAR<\/jats:styled-content>) disease activity score of 28 joints \u2013 <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>\u2010reactive protein (<jats:styled-content style=\"fixed-case\">DAS<\/jats:styled-content>28 (3)\u2010<jats:styled-content style=\"fixed-case\">CRP<\/jats:styled-content>) and <jats:styled-content style=\"fixed-case\">DAS<\/jats:styled-content>28 (3)\u2010<jats:styled-content style=\"fixed-case\">ESR<\/jats:styled-content> (erythrocyte sedimentation rate) and newer <jats:styled-content style=\"fixed-case\">ACR<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">EULAR<\/jats:styled-content> remission criteria from 2011. We assessed the agreement between these definitions using kappa statistics in a real\u2010time clinical scenario.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>This is a cross sectional study in which 460 patients' charts were reviewed. Their data on tender and swollen joint counts, visual analogue scale of patient global assessment (<jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>t <jats:styled-content style=\"fixed-case\">GA<\/jats:styled-content>), <jats:styled-content style=\"fixed-case\">ESR<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">CRP<\/jats:styled-content> were retrieved. One hundred patients who fulfilled one of the remission criteria and had all the required five variables were selected and they were categorized into remission using all the four definitions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Only one case out of 100 fulfilled all four remission criteria. Among 100 cases: <jats:styled-content style=\"fixed-case\">ACR<\/jats:styled-content> 1981 classified six in remission; <jats:styled-content style=\"fixed-case\">ACR<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">EULAR<\/jats:styled-content> 2011, eight; <jats:styled-content style=\"fixed-case\">DAS<\/jats:styled-content>28 (3)\u2010<jats:styled-content style=\"fixed-case\">ESR<\/jats:styled-content>, 24; and <jats:styled-content style=\"fixed-case\">DAS<\/jats:styled-content>28 (3)\u2010<jats:styled-content style=\"fixed-case\">CRP<\/jats:styled-content> classified 100 patients in remission. A substantial number of patients continued to have features suggesting persisting active inflammation, despite being categorized into remission. A major portion of disagreement was in <jats:styled-content style=\"fixed-case\">ESR<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">CRP<\/jats:styled-content>. The value spread of all clinical parameters such as swollen joint count, tender joint count and Pt <jats:styled-content style=\"fixed-case\">GA<\/jats:styled-content> had no significant difference in the patients classified as being in remission.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The <jats:styled-content style=\"fixed-case\">DAS<\/jats:styled-content>28 (3)\u2010<jats:styled-content style=\"fixed-case\">CRP<\/jats:styled-content> overestimated remission compared to all other criteria. Disagreement was more in laboratory inflammatory parameters. A uniform definition of remission is needed.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1756-185x.12091","type":"journal-article","created":{"date-parts":[[2013,6,8]],"date-time":"2013-06-08T10:12:45Z","timestamp":1370686365000},"page":"291-296","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Remission in rheumatoid arthritis by different criteria does not converge over the inflammatory markers"],"prefix":"10.1111","volume":"16","author":[{"given":"S.","family":"Chandrashekara","sequence":"first","affiliation":[{"name":"ChanRe Rheumatology and Immunology Center and Research Basaweswarnagar Bangalore India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B. 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