Rheumatoid arthritis (RA) is a disease that can damage a person’s joints and cause pain throughout the body. It is a chronic condition with no known cure. However, some treatments can cause dramatic improvements in the symptoms of RA, which can lead to remission.

RA is an autoimmune disease that attacks the lining of the joints. It commonly affects the hands, knees, or ankles and often occurs within the same joint on both sides of the body. RA may also cause issues relating to other parts of the body, including the eyes, heart, lungs, and circulatory system.

If a person’s symptoms disappear for a certain length of time, doctors will describe the individual as being in remission.

In this article, we discuss how healthcare professionals define remission in relation to RA. We also look at how a person can achieve remission.

A person rubbing their wrist who may have achieved rheumatoid arthritis remission.Share on Pinterest
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Although there is no cure for RA, a person can go into remission. Treatment with disease-modifying antirheumatic drugs (DMARDs) can reduce symptoms and help a person achieve remission.

According to a 2017 review, a person who has maintained remission for 6 months or more has achieved sustained remission.

The American College of Rheumatology and the European League Against Rheumatism have developed criteria for defining RA remission. These guidelines allow researchers to compare the effectiveness of different treatments in achieving RA remission.

The criteria for RA remission include:

  • one or fewer swollen joints
  • one or fewer tender joints
  • a patient assessment showing that on a 0–10 scale, the arthritis activity is 1 or less
  • blood test results that show little or no inflammation in the levels of C-reactive protein, which is a key marker of inflammation

A doctor may also use a second definition to decide whether a person has entered RA remission. This definition uses the Simplified Disease Activity Index (SDAI), which measures disease activity.

To get an SDAI score, the doctor will combine a sum score of the four measures above with an assessment.

Once a person has achieved sustained remission, they may be able to decrease their DMARD dosage slowly and then stop taking this medication.

In some cases, this treatment reduction can lead to a relapse, meaning that symptoms return. In other cases, however, people can experience drug-free remission, or sustained DMARD-free remission, where they no longer require medication to prevent the symptoms of RA.

With an early diagnosis and prompt, successful treatment, sustained DMARD-free remission is not uncommon.

The Arthritis Foundation notes that because the definitions of RA remission were subjective in the past, the published rates of remission vary greatly, ranging from 10% to 60%.

For instance, in a 2017 review of RA remission studies, the range of remission rates across the studies was 5–45%. However, no accurate time frame was in place to define remission in these cases.

Early diagnosis and treatment are important factors that can affect a person’s chance of achieving remission.

One 2015 review of different RA treatment studies states that the rate of medication-free remission is about 3.6–22%. However, the authors note that further studies are necessary to determine the best treatment strategies that can help people achieve drug-free remission.

The following can help a person achieve RA remission.

Early treatment

An early diagnosis of RA allows a person to begin treatment quickly. Quick treatment is an important factor in achieving RA remission.

Research has shown that early treatment improves a person’s chances of achieving lasting remission.

Medications

Treatment for RA can include a number of drugs that help ease symptoms.

A healthcare professional may prescribe DMARDs to a person with RA to treat inflammation. According to a 2020 article, DMARDs can also slow the progression of RA, which can help a person achieve remission.

Biologics also help reduce inflammation. These genetically modified drugs target the immune system cells that attack the inflammatory cells. A healthcare professional may prescribe biologics when DMARDs alone are not enough to treat the symptoms of RA.

A person with a compromised immune system or an infection should avoid taking biologics, as these may increase their risk of developing a serious infection.

Low disease levels

According to the Arthritis Foundation, if a person has low disease activity levels when their treatment begins, they are more likely to achieve and maintain RA remission.

Approximately one-third of those with RA alternate between remission and relapse, and flare-ups of symptoms are common.

Although relapses often occur, an older study showed that some people were able to remain in remission for up to 4 years.

Additionally, even though it is possible for some people to achieve drug-free remission, relapses can occur if a person stops taking their medications.

A person may, therefore, wish to continue taking DMARDs during remission to prevent symptoms of RA from returning.

Some dietary and lifestyle factors, such as body weight and smoking, can affect a person’s chance of achieving and maintaining RA remission.

A 2018 article reports on research showing that people with obesity are less likely to achieve and sustain remission than overweight people and those with a moderate weight.

Other research has indicated that obesity more than doubles females’ likelihood of not achieving remission. This study also found that smoking significantly decreases the chance of males achieving remission.

Diet

A 2017 article notes that incorporating certain foods into a person’s diet may help by:

  • reducing disease activity
  • delaying the progression of RA
  • reducing damage to the joints
  • reducing the necessary dosage of drugs

The authors note that the following foods may have anti-inflammatory effects:

  • fruits, such as dried plums, blueberries, grapes, pomegranate, grapefruit, mango, and banana
  • cereals, including whole oatmeal and whole wheat bread
  • legumes, such as black soybeans
  • spices, including ginger and turmeric
  • yogurt
  • green tea
  • basil, or tulsi, tea
  • olive oil

Foods that it may be best to avoid include:

  • processed foods
  • high levels of salt
  • most animal products
  • sugar

If a person with RA has achieved remission but starts to experience RA symptoms again, they should speak with a doctor as soon as possible.

A flare-up may be a sign that a drug that was initially working is no longer having an effect.

A doctor can work with the individual to adjust their treatment plan to prevent serious joint damage from occurring.

RA is an inflammatory condition that can damage joints and cause pain throughout the body. It is a chronic condition without a known cure.

However, some RA treatments can lead to a person entering RA remission. When in remission, a person will experience an improvement in symptoms or even no symptoms at all.

During remission, a person can taper off their medication. Some individuals can stop taking it entirely, leading to them being in drug-free remission.

It is not uncommon for people to alternate between remission and relapse. If a person is in remission and starts to experience symptoms once again, they should speak with a doctor.