scholarly journals Influence of disease activity on functional capacity in patients with rheumatoid arthritis

2015 ◽  
Vol 72 (1) ◽  
pp. 21-25 ◽  
Author(s):  
Jelena Jovanovic ◽  
Miodrag Stojanovic ◽  
Vladimir Jovanovic ◽  
Aleksandar Dimic ◽  
Sladjana Bozilov ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Functional Status ◽  
Functional Disability ◽  
Health Assessment ◽  
Group Iii ◽  
Group I ◽  
Group Ii ◽  
The Impact ◽  
Significant Factors

Background/Aim. Progressive erosive changes in cartilage and bone in rheumatoid arthritis (RA) ultimately lead to joint deformities and disability which may be early, severe and permanent. Consequently, there is the reduction of functional ability and changes in the quality of life. The aim of this study was to estimate the impact of disease activity on functional status of patients with RA. Methods. A prospective investigation included 74 patients with RA who were treated in the Rheumatology Clinic of the ?Niska Banja? Institute. Assessment of functional status (capacity) was measured by the Health Assessment Questionnaire (HAQ) with the values from 0 to 3 that patients fill out on their own. The patients were then divided into three groups: the group I with the HAQ values from 0.125 to 1.000, the group II with the values from 1.125 to 2.000 and the group III with the values from 2.125 to 3.000. Disease activity was measured by Disease Activity Score (DAS28). The assessment also included sedimentation rate (SE) influence, IgM rheumatoid factor (RF) and C-reactive protein (CRP) positivity, age, and disease duration. Results. The patients with the most severe functional damage estimated by the HAQ - the group III, had the highest values of DAS28 SE (7.4 ? 0.8) compared to the group II (6.5 ? 1.2) and the group I (3.4 ? 1.2). The group III also showed the highest values of DAS28 CRP (7.1 ? 0.8) compared to the group II (6.7 ? 0.8) and the group I (3.6 ? 0.4). Compared with the patients with small and moderate functional damage, the patients in the group III had positive IgM RF and CRP as well as higher SE values more frequently and the difference was statistically significant. In the univariate logistic model, the tested parameters of DAS28 SE, DAS 28 CRP, SE, RF and CRP represent significant predictors of functional disability. The most significant factors that increase the odds of patient having the most severe functional damage include DAS28 SE which increases the odds by 5.5 times (OR = 5.450, 95% CI = 3.211-7.690, p = 0.001), DAS28 CRP by 5.1 times (OR = 5.111, 95% CI = 2.123-10.636, p < 0.01), and the presence of increased CRP (OR = 5.219, 95% CI = 1.305-18.231, p = 0.019) by 5.2 times. Conclusion. Functional status evaluated by the HAQ is a standard for assessment of RA due to its convenience and good correlation with parameters of disease activity. The most significant factors that increase the odds that the patient has the greatest functional damage are DAS28 SE, DAS28 CRP and the presence of CRP.

scholarly journals Use of Clinical Disease Activity Index Score for Assessment of Disease Activity in Rheumatoid Arthritis Patients: An Indian Experience

Arthritis ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
H. Singh ◽  
H. Kumar ◽  
R. Handa ◽  
P. Talapatra ◽  
S. Ray ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Objective Assessment ◽  
Group Iv ◽  
Kappa Statistics ◽  
Group Iii ◽  
Das 28 ◽  
Group I ◽  
Group Ii ◽  
Assessment Of Disease Activity

Introduction. Serial objective assessment of disease activity in Rheumatoid Arthritis (RA) is imperative to achieve remission. The CDAI score appears more practical than DAS-28 in routine assessment of disease activity in RA patients. Objective. To evaluate correlation and agreement of the DAS-28 with CDAI in RA patients. Methods. A total of 200 patients of RA were evaluated by DAS-28 and CDAI and divided into 4 categories of disease activity i.e. Group-I: Remission (DAS-28 < 2.6; CDAI < 2.8), Group II: Low disease activity (DAS-28 = 2.6–3.2; CDAI = 2.8–10), Group III: Moderate disease activity (DAS-28 = 3.2– 5.1; CDAI = 10–22), Group IV: High disease activity (DAS-28 > 5.1; CDAI > 22). DAS-28 was compared to CDAI in each group using spearman correlation coefficient and kappa statistics. Results. Group I shows mean DAS-28 of 1.99±0.38; mean CDAI of 0.90±0.65, (P = 0.0001). Group II shows mean DAS-28 of 3.04±0.17; mean CDAI of 6.45±02.35, (P = 0.0001). Group III shows mean DAS-28 of 4.25±0.58; mean CDAI of 16.46±3.31 (P < 0.0001). Group IV shows mean DAS-28 of 6.38±0.87; mean CDAI of 38.56±11.88 (P < 0.0001). Kappa statistics (κ) of the above comparison was 0.533. Conclusion. Our findings indicate that CDAI—a composite score that employs only clinical variables and omits assessment of Acute Phase Reactant (APR), has moderate to good correlation (Kappa value = 0.533) to DAS-28 for assessment of disease activity in RA patients.

scholarly journals Fibromyalgia Is Common and Adversely Affects Pain and Fatigue Perception in North Indian Patients with Rheumatoid Arthritis

2009 ◽  
Vol 36 (11) ◽  
pp. 2443-2448 ◽  
Author(s):  
VARUN DHIR ◽  
ABLE LAWRENCE ◽  
AMITA AGGARWAL ◽  
RAMNATH MISRA
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Functional Disability ◽  
Health Assessment ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
The North ◽  
Indian Patients

Objectives.Fibromyalgia (FM) has been shown to be common in patients with rheumatoid arthritis (RA), but studies on Asian patients are lacking. It remains unclear whether FM has an adverse influence on pain, fatigue, quality of life, and mood in these patients, and what its relationship is with disease activity. We studied prevalence and effects of FM in North Indian patients with RA and associations of RA with disease activity.Methods.This cross-sectional study included 200 RA patients and an equal number of controls. Presence of FM was defined using the American College of Rheumatology 1990 criteria. Pain and fatigue scores were assessed using a 10 cm visual analog scale. Quality of life and presence of depression/anxiety were determined using validated questionnaires. Disease activity and functional disability in RA patients was assessed using the Disease Activity Score 28-3 and Health Assessment Questionnaire, respectively.Results.FM was present in 15% of patients with RA compared to 2.5% of controls in the North Indian population. RA patients with FM did not differ from those without FM in terms of age, gender, current disease-modifying agents, or steroid use. RA patients with FM had higher disease activity and worse functional disability. The number of tender and swollen joints was higher in patients with FM, but correlated poorly with each other. RA patients with FM had higher pain and fatigue scores but were not different in the quality of life or mood.Conclusion.FM is more common in North Indian patients with RA compared to controls. It adversely affects the pain and fatigue felt by RA patients. Disease activity and FM influence each other.

scholarly journals EFFECT OF SMOKING ON ORAL HYGIENE PARAMETERS IN ADOLESCENTS AND YOUNG ADULTS

2021 ◽  
Vol 21 (3) ◽  
pp. 160-163
Author(s):  
I. Lisetska ◽  
M. Rozhko
Keyword(s):  
Young Adults ◽  
Oral Hygiene ◽  
Electronic Cigarettes ◽  
Group Iv ◽  
Adolescents And Young Adults ◽  
Group Iii ◽  
Group I ◽  
Dental Diseases ◽  
Group Ii ◽  
The Impact

Recent studies have shown that the prevalence of dental diseases is remaining high among the population. It is known that the pathogenesis of dental diseases is strongly associated with smoking. Maintaining proper oral hygiene is an important factor in the prevention of dental diseases. Therefore, the question of studying the impact of smoking on the oral hygiene status in adolescents and young adults is quite relevant as it can promote further development of more effective preventive measures. The aim of the study is to examine the effect of smoking on the oral hygiene parameters in adolescents and young adults. Oral Hygiene Index-Simplified (Green-Vermillion, 1964) was applied to assess the oral hygiene status in 114 adolescents and young adults aged 15 to 24 years, who were divided into groups: group I included 26 people who smoked traditional cigarettes on regular basis; group II included 22 people who smoked electronic cigarettes (Vapes); group III involved 23 people who used to smoke tobacco heating devices (IQOS); group IV included 43 non-smokers. The subjects of group I were found to have an unsatisfactory oral hygiene status, their OHI-S index was equal to 1.77 ± 0.02 scores. The subjects of group II demonstrated 1, 53±0, 01 scores, and the subjects of group III – 1.46±0.02 scores that corresponds to a satisfactory level of hygiene. The subjects of group IV, whose oral hygiene status was also satisfactory, had 0.87±0.03 scores. The study has shown that the state of oral hygiene is affected by smoking of traditional cigarettes or alternative smoking devices and smoking duration. Therefore, much attention should be paid and more efforts should be applied to promote smoking cessation and to elaborate the algorithm of medical and preventive dental care for those who is still smoking.

scholarly journals Has the Severity of Rheumatoid Arthritis at Presentation Diminished Over Time?

2014 ◽  
Vol 41 (8) ◽  
pp. 1590-1599 ◽  
Author(s):  
Janet G. Diffin ◽  
Mark Lunt ◽  
Tarnya Marshall ◽  
Jacqueline R. Chipping ◽  
Deborah P.M. Symmons ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Drug Exposure ◽  
Functional Disability ◽  
Health Assessment ◽  
Joint Disease ◽  
Symptom Duration ◽  
Recent Onset ◽  
American College Of Rheumatology ◽  
Over Time

Objective.To examine the pattern of disease severity in patients with rheumatoid arthritis (RA) at presentation to the Norfolk Arthritis Register (NOAR) over 20 years.Methods.NOAR is a primary-care–based cohort of patients with recent-onset inflammatory polyarthritis. At baseline, subjects are assessed and examined by a research nurse. The Health Assessment Questionnaire (HAQ) is administered and the DAS28 (28-joint Disease Activity Score) is calculated. Information is collected on disease-modifying antirheumatic drug exposure. In this study, patients (symptom duration of < 2 years at baseline) were grouped into 4 cohorts (Cohort 1: 1990–1994; Cohort 2: 1995–1999; Cohort 3: 2000–2004; Cohort 4: 2005–2008). The American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) 2010 criteria for RA were applied retrospectively at baseline. Regression analyses were used to examine whether calendar year of presentation to NOAR was associated with baseline HAQ and DAS28 scores. Potential confounders included age at symptom onset, sex, rheumatoid factor, and anticyclic citrullinated peptide antibody positivity.Results.A total of 1724 patients met the ACR/EULAR 2010 RA criteria at baseline. Unadjusted mean DAS28 scores decreased over time. Calendar year of presentation to NOAR was significantly associated with lower DAS28 scores over time [Y = 4.51 + (–0.56 × year) + (0.44 × year2)]. Although unadjusted median HAQ scores increased over time, calendar year of presentation to NOAR was not significantly associated with HAQ scores [Y = (1.1) + (0.023 × year) + (0.05 × year2)]. Similar results were observed in each subpopulation of patients.Conclusion.While baseline disease activity has lessened slightly over time, there has been no improvement in baseline levels of functional disability.

scholarly journals The Effectiveness of Various Types of Psychological Correction of Anxiety in Primary School

2019 ◽  
Vol 10 (1) ◽  
pp. 20
Author(s):  
Olga P. Bartosh ◽  
Tatiana P. Bartosh
Keyword(s):  
Child Anxiety ◽  
Self Regulation ◽  
Childhood Anxiety ◽  
Group Iii ◽  
Group I ◽  
Psychological Training ◽  
Group Ii ◽  
The Impact ◽  
Therapy Sessions ◽  
Healthy Personality

At various stages of the development and education of children, there are psychoemotional difficulties that create prerequisites for impairment of the development of the child’s personality. The timely detection of difficulties in schoolchildren and therapeutic efforts are important for the formation of a psychologically healthy personality. The study of the effectiveness of various remedial techniques for childhood anxiety has therefore become theoretically and practically significant. The purpose of our study is to determine the effectiveness of various types of such therapeutic efforts: social and psychological training, a method of biological feedback, and Sandplay for the indicators of childhood anxiety among younger schoolchildren. The study was conducted in the school of Magadan, northeast of Russia (9–10-year-old students, n = 43). We used a standardized method of Multidimensional Assessment of Child Anxiety which included 10 scales. The following therapeutic efforts were used: sociopsychological training (SPT), biofeedback method (BFB), individual and group Sandplay. Students of group I (n = 12) participated only in the SPT. Students of group II (n = 11) participated in the SPT and underwent a course of training in self-regulation using the BFB method. In therapy work with the students of group III (n = 20), the SPT, BFB, individual and group Sandplay were used. In group I, after the therapy sessions, a significant decrease in anxiety was observed in 3 of 10 scales (2, 6, 7; p < 0.05). In group II, it was seen in 5 scales (1, 3, 6, 7, 8; p < 0.05). In group III, significant improvements took place in 7 scales (1, 2, 5, 6, 7, 9, 10; p < 0.01–p < 0.05). The present study has shown the different efficacy of applying the remedial techniques separately and in combination. The use of the therapy methods, in the complex, enhances the impact on the types of child anxiety.

scholarly journals AB0797 THE ROLE OF ULTRASOUND CRITERIA IN ASSESSING PAIN SYNDROME IN THE KNEE JOINT IN PATIENTS WITH RHEUMATOID ARTHRITIS AND OSTEOARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1423.1-1423
Author(s):  
N. Aleksandrova ◽  
A. Aleksandrov
Keyword(s):  
Rheumatoid Arthritis ◽  
Knee Joint ◽  
Synovial Membrane ◽  
Pain Syndrome ◽  
Synovial Proliferation ◽  
Group Iii ◽  
Joint Cavity ◽  
Group I ◽  
Number Of Patients ◽  
Group Ii

Background:Pain syndrome and pathological changes in the synovium detected by ultrasound can be early signs of various diseases of the joints [1].Objectives:the use of ultrasound criteria for changes in the synovial membrane of the joint cavity to assess the severity of pain in patients with rheumatoid arthritis (RA) and osteoarthritis (OA).Methods:The study included 36 patients with RA (32 women and 4 men aged 22 to 55 years old) and 38 patients with OA (30 women and 8 men aged 30 to 50 years old) with lesions of the knee joints. A visual analogue scale (VAS) was used to determine the severity of pain. The severity of pain in the knee when walking was at least 40 mm according to the VAS in all examined patients. Joint ultrasound examination was carried out according to the standard technique using a linear transducer with a frequency of 5–12 MHz on an Accuvix V10 ultrasound diagnostic system (Samsung Medison, South Korea). The evaluation of ultrasound changes in the upper inversion of a knee joint was carried out according to the following criteria: the severity of intra-articular effusion (1), synovial proliferation (2), local vascularization of the synovial membrane using power Doppler (3) (Table 1).Table 1.Parameters of ultrasound criteria for assessing changes in the synovial membrane of the joint cavityNormal indicators1 - width of the suprapatellar turn is 6 mm2 - thickness of the synovial membrane is 3 mm (from the anterior approach)3 - lack of vascularization lociMinimum changes1 - delamination of the suprapatellar curl leaves from 7 to 9 mm2 - thickness of the synovial membrane 3.1–4.5 mm3 - appearance of single loci of vascularization (1-2 in the Doppler field)Moderate changes1 - delamination of the leaves of the suprapatellar twist 10-14 mm2 - thickness of the synovial membrane is 4.6–6.4 mm3 - appearance of moderate (> 5) vascularization lociSevere changes1 - delamination of suprapatellar folds of more than 15 mm2 - thickness of the synovial membrane is more than 6.5 mm3 - multiple foci of vascularization (> 5, merging in places)Results:Correlations of various severity were found between pain indices according to VAS and the thickness of the synovial membrane of the knee joint (r = 0.33, p = 0.019) and the number of vascularization foci (rS = 0.29, p = 0.04) in RA patients, as well as between pain according to VAS and the severity of intra-articular effusion (r = 0.28, p <0.002) in patients with OA.The patients were divided into three groups according to the severity of pain in the knee joint: group I - 41-59 mm (12 patients with OA and 9 patients with RA), group II - 60-79 mm (16 patients with OA and 12 patients with RA), group III - 80–100 mm on the VAS scale (10 patients with OA and 15 patients with RA). Group I was dominated by OA patients with minimal changes in intra-articular effusion and local vascularization of the synovial membrane, with moderate synovial proliferation (28.6% of the total number of patients in the group). In group II patients with OA with moderate severity of intra-articular effusion and local vascularization (21.4%) and patients with RA with moderate changes in the thickness of the synovium and local vascularization (25%) were equally common. Group III was dominated by RA patients with severe synovial proliferation and moderate local vascularization (28%), as well as patients with OA with moderate intra-articular effusion (20%).Significant differences in the thickness of the synovium in patients with RA in the first and third groups were noted (H-test = 5.9, p = 0.025).Conclusion:The additional use of ultrasound criteria for changes observed in the synovial membrane of the joint cavity in patients with RA and OA can help predict pain in the knee joint. The manifestation of pain syndrome in patients with OA is most associated with the severity of synovitis in the joint, and in patients with RA - with the severity of synovial proliferation.References:[1]Sarmanova A et al. Arthritis Res Ther. 2017;19(1):281.Disclosure of Interests:None declared

scholarly journals Comparative Analyses of Serological Biomarkers and Disease Characteristics between Elderly-onset and Younger-onset Rheumatoid Arthritis

2021 ◽  
Vol 16 (1) ◽  
pp. 237-245
Author(s):  
Rajalingham Sakthiswary ◽  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Functional Disability ◽  
Disease Duration ◽  
Severe Disease ◽  
Age At Onset ◽  
Health Assessment ◽  
Joint Damage ◽  
Study Data ◽  
Elderly Onset

The onset of rheumatoid arthritis (RA) may occur any time after the age of 16 years. The purpose of this study was to compare the clinical and serological differences between elderly onset RA (EORA); which is begins at the age of 60 and above, with younger onset RA (YORA). A total of 69 EORA and 82 YORA female patients were enrolled in this study. Data on medications, disease duration, age at onset, disease activity at onset and laboratory parameters were collected by reviewing the medical records. All patients had their blood samples taken for serum anticyclic citrulinated peptide (anti-CCP), IgA rheumatoid factor (RF), IgM RF and IgG RF. Besides, the subjects were assessed for their radiographic joint damage based on Modified Sharp Score (MSS) and functional disability based on the Health Assessment Questionnaire-disability Index (HAQ-DI) scores. Despite comparable disease duration and frequency of seropositivity, the YORA group had significantly higher disease activity at onset of the disease (p=0.009). In keeping with this finding, the YORA group had more severe joint damage based on radiographic assessment (MSS scores of 17.49+19.04 versus 10.04+12.79). The YORA group had significantly higher levels of IgA RF and anti-CCP with p-values of 0.035 and 0.002, respectively. Our findings suggest that YORA is associated with more severe disease, worse radiographic joint damage and higher levels of anti-CCP and IgA RF.

scholarly journals The Impact of Time Length to Boolean Remission for Tight Disease Activity Control After Acquisition in Rheumatoid Arthritis Patients

2021 ◽  
Author(s):  
Ichiro Yoshii ◽  
Tatsumi Chijiwa ◽  
Naoya Sawada
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Remission Rate ◽  
Health Assessment ◽  
Time Length ◽  
First Remission ◽  
The Impact ◽  
Questionnaire Disability

Abstract Importance of time length to achieving clinical remission on disease activity control, daily activities (ADL) and quality of life (QOL) maintenance after the remission was investigated for patients with rheumatoid arthritis (RA).In patients who achieved remission once or more, relationship between time length from initiation to achieve remission (TL) and patients’ background data at baseline, and relationship between TL and mean simplified disease activity score (SDAI), modified Health Assessment Questionnaire Disability Index (HAQ-DI) score, pain score with visual analog scale (PS-VAS), Sharp/van der Heijde Score (SHS) and quality of life score (QOLS) at the first remission and thereafter were evaluated statistically. Patients were divided into two groups whether TL was within 6 months or longer (G≤6 and G>6). Change of the parameters and Boolean remission rate (BRR) after the first remission between the two groups were compared statistically.In 465 patients, TL correlated significantly with the SDAI score, the HAQ score, PS-VAS, SHS, and the QOLS after the remission. The SDAI score and the BRR after the first remission were significantly better in the G≤6 than in the G>6.TL is an important key to guarantee good disease activity control, ADL and QOL.

scholarly journals Background Glucocorticoid Therapy Has No Impact on Efficacy and Safety of Abatacept or Adalimumab in Patients with Rheumatoid Arthritis

2020 ◽  
Vol 9 (6) ◽  
pp. 2017
Author(s):  
Yannick Degboé ◽  
Michael Schiff ◽  
Michael Weinblatt ◽  
Roy Fleischmann ◽  
Harris A. Ahmad ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Health Assessment ◽  
Similar Proportion ◽  
Efficacy And Safety ◽  
Reactive Protein ◽  
Radiographic Outcomes ◽  
Score Improvement ◽  
Additional Value ◽  
The Impact

To date, the impact of background glucocorticoids (GC) on the efficacy and safety of abatacept or adalimumab in patients with active rheumatoid arthritis (RA) is not clearly established. This post hoc analysis of (AMPLE) trial (NCT00929864) compared efficacy and safety outcomes over 2 years in patients treated with abatacept or adalimumab plus background methotrexate (MTX), who continued GC (≤10 mg/day) versus those who were not receiving GC (no-GC). Of 646 randomized patients, 317 received abatacept + MTX (161 GC, 156 no-GC) and 326 received adalimumab + MTX (162 GC, 164 no-GC). At Year 2, the adjusted mean changes from baseline in Disease Activity Score (DAS28 C-reactive protein (CRP)) and Health Assessment Questionnaire-Disability Index (HAQ-DI) were not significantly different in the GC versus no-GC subgroups receiving abatacept or adalimumab. A similar proportion of patients achieved remission, HAQ-DI score improvement ≥0.3 and radiographic progression rates. No clinically meaningful safety differences were observed between GC versus no-GC subgroups either with abatacept or adalimumab. In patients with active RA of similar baseline disease activity treated with abatacept or adalimumab plus background MTX, there was no additional value of background GC on clinical, functional or radiographic outcomes over two years.

scholarly journals Association of 17 Definitions of Remission with Functional Status in a Large Clinical Practice Cohort of Patients with Rheumatoid Arthritis

2019 ◽  
Vol 47 (1) ◽  
pp. 20-27 ◽  
Author(s):  
Pedro D. Carvalho ◽  
Ricardo J.O. Ferreira ◽  
Robert Landewé ◽  
David Vega-Morales ◽  
Karen Salomon-Escoto ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Practice ◽  
Disease Activity ◽  
Functional Status ◽  
Physical Function ◽  
Activity Index ◽  
Health Assessment ◽  
Disease Activity Index ◽  
Sensitivity Analyses ◽  
American College Of Rheumatology

Objective.To compare the association between different remission criteria and physical function in patients with rheumatoid arthritis followed in clinical practice.Methods.Longitudinal data from the METEOR database were used. Seventeen definitions of remission were tested: American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) Boolean-based; Simplified/Clinical Disease Activity Index (SDAI/CDAI); and 14 Disease Activity Score (DAS)-based definitions. Health Assessment Questionnaire (HAQ) ≤ 0.5 was defined as good functional status. Associations were investigated using generalized estimating equations. Potential confounders were tested and sensitivity analyses performed.Results.Data from 32,915 patients (157,899 visits) were available. The most stringent definition of remission was the ACR/EULAR Boolean-based definition (1.9%). The proportion of patients with HAQ ≤ 0.5 was higher for the most stringent definitions, although it never reached 100%. However, this also meant that, for the most stringent criteria, many patients in nonremission had HAQ ≤ 0.5. All remission definitions were associated with better function, with the strongest degree of association observed for the SDAI (adjusted OR 3.36, 95% CI 3.01–3.74).Conclusion.The 17 definitions of remission confirmed their validity against physical function in a large international clinical practice setting. Achievement of remission according to any of the indices may be more important than the use of a specific index. A multidimensional approach, targeted at wider goals than disease control, is necessary to help all patients achieve the best possible functional status.

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