EULAR response criteria are based upon the DAS or DAS28, categorizing improvement into either good or moderate responses. These criteria require not only a certain degree of improvement but also attainment of a good (or moderate) disease activity state. CDAI and SDAI response criteria CDAI and SDAI are continuous scores for which validated response criteria exist that are useful in clinical practice. Response cutoffs have been defned for the CDAI and SDAI that correspond with the traditional ACR responses; these defnitions of minor, moderate, and major response have been defned as relative improvements of SDAI or CDAI of 50, 70, or 85 percent, respectively. Remission criteria Remission is the ultimate treatment goal for RA treatment. Remission is regarded as no or only minimal residual disease activity. ACR and EULAR provisional defnition of remission defnition ACR and EULAR provisional defnition of remission for clinical trials and for clinical practice are stringent and do not allow residual disease activity beyond a minimal extent of residual joint swelling or tenderness. They are either index based on the SDAI (<=3.3) or Boolean based (i.e., an “intersection” of several criteria) that include the fulfllment of the following four conditions: a maximum of 1 swollen joint + a maximum of 1 tender joint + a maximum of 1 cm patient global assessment (0- to 10-cm scale) + a maximum of 1mg/dl of CRP. For clinical practice, clinical remission criteria correspond to the CDAI (≤2.8) and the Boolean without the CRP requirement (i.e., needing 3/3). ACR Response Criteria ACR20 / ACR50 / ACR70 • ≥ 20%/50%/70% improvement in: - Swollen joint count - Tender joint count - Improvement in at least 3 of the following 5 measures: • Patient's global assessment of disease activity • Physicians' global assessment of disease activity • Patient's assessment of pain • Acute-phase reactant (ESR, CRP) • Disability (HAQ) EULAR response criteria DAS28 at (mprovtmtnt in DAS or DAS28 from Bastlint Endpoint > 1.2 > 0.6 and ≤ 1.2 ≤0.6 ≤ 3.2 Good >3.2 and ≤ 5.1 Moderate >5.1 None Ref: van Gestel AM. Arthritis Rheum 1996; 39:34. van Gestel AM. Arthritis Rheum 1998; 41:1845. Smolen J. Rheumatology 2003;42:244–257; Aletaha D. Res Clin Rheumatol. 2007 Aug;21(4):663-75. Ref: Aletaha D. Ann Rheum Dis 2012; 71:1190. 9
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