what is remission? | Arthritis Information

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Hi Everyone,

 
I was curious as to what reasonable expectations are for these meds.  I'm on enbrel, mtx, plaquenil, and aleve to aleviate symptoms.  I still experience pain and some enlarged joints, etc.
 
I've been on Enbrel since late Feb '08 (off for a couple of weeks due to illness).  Can I expect more improvement?  Should I be satisfied w/ a good bit of mobility but not ever feeling great or normal?
 
I'm almost ready to go back to work, but I know I now have limitations w/ typing, etc.  I want to move back out on my own (I'm 34), but I can't always run the vacuum, etc.  I can't imagine ever dating again.  Who would want me now?  Oh, and I'm super depressed too.
 
I appreciate any feedback!
 
Take care,
Nori
The American College of Rheumatology (ACR) classification criteria for determining clinical remission include:
  • morning stiffness less than or equal to 15 minutes
  • no fatigue
  • no joint pain
  • no joint tenderness or pain on motion
  • no soft tissue swelling in joints or tendon sheaths
  • erythrocyte sedimentation rate -(a blood test which measures inflammation) less than or equal to 30 in females and 20 in males

    While there is no way to determine who will achieve remission with therapy, patients with a negative rheumatoid factor and CCP antibody as well as a normal C-reactive protein (another measure of inflammation in the blood) appear to have a better outcome. In addition, patients taking combination therapy (e.g. methotrexate and a TNF inhibitor) are more likely to achieve remission than those taking either drug alone. Nevertheless, patients on monotherapy (eg. methotrexate only) still may achieve clinical remission. The longer the disease remains in remission, the less likey it is to become active again.

    • You've only been on Enbrel for 4 months and it may not be enough time to reach remission or a lessening of symptoms.  I refused to be satisfied with only some relief.  I wanted clinical remission and after 10 years I've achieved it.  Never give up.  You may have to give Enbrel a few more months.  MXT may be increased. 

    Having RA isn't the end of the world.  There are plenty of dates out there and if they don't date you again because you have RA then they're not worth your time and effort. 

    Take care and keep us posted.  Lindy
    LinB - even the fatigue is gone for you?  That's the one thing that still troubles me. Hi Jas, yes, fatigue was the first thing to go.  Pain in my hands, wrist, toes and back was the next.  My cognitive skills came back in stages over a period of 2-3 months.  It was a fascinating process to observe.  Unfortunately, I developed severe pain in my achilles tendons, toes and elbows from PsA.  Humira sent me into a PsA flare but that has almost subsided but it was so much more painful than the RA.  My collateral tendons in knees are still tender from PsA but everything is 90% improved. 
     
    Having my brain function back is absolutely the most exciting part of remission.  I can think.  I still have days that I'm fatigued but I think it's med related.  There's a difference between RA fatigue and med fatigue, at least for me.  Lindy

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