Polyarthrite rhumatoïde : définitions de la réponse, des différents niveaux d'activité et de la rémission

Response criteria have been available for about fifteen years in rheumatoid arthritis. The American College of Rheumatology (ACR) criteria (ACR 20, 50, 70) were created for clinical studies, i.e. to demonstrate the efficacy of a treatment versus a comparator. European response criteria were initially created to define, in daily life, a therapeutic target for a given patient (Disease Activity Score [DAS] and DAS 28 with three or four variables, then Simplified Activity Index [SDAI] and Clinical Activity Index [CDAI]). DAS and DAS 28 are now used also in clinical studies. In this paper, the available tools measuring clinical response, clinical remission and low/very low levels of activity were reviewed. Metrologic properties and use in clinical studies and in daily practice were described. At the present time, we urgently need consensual definitions of remission and of very low level of activity since these levels are recommended therapeutic targets in rheumatoid arthritis.