New insights into the measurement of disease activity in rheumatoid arthritis.

Abstract

Disease activity assessment in rheumatoid arthritis (RA) is a rapidly evolving field. Not only are new measures suggested or introduced in the field, but also we continuously learn about the better use of existing ones in the context of managing disease. On that background, we reviewed the literature on disease activity in RA of 2014 and selected interesting or relevant studies for further discussion. EULAR Management Criteria suggest that stringent disease activity targets should be used to guide treatment adaptation. Several studies support this, some even claim to change cutpoints for existing composite indices to match this stringency requirement, while others suggest seeking additional guidance by musculoskeletal ultrasound. One study suggests substantial modifications of existing composite measures in order to make them more objective, although the evident patient contribution to treatment decisions from another study would claim the opposite, namely to give more emphasis on the patient's perspective. New measures of disease activity include modification of core set parameters or existing MRI scores, but range up to currently less feasible whole-body MRI scans or sophisticated nuclear medicine methods. Here, we review several new studies on disease activity assessment in the management of RA. On the basis of the studies in 2014, we expect that this specific field will continue to attract scientific attention.