Background: Remission is the primary therapeutic goal in rheumatoid arthritis (RA). Clinical trials have proven that systematic monitoring of disease activity, adjusting medication accordingly and aiming at a predefined target is effective in reaching this goal. However, aiming for remission is not implemented yet. Data on achieving and sustaining remission in daily clinical practice are limited. The objective was to evaluate disease activity in very early RA patients in clinical practice after 2 years of applying a tight control treatment strategy. Methods: Since January 2006, more than 700 newly diagnosed patients with early RA (symptom duration ≤1 year) were enrolled in the DREAM remission induction cohort. Treatment adjustments (4-8 weekly) were based on the DAS28, aiming at DAS28<2.6 (initial MTX, addition of SSZ, exchange of SSZ by anti-TNF in case of persistent high disease activity). Primary outcome was the disease activity according to DAS28, EULAR response criteria and modified ACR criteria for remission after 1 and 2 years. Additional measures included sustainability of remission. Results: Baseline characteristics were as follows: mean (SD) age 57.7 (13.9) years, 62.8% female, 56.6% RF positive, 62.4% anti-CCP positive, median symptom duration 15 weeks, mean (SD) baseline DAS28 5.0 (1.1) and 82.8% of patients fulfilled the ACR classification criteria for RA. Table 1 presents the clinical outcomes after 1 year (n = 392) and 2 years (n = 210) of follow-up. In 60% of patients sustained DAS28 remission (≥6 months) was observed during the first 2 years of follow-up. The majority of patients achieved remission on conventional DMARDs. Conclusions: Long-term remission is a realistic goal in very early RA patients in clinical practice. Implementation of a tight control treatment strategy results in high remission rates. The management of very early RA patients in clinical care can go beyond the control of signs and symptoms, and should aim at remission. Disclosure statement: M.V. received an unrestricted educational grant from Abbott, The Netherlands. All other authors declared no conflicts of interest.