ArticleArthritis research & therapy2011
Pain persists in DAS28 rheumatoid arthritis remission but not in ACR/EULAR remission: a longitudinal observational study.
Article in Arthritis research & therapy, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 134 papers, 1 of them a synthesis that pooled it.
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Who cites it
134 citing papers in PubMed, 1 synthesis or guideline pooled it, 253 citations in OpenAlex.
- Pain beliefs and problems in functioning among people with arthritis: a meta-analytic review.Journal of behavioral medicine · 2016Pooled it
- Efficacy of Paroxetine as an Adjuvant Therapy in Rheumatoid Arthritis Patients: A Randomized Controlled Study.Drug design, development and therapy · 2025Trial
- Anti-GM-CSF otilimab versus tofacitinib or placebo in patients with active rheumatoid arthritis and an inadequate response to conventional or biologic DMARDs: two phase 3 randomised trials (contRAst 1 and contRAst 2).Annals of the rheumatic diseases · 2023Trial
- The effect of flaxseed with or without anti-inflammatory diet in patients with rheumatoid arthritis, a randomized controlled trial.European journal of nutrition · 2022Trial
- Associations between Patient Global Assessment scores and pain, physical function, and fatigue in rheumatoid arthritis: a post hoc analysis of data from phase 3 trials of tofacitinib.Arthritis research & therapy · 2020Trial
- Long-term, health-enhancing physical activity is associated with reduction of pain but not pain sensitivity or improved exercise-induced hypoalgesia in persons with rheumatoid arthritis.Arthritis research & therapy · 2018Trial
- Evaluation of two doses of etoricoxib, a COX-2 selective non-steroidal anti-inflammatory drug (NSAID), in the treatment of Rheumatoid Arthritis in a double-blind, randomized controlled trial.BMC musculoskeletal disorders · 2016Trial
- Do COX-2 inhibitors provide additional pain relief and anti-inflammatory effects in patients with rheumatoid arthritis who are on biological disease-modifying anti-rheumatic drugs and/or corticosteroids? Post-hoc analyses from a randomized clinical trial with etoricoxib.BMC musculoskeletal disorders · 2015Trial
- Is painless synovitis different from painful synovitis? A controlled, ultrasound, radiographic, clinical trial.Clinics (Sao Paulo, Brazil) · 2014Trial
- Article
- Beyond Pain Intensity: Central Sensitization and Psychosocial Symptom Burden in Women with Rheumatoid Arthritis.Medicina (Kaunas, Lithuania) · 2026Observational
- Psychological Aspects of Rheumatic Diseases: Psychorheumatology in Clinical Practice.Rheumatology and therapy · 2026Review
- Cerebral Pain Processing Following TNFα Inhibitor Treatment in Rheumatoid Arthritis: A Randomized Double-Blind Placebo-Controlled fMRI Study.ACR open rheumatology · 2026Article
- The effect of tumor necrosis factor-alpha on rheumatoid arthritis-related pain: overview of evidence and mechanistic pathways.Croatian medical journal · 2026Review
- High Burden and Phenotype-Specific Variability of Pain Polypharmacy in Early Autoimmune Rheumatic Diseases: A 15-Year Real-World Analysis.Research square · 2026Article
- Effect of Interleukin-6 Inhibitors on Rheumatoid Arthritis Pain: Overview of Evidence and Mechanistic Pathways.Pharmacology research & perspectives · 2026Review
- Musculoskeletal Ultrasound and the Decision to Switch Therapy in Patients With Established Rheumatoid Arthritis.Cureus · 2026Article
- The Association Between Neuropathic Pain, Pain Intensity, and Inflammatory Activity in Rheumatoid Arthritis.Journal of clinical medicine · 2026Article
- Neuropathic pain in rheumatoid arthritis: prevalence and associated factors.Reumatologia · 2026Article
- UK Medical Cannabis Registry: An Updated Analysis of Inflammatory Arthritis.Clinical medicine insights. Arthritis and musculoskeletal disorders · 2026Article
74 more citing papers are in PubMed but not listed here.
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
Abstract
introductionDisease remission has become a feasible goal for most rheumatoid arthritis (RA) patients; however, patient-reported symptoms, such as pain, may persist despite remission. We assessed the prevalence of pain in RA patients in remission according to the Disease Activity Score (DAS28-CRP4) and the American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) remission criteria.
methodsData were analyzed from RA patients in the Brigham Rheumatoid Arthritis Sequential Study with data at baseline and 1 year. DAS28 remission was defined as DAS28-CRP4 <2.6. The ACR/EULAR remission criteria included (a) one or more swollen joints, (b) one or more tender joints, (c) C-reactive protein ≤1 mg/dl, and (d) patient global assessment score ≤1. Pain severity was measured by using the pain score from the Multi-Dimensional Health Assessment Questionnaire (MDHAQ). The associations between baseline clinical predictors and MDHAQ pain at baseline and 1 year were assessed by using multivariable linear regression.
resultsAmong the 865 patients with data at baseline and 1 year, 157 (18.2%) met DAS28-CRP4 remission criteria at both time points. Thirty-seven (4.3%) met the ACR/EULAR remission criteria at baseline and 1 year. The prevalence of clinically significant pain (MDHAQ pain ≥4) at baseline ranged from 11.9% among patients meeting DAS28-CRP4 remission criteria to none among patients meeting ACR/EULAR remission criteria. Patient global assessment, MDHAQ function, MDHAQ fatigue, MDHAQ sleep, and arthritis self-efficacy were significantly associated with MDHAQ pain in cross-sectional (P ≤ 0.0005) and longitudinal analyses (P ≤ 0.03). Low swollen-joint counts were associated with high MDHAQ pain in longitudinal analyses (P = 0.02) but not cross-sectional analyses. Other measures of inflammatory disease activity and joint damage were not significantly associated with MDHAQ pain at baseline or at 1 year.
conclusionsClinically significant pain continues among a substantial proportion of patients in DAS28 remission but not among those in ACR/EULAR remission. Among patients in DAS28 remission, patient global assessment, disability, fatigue, sleep problems, and self-efficacy are strongly associated with pain severity at baseline and 1 year, whereas inflammatory disease activity and joint damage are not significantly associated with elevated pain severity at either baseline or 1 year.
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