Validation of rheumatoid arthritis low inflammatory activity: a novel clinical target quantifying inflammatory disease activity
Authors' conclusion
More patients achieved RALI than traditional remission with similar or lower rates of radiographic progression as well as low rates of high-risk characteristics and adverse long-term outcomes. These results support RALI as a point-of-care clinical target to inform management.
Study context
- Population
- Patients with rheumatoid arthritis in 3 clinical trials and the Veterans Affairs Rheumatoid Arthritis (VARA) RegistryParticipants from 3 clinical trials and the VARA Registry · 3 clinical trials 960 · VARA Registry 3,423
- Comparison
- RALI compared with traditional clinical remission
- Outcome
- Thresholds for RALI
Methodological detailsreceiver-operating-characteristic analyses, descriptive statistics, Cox regression
- Receiver-operating-characteristic analyses
- Descriptive statistics
- Cox regression
Performance
As reported in the abstract
M-DAS28
<1.4
Modified Simplified Disease Activity Index
≤3
Modified Clinical Disease Activity Index
≤2
Further findings
Frequency in VARA
- Frequency in VARA: M-DAS28 RALI vs DAS28 remission
Number in RALI vs in remission by traditional scores (3 datasets)
- A greater number were in RALI compared with the number in remission by traditional scores
Radiographic progression
- RALI was similarly predictive of radiographic progression compared with remission defined by traditional scores
Characteristics of those in RALI but with high traditional scores
- Higher rates of comorbidity (eg, anxiety and depression) and lower rates of seropositivity and erosive disease
Cardiovascular disease and death
- RALI was a stronger predictor of cardiovascular disease and death than traditional scores
Original publication
Validation of rheumatoid arthritis low inflammatory activity: a novel clinical target quantifying inflammatory disease activity. Ann Rheum Dis. Published 12 November 2026. doi:10.
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