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Seminars in arthritis and rheumatism · 22h
ReviewSeminars in arthritis and rheumatism · 2026

Definition and prevalence of residual disease in inflammatory arthritis: a systematic literature review and meta-analysis.

Casper Webers, Marius L Smits, Ellen Renet … Astrid van Tubergen
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RheumatologyReview

Patient-reported indicators are frequently used to define residual disease.

Definition and prevalence of residual disease in inflammatory arthritis: a systematic literature review and meta-analysis.

Casper Webers et al. · Seminars in arthritis and rheumatism · 2026
Purpose

To assess how residual disease (i.e., clinically relevant signs/symptoms despite achieving treatment targets) is defined in rheumatoid arthritis (RA), psoriatic arthritis (PsA) or axial spondyloarthritis (axSpA), and estimate the prevalence/severity of residual disease in these diseases.

Methods

Systematic review of original research in RA/PsA/axSpA.

n = 84 studies
73%
Results
patient-reported symptoms were used more often to define ongoing symptoms
n = 84 studies
More results

Regarding residual disease definitions (59 studies), disease states were almost exclusively disease activity-based (>99%), but with much variation in specific instruments/thresholds.

Especially peripheral joint counts, pain, physical function and CRP were frequently used (42-56% of studies).

The prevalence of residual disease (84 studies) was notable.

More results

For example, 5-25% of RA and PsA patients in remission still had swollen joints, and up to one-third reported relevant pain or fatigue.

“
Conclusion · 1 of 2

Residual disease definitions in RA/PsA/axSpA are based on various disease activity instruments/thresholds and indicators (signs/symptoms). Residual disease affects up to half of patients.

Conclusion · 2 of 2

Future research should aim for a consensus-based definition of residual disease.

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