Hands gently holding glowing joints, symbolizing rheumatoid arthritis relief.

RA Relief: How TNF Inhibitors are Evolving in Rheumatoid Arthritis Treatment

Jordan Keane in Health & Wellness December 2025 • 4 min read.

"Discover how recent data is showing the long-term effectiveness of anti-TNF therapies in achieving sustained remission and low disease activity in RA patients."

Rheumatoid arthritis (RA) is a chronic autoimmune disease affecting millions worldwide, characterized by inflammation of the joints, leading to pain, stiffness, and reduced mobility. The primary goal of RA treatment is to achieve remission or low disease activity (LDA) to improve patients' quality of life and prevent long-term joint damage.

Anti-tumor necrosis factor (anti-TNF) therapies have revolutionized RA treatment, offering significant improvements in disease control and slowing disease progression. Since their introduction, these therapies have become a cornerstone in managing RA, providing relief for many patients who previously had limited treatment options. However, achieving sustained remission or LDA remains a challenge for many, prompting ongoing research and refinement of treatment strategies.

Recent data from the British Society for Rheumatology Biologics Register for Rheumatoid Arthritis (BSRBR-RA) provides valuable insights into the long-term effectiveness of anti-TNF therapies. The BSRBR-RA is a comprehensive registry that tracks RA patients treated with biologic therapies, offering a rich source of data for evaluating treatment outcomes and identifying factors associated with successful disease management.

Sustained Remission and LDA: What Do the Numbers Say?

Hands gently holding glowing joints, symbolizing rheumatoid arthritis relief.

A longitudinal analysis of data from the BSRBR-RA examined the prevalence of sustained remission and LDA in RA patients treated with anti-TNF agents between 2001 and 2013. The study defined sustained remission as a DAS28-ESR (Disease Activity Score using 28 joints and Erythrocyte Sedimentation Rate) score of ≤2.6 for at least six months, while sustained LDA was defined as a DAS28-ESR score of ≤3.2 for the same period.

The results indicated that while sustained remission/LDA was infrequent overall, there were improvements over time. Specifically:

Only 14.9% of patients achieved sustained remission.
Point remission (remission at a single time point) was more common at 22.0%.
Sustained LDA was achieved by 26.3% of patients.
A significant proportion of patients achieving sustained LDA also experienced sustained remission.
The proportion of patients achieving sustained LDA without ever achieving remission decreased over time.
The overall proportion of patients achieving sustained LDA increased over time.

These findings suggest that while achieving sustained remission and LDA remains challenging, treatment strategies have improved over time. More patients are experiencing sustained LDA, indicating better disease control, even if they do not always achieve full remission. However, the relatively low overall rates of sustained remission and LDA highlight the need for continued research to optimize treatment approaches and identify factors associated with better outcomes.

The Future of RA Treatment: Personalized Approaches and Novel Therapies

The study underscores the importance of continued research to refine treatment strategies and identify factors that predict successful outcomes. Future research should focus on personalized medicine approaches, tailoring treatment to individual patient characteristics and disease profiles. Additionally, exploring novel therapeutic targets and treatment combinations may offer new avenues for achieving sustained remission and LDA in RA patients. Ultimately, the goal is to provide more effective and personalized care to improve the lives of individuals living with rheumatoid arthritis.

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This article is based on research published under:

DOI-LINK: 10.1093/rheumatology/key075.310, Alternate LINK

Title: 086 A Longitudinal Analysis Of Prevalence Of Sustained Remission And Low Disease Activity In Rheumatoid Arthritis Patients Treated With Anti-Tumour Necrosis Factor: An Analysis Of The British Society For Rheumatology Biologics Register For Rheumatoid Arthritis

Subject: Pharmacology (medical)

Journal: Rheumatology

Publisher: Oxford University Press (OUP)

Authors: Philip D H Hamann, Gavin Shaddick, Neil Mchugh, Kimme Hyrich, John D Pauling

Published: 2018-04-01

Everything You Need To Know

What is the primary goal of Rheumatoid Arthritis (RA) treatment?

The main objective in treating Rheumatoid Arthritis (RA) is to achieve either remission or low disease activity (LDA). This approach aims to improve the patient's quality of life by reducing pain and stiffness and preventing long-term joint damage. By controlling the inflammation, the progression of the disease can be slowed down, leading to better long-term outcomes for individuals affected by RA.

How have anti-TNF therapies impacted Rheumatoid Arthritis (RA) treatment?

Anti-tumor necrosis factor (anti-TNF) therapies have significantly changed the management of Rheumatoid Arthritis (RA). These treatments have provided substantial improvements in controlling the disease and slowing its progression. They have become a cornerstone in RA treatment, offering relief to many patients who previously had limited options. Their introduction has allowed for more effective management of the symptoms and the underlying disease process.

What does the BSRBR-RA registry tell us about sustained remission and LDA with anti-TNF therapies?

The British Society for Rheumatology Biologics Register for Rheumatoid Arthritis (BSRBR-RA) provides valuable data on the long-term effectiveness of anti-TNF therapies. Results from this registry, which tracked RA patients treated with biologics between 2001 and 2013, showed that while sustained remission was achieved by only 14.9% of patients, sustained LDA was achieved by 26.3%. The registry highlights that although sustained remission/LDA is challenging, improvements are being made over time, with more patients experiencing sustained LDA, indicating better disease control. The DAS28-ESR score of ≤2.6 for at least six months defines sustained remission, while sustained LDA is defined as a DAS28-ESR score of ≤3.2 for the same period.

What is the difference between sustained remission and sustained LDA in the context of RA treatment?

In the treatment of Rheumatoid Arthritis (RA), sustained remission and sustained low disease activity (LDA) are both indicators of successful treatment, but they represent different levels of disease control. Sustained remission, defined by a DAS28-ESR score of ≤2.6 for at least six months, signifies the absence of significant disease activity. Sustained LDA, indicated by a DAS28-ESR score of ≤3.2 for the same period, means that the disease activity is present but at a low level. While remission is the ultimate goal, achieving sustained LDA is also a positive outcome, reflecting improved disease management and better quality of life for the patient. The key difference lies in the degree of disease activity present.

What are the future directions for Rheumatoid Arthritis (RA) treatment, according to the research?

Future research in Rheumatoid Arthritis (RA) treatment should focus on personalized medicine approaches, tailoring treatments to individual patient characteristics and disease profiles. This involves identifying factors that predict successful outcomes to refine treatment strategies. Additionally, exploring novel therapeutic targets and treatment combinations may offer new avenues for achieving sustained remission and LDA in RA patients. The ultimate aim is to provide more effective, personalized care to improve the lives of individuals living with RA.