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Drug-free remission in rheumatoid arthritis: wishful thinking or achievable goal?

Published on January 28, 2026   23 min

Other Talks in the Series: The Immune System - Key Concepts and Questions

Other Talks in the Series: Periodic Reports: Advances in Clinical Interventions and Research Platforms

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0:00
Hello. My name is Ken Baker. I'm an NIHR advanced fellow and honorary consultant rheumatologist here in Newcastle upon Tyne in the United Kingdom, and I'm delighted to talk to you today about Drug-Free Remission in Rheumatoid Arthritis: Wishful Thinking or Achievable Goal? This here is photographic evidence that although I'm a clinically trained doctor, I do have a PhD, and they occasionally let me go into the lab to do some sciencey stuff.
0:27
Rheumatoid arthritis has undergone a treatment revolution over the past two decades. We've gone from a situation where joint damage and disability were commonplace and almost unavoidable for patients with rheumatoid arthritis, to one in the modern era, where we can now effectively switch off joint inflammation for the majority of patients to achieve remission with no joint damage. How have we achieved this? Well, this has been through the effective use of modern disease-modifying anti-rheumatic drugs, or DMARDs for short.
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Historically, rheumatoid arthritis used to be treated like this. Painkillers were started as a first-line treatment, and when joint damage happened, a DMARD was added in, and when further joint damage happened, the dose of the DMARD was slowly increased, and maybe that was switched to a second DMARD. Unfortunately, this start low and go slow approach resulted in prolonged joint inflammation and joint damage in the majority of patients.
1:28
If we contrast that with modern rheumatoid arthritis treatment, we now start DMARDs' first presentation, and if there's an ongoing active disease, second DMARDs are added in in combination therapy, and we now have an upper tier of biologic treatments now available for use. This is very much maximising the early window opportunity and also using combination DMARD therapies as well. The result for most patients, then, is maintenance of remission and prevention of joint damage, with remission now being achievable in at least 60% of patients in our clinic.

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Drug-free remission in rheumatoid arthritis: wishful thinking or achievable goal?

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