Clinical disease activity assessments in rheumatoid arthritis

Over the years, the growing need to standardize methodologies in rheumatoid arthritis, to improve the clinical management and evaluation of the effectiveness of treatments, has led to the development of different assessment tools. Since there is no gold standard for measuring disease activity in rheumatoid arthritis, a variety of instruments, which include continuous measures of disease activity and patient-reported outcomes questionnaires, have been described and used for this purpose. Although they were originally developed to be used in clinical trials, some of these tools have been adopted in daily practice. Clear evidence from several studies has shown that treatment decisions driven by quantitative monitoring of the disease significantly improve patient outcomes. This review provides a comprehensive overview of assessment tools currently available in rheumatoid arthritis that are used in clinical trials and daily practice, highlighting their main features and limitations.