The past two decades have witnessed a revolution in rheumatoid arthritis (RA) outcomes, with remission now a realistic and achievable target for many patients. However, this heralds a new dilemma increasingly encountered in routine clinical practice: how best to manage expensive and potentially toxic immunosuppressive therapy in such individuals?

I will present our clinical trial data to support a composite biomarker capable of predicting drug-free remission in established RA. The concept of drug-free remission will also be explored from a patient perspective, together with ongoing and future avenues of research to better understand the pathoimmunological processes underpinning RA flare.