Despite the advance in the treatment of rheumatoid arthritis (RA), a proportion of patients suffer from residual symptoms such as pain and functional disability, even after they achieve inflammatory remission or low disease activity (LDA), which is defined as criteria of difficult-to-RA. This review summarizes current knowledge on frequency, possible pathogenesis, risk factors, and treatment options of remaining pain/functional disability among patients in inflammatory remission or LDA to highlight the complexity and difficulty in managing this condition. As an increased number of patients are achieving clinical remission, the residual symptoms will become one of the most significant unmet needs in the treatment of RA.

Rheumatoid arthritis, Low disease activity, Inflammatory remission, Pain