Patients with psoriatic arthritis (PsA) frequently ask whether their disease can be “cured” or if treatment can eventually be stopped. This study aimed to evaluate how often drug‑free remission (DFR) occurs and which patients are most likely to achieve it.

We analyzed data from approximately 1,500 patients followed longitudinally. DFR was achievable but uncommon. About 13% of patients achieved DFR using a definition focused on objective inflammation, while only 6% achieved DFR when using a broader definition that included patient‑reported outcomes such as pain and fatigue.

Patients who achieved DFR had lower disease activity at baseline, including fewer swollen and tender joints, less skin involvement, less structural damage, and better functional status. Key predictors included lower BMI, older age, less structural damage, and HLA-B27 negativity.

Importantly, remission rates vary depending on the definition used. Many patients who met inflammation-based remission did not meet broader criteria due to persistent symptoms. These symptoms may be influenced by non‑inflammatory factors, such as fibromyalgia, which is common in PsA and can elevate pain and global scores despite well‑controlled inflammation.

Overall, these findings suggest that DFR is achievable in a selected subgroup of patients, particularly those with milder disease early in the course, supporting a personalised approach to treatment tapering and withdrawal in clinical practice.