How long do you recommend to give a treatment before changing if remission has not occurred?

Remission actually means "no signs of active inflammation", including the absence of joint pains, morning stiffness, limitations in range of motion, and fatigue. Often, people with RA do not attain this full definition but are much improved from their status prior to taking their medications. A more difficult definition is to have no joint problems off of all medications. This is even rarer. Rheumatologists will commonly add medications to the drug regimen in order to attain, as much as possible, a full remission. The use of anti-TNF medications such a etanercept, infliximab, adalimumab and the IL-1 blocker anakinra can add greatly to a regimen such as yours and can go a long way to helping your achieve the sought-after remission.