Objective. To identify serum ion patterns that distinguish remission from active disease in patients with Wegener's granulomatosis (WG).Methods. Using sera collected in the WG Etanercept Trial, we selected samples from patients who either were undergoing a period of extended disease remission or had recent flares of active WG. Unfractionated samples were randomized into sets for training and testing, such that remission sera and active disease sera could be analyzed without batch bias. Molecular species within the sera were ionized by high-resolution, matrixassisted laser desorption ionization time-of-flight mass spectrometry. We then used a bioinformatics patternrecognition tool to identify optimal combinations of ions. During the training stage, the clinical data (remission versus active disease) were provided in association with the spectral data from each sample. In the testing stage, we performed blinded testing on a previously unexamined set of samples.Results Conclusion. This serum proteomic profiling approach appears to be useful in distinguishing between states of stable clinical remission and active disease.