Successful Treatment of the Anemia of Rheumatoid Arthritis with Subcutaneously Administered Recombinant Human Erythropoietin: Slower response in patients with more severe inflammation

Abstract

We performed a 24-week open clinical study in which 12 patients with rheumatoid arthritis (RA) and anemia (mean hemoglobín (Hb) value 102 g/l, range 90–109 g/l) were treated with recombinant human erythropoietin (rHuEPO). rHuEPO was given as a subcutaneous injection twice weekly with an initial dose of 300 U/kg/week. Nine of the II patients who completed the study responded with an increase in Hb value of 15 g/l or more within 3 to 17 weeks. Three months after treatment the Hb levels were significantly lower than the highest Hb levels (p < 0.0001). There was an inverse correlation between the response rate md the mean scrum concentrations of C-reactive protein and serum amyloid A protein (p <0.001 and p <0.003. respectively). We conclude that rHuEPO can correct anemia in patients with RA. but the response seems to be adversely influenced by the inflammatory activity of the disease.

Key Words:

• rheumatoid arthritis
• anemia of chronic disease
• anemia of inflammation
• recombinant human erythropoietin