Effect of r-hu-Erythropoietin on the Anaemia and disease activity in patients with Rheumatoid Arthritis and Chronic Disease.
Journal/Book: Z Rheumatol 1999; 58 Suppl. 1: I/13 (S 19). 1999;
Abstract: A. J. G. Swaak; Zuiderziekenhuis Rotterdam Anaemia of chronic disease (ACD) is the most important cause of anaemia in RA. It is characterized by low serum iron levels despite of normal or increased body iron stores. In a number of studies treatment with recombinant human erythropoietin (EPO) resulted in improvement of ACD in RA patients. To study whether r-hu-EPO could improve anaemia in patients with RA a 52 weeks placebo-controlled randomized double blind trial with r-hu-EPO was performed in 70 patients characterized by active RA and ACD. In this study the effect of r-hu-EPO on the disease activity was studied as well. Thirty-four patients were treated with initially three times 240 U/kg r-hu-EPO subcutaneously weekly whereas 36 patients received placebo. A significant increase of haemoglobulin from median 112 to 135 g/l occured in the EPO-group within 6 weeks and could sustain with reduced doses of median 240 U/kg once weekly. Sustained benefit compared to placebo was also apparent by 6 weeks for disease activity as indicated by the Paulus 20 % respons rate. In the EPO treated group 32 % of the patients showed Paulus 20 % response compared to 8 % of the placebo group (p = 0016). Significant differences in favor of the EPO-group were also observed in the secondary disease activity measures Ritchie-index number of swollen joints pain score ESR and patients global assessment of disease activity. It was concluded that treatment of ACD with r-hu-EPO is efficacious in restoring normal haemoglobulin levels and exerts beneficial effects on disease activity as well. le