Rheumatoid arthritis and anemia: the impact of different anti-inflammatory therapies on hemoglobin levels. An observational study.

Unlabelled: Rheumatoid Arthritis (RA) has been associated with anemia. The treatment of anemia in RA includes blood transfusions, erythropoietic agents and iron supplements. Our observations suggest that the treatment of the inflammatory disease is associated with an improvement of hemoglobin (Hgb) levels in RA patients.

Methods: Record review, analyzing anemic RA patients and hemoglobin level changes after intensification of RA therapy. Three initial regimes were identified: corticosteroid (Prednisone), Disease Modifying Anti-rheumatic Drugs (DMARD's) plus Prednisone and for patients with no initial treatment with the initiation of Prednisone and or TNF a inhibitors (Etanercept).

Results: 8 female and 2 male patients with average age 59.7 + 14 years were selected. The results for the group treated with Prednisone initially N=4; showed a 0.9 g/dL increase in Hgb and Hct increase of 3% after addition of Etanercept. Those with DMARDs and corticosteroid regime had an Hgb and Hct increase of 1.2 g/dL and 3.5% after addition of Etanercept. The group with no initial treatment was further divided in two groups. The first was treated with Etanercept and the second was treated with Prednisone, resulting in average Hgb increases of 1.9 g/dl Hgb and 1.8 g/dL, and HCT increase 4% and 3.9% respectively. The global average change in Hgb was 1.3g/dL and HCT increase 3.2%.

Conclusion: The intensity of treatment of RA including Etanercept and Prednisone improved cases of mild anemia in rheumatoid arthritis.