Prevalence of Anemia in Patients With Rheumatoid Arthritis Presenting at Multi-organization Tertiary Care Hospitals.

Background: Rheumatoid arthritis (RA) patients often have anemia, which is frequently made worse by the severity of the illness and ongoing inflammation.

Objective: The objective of this study is to determine the prevalence of anemia among patients with RA presenting at a tertiary care hospital and to explore the relationship between anemia and various clinical parameters of RA.

Methodology: This cross-sectional research evaluated anemia in 330 RA patients in three different hospitals in Pakistan between January and December of 2023. Ages 18 and above, RA diagnosis as defined by the American College of Rheumatology, and permission were the inclusion criteria. Incomplete data or secondary anemic causes were the exclusion criteria. Medical records and interviews were used to gather information on demographics, hemoglobin levels, inflammatory markers, and the severity of RA. SPSS was utilized for the statistical analysis, with significance set at p < 0.05 and Chi-square testing employed to look for relationships between anemia.

Results: In this study of 330 RA patients, anemia was present in 180 patients (54.55%). The mean hemoglobin level among these patients was 11.41 ± 1.87 g/dL, and the red blood cell count averaged 4.26 ± 0.69 million/µL. Anemic patients had a higher Disease Activity Score (DAS28) with a mean of 5.23 ± 1.42, compared to 4.98 ± 1.35 in the 150 non-anemic patients (45.45%). Elevated C-reactive protein (CRP) levels were observed in 150 (83.33%) of the anemic patients, with a mean CRP of 28.79 ± 12.56 mg/L, while 160 (88.89%) of the anemic patients had an elevated erythrocyte sedimentation rate (ESR), with a mean ESR of 45.17 ± 16.29 mm/hr. Significant associations were found between anemia and longer disease duration (p = 0.042), higher RA severity (p = 0.002), and increased inflammatory markers (p < 0.001).

Conclusion: Anemia is prevalent among RA patients and is significantly associated with higher disease severity, longer disease duration, and elevated inflammatory markers.