title: Iron stores and serum transferrin receptor levels during recombinant human erythropoietin treatment of anemia in rheumatoid arthritis.
abstract: Ten rheumatoid arthritis (RA) patients with anemia of chronic disorders (ACD) were treated with recombinant human erythropoietin (r-Hu-Epo) using a dose of 250 U/kg s.c. 3 times a week for 6 weeks, in order to evaluate its effects on the anemia, iron stores, and serum-soluble transferrin receptor (sTfR) levels. All patients showed a rise in hemoglobin (Hb). Median Hb increased from 5.9 (5.5-7.0) at baseline to 6.7 (5.8-7.8) at 3 weeks and to 7.2 (5.9-8.5) mmol/l at 6 weeks during treatment. Ferritin levels decreased significantly during the 6 weeks, and five patients were iron deficient after 6 weeks of treatment. TfR levels increased significantly at 3 and 6 weeks during treatment. These preliminary findings may indicate that r-Hu-Epo is effective in improving ACD in RA. The sTfR rise may be explained by an increase in erythroid precursor cell mass or increased TfR expression and a decrease in tissue iron stores, although direct effects of Epo on TfR regulation cannot be excluded. Large double-blind studies with r-Hu-Epo in patients with RA and ACD are warranted.
authors.affiliation: Department of Internal Medicine, University Hospital, Nijmegen, The Netherlands.
authors.forename: G
authors.initials: G
authors.lastname: Vreugdenhil
authors.forename: B
authors.initials: B
authors.lastname: Manger
authors.forename: C
authors.initials: C
authors.lastname: Nieuwenhuizen
authors.forename: R A
authors.initials: RA
authors.lastname: Feelders
authors.forename: H G
authors.initials: HG
authors.lastname: van Eijk
authors.forename: A J
authors.initials: AJ
authors.lastname: Swaak
mesh_terms: D000368:Aged; D000740:Anemia / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D001172:Arthritis, Rheumatoid / Q000150:complications*; D004921:Erythropoietin / Q000627:therapeutic use*; D005260:Female; D005293:Ferritins / Q000378:metabolism; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007501:Iron / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011990:Receptors, Transferrin / Q000378:metabolism*; D011994:Recombinant Proteins / Q000627:therapeutic use
chemical_list: D006454:Hemoglobins; D011990:Receptors, Transferrin; D011994:Recombinant Proteins; D004921:Erythropoietin; D005293:Ferritins; D007501:Iron