title: Effect of recombinant human erythropoietin and intravenous iron on anemia and disease activity in rheumatoid arthritis.
abstract: OBJECTIVE
  To investigate whether treatment of anemia of chronic disease (ACD) in patients with rheumatoid arthritis (RA) with recombinant human erythropoietin (rHu-Epo) in combination with intravenous (i.v.) iron influences health related quality of life (HRQoL) and clinical outcome including disease activity.
  
  
  METHODS
  Thirty patients with ACD and RA were treated with 150 IU/kg rHu-Epo twice weekly for 12 weeks. As well, in case of functional iron deficiency 200 mg of iron-sucrose per week was given intravenously. Vitality and fatigue as dimensions of HRQoL were evaluated by the vitality subscale of the Short Form-36 (SF-36-VT) and the Multidimensional Assessment of Fatigue (MAF). Muscle strength was measured by the Muscle Strength Index.
  
  
  RESULTS
  All 28 patients completing the study responded to treatment; 23/28 patients developed functional iron deficiency and received i.v. iron (mean absolute dose 710 +/- 560 mg). Average hemoglobin concentration increased from 10.7 +/- 1.1 to 13.2 +/- 1.0 g/dl after a mean treatment period of 8.7 +/- 2.3 weeks. Muscle strength increased from 43.5 +/- 11.2 to 49.1 +/- 12.9 and SF-36-VT from 28.2% +/- 14.3% to 47.1% +/- 20.8%. while fatigue decreased (MAF from 34.7 +/- 9.3 to 25.0 +/- 11.3). Among the disease activity variables the number of swollen/tender joints, erythrocyte sedimentation rate, Disease Activity Score, and RA Disease Activity Index improved significantly during treatment.
  
  
  CONCLUSIONS
  Treatment of ACD in RA patients with rHu-Epo and i.v. iron is safe and effective in correction of anemia, increases muscle strength. improves vitality, and lowers fatigue. In addition we observed a reduction of disease activity.
authors.affiliation: Medizinische Klinik III, Bereich Rheumatologie, J.W. Goethe-Universität, Frankfurt/Main, Germany. Kaltwasser@em.Uni-frankfurt.de
authors.forename: J P
authors.initials: JP
authors.lastname: Kaltwasser
authors.forename: U
authors.initials: U
authors.lastname: Kessler
authors.forename: R
authors.initials: R
authors.lastname: Gottschalk
authors.forename: G
authors.initials: G
authors.lastname: Stucki
authors.forename: B
authors.initials: B
authors.lastname: Möller
mesh_terms: D000328:Adult; D000368:Aged; D000740:Anemia / Q000188:drug therapy* / Q000209:etiology; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D004185:Disability Evaluation; D004921:Erythropoietin / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005290:Ferric Compounds / Q000008:administration & dosage / Q000627:therapeutic use*; D000077605:Ferric Oxide, Saccharated; D005937:Glucaric Acid; D006304:Health Status; D006801:Humans; D007275:Injections, Intravenous; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D011994:Recombinant Proteins; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D005290:Ferric Compounds; D011994:Recombinant Proteins; D004921:Erythropoietin; D000077605:Ferric Oxide, Saccharated; D005937:Glucaric Acid