Abstract
Rheumatoid arthritis is a chronic disease of the joints, which causes joint pain and disability. Anaemia is a frequent extra-articular manifestation in rheumatoid arthritis, affecting 30-70% of the patients; presenting a negative impact on patient´s quality of life. Some of the drugs used in rheumatoid arthritis treatment improve anaemia; but little is known on the beneficial effects of the anti-rheumatic leflunomide or the anti-TNFα adalimumab, in this parameter. We investigated the incidence of anaemia in rheumatoid arthritis patients treated or not with leflunomide or adalimumab. We also assessed whether anaemia correlates with disease activity. Anaemia was present in patients who had just been diagnosed with rheumatoid arthritis and had never taken disease modifying agents or biologicals (non-specific therapy group), but not in those taking either leflunomide or adalimumab. The erythrocyte sedimentation rate was increased in patients with non-specific therapy in comparison with those taking either leflunomide or adalimumab. Anaemia correlated with increased erythrocyte sedimentation rate. We suggest that leflunomide and adalimumab may be useful in treating anaemia in patients with rheumatoid arthritis.
Highlights
Rheumatoid arthritis (RA) is a chronic disease of the joints, which causes joint pain and disability
Lowering of haemoglobin levels was found not be associated with chronic fatigue in RA patients, this response has been highly associated with disease activity (Singh et al 2014)
Five millilitres of peripheral blood were collected from each patient, in tubes containing ethylenediamine tetraacetic acid (EDTA) and used for automated analysis of red blood cell numbers, haemoglobin, haematocrit and erythrocyte sedimentation rate (ESR)
Summary
Rheumatoid arthritis (RA) is a chronic disease of the joints, which causes joint pain and disability. Articular (pain and loss of joint function) and extra-articular manifestations of the disease. Anaemia is one of the most common extra-articular manifestations of RA, affecting 30-70% of the patients, and it has been linked to reduced quality of life (Song et al 2013, Ganna 2014). Known as anaemia of inflammation, it can be triggered by increased release of cytokines, An Acad Bras Cienc (2018) 90 Cytokine generation in RA has been associated with decreased iron availability, and increased absorption and retention within reticulo-endothelial cells; in addition to reduced numbers of red blood cells (for review see: Moreland and Curtis 2009, Masson 2011). Lowering of haemoglobin levels was found not be associated with chronic fatigue in RA patients, this response has been highly associated with disease activity (Singh et al 2014)
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