Dr. Braun has received honoraria for talks, advisory boards, and grants (less than $10,000 each) from Centocor, Schering-Plough, Wyeth, Amgen, Abbott, Roche, Bristol-Myers Squibb, Novartis, Pfizer, and Merck Sharp & Dohme.
Improvement in hemoglobin levels in patients with ankylosing spondylitis treated with infliximab
Article first published online: 30 JUL 2009
Copyright © 2009 by the American College of Rheumatology
Arthritis Care & Research
Volume 61, Issue 8, pages 1032–1036, 15 August 2009
How to Cite
Braun, J., van der Heijde, D., Doyle, M. K., Han, C., Deodhar, A., Inman, R., Vlam, K. d., Burmester, G. R., Van den Bosch, F., Xu, S., Visvanathan, S. and Rahman, M. U. (2009), Improvement in hemoglobin levels in patients with ankylosing spondylitis treated with infliximab. Arthritis & Rheumatism, 61: 1032–1036. doi: 10.1002/art.24865
- Issue published online: 30 JUL 2009
- Article first published online: 30 JUL 2009
- Manuscript Accepted: 13 APR 2009
- Manuscript Received: 8 DEC 2008
Anemia is a common complication in patients with inflammatory diseases such as ankylosing spondylitis (AS). This post hoc analysis of a large, randomized, placebo-controlled trial examined the effect of infliximab on hemoglobin levels, physical function, and fatigue in patients with AS.
Patients received infliximab 5 mg/kg (n = 188) or placebo (n = 68) at weeks 0, 2, 6, 12, and 18. Hemoglobin, interleukin-6 (IL-6), and C-reactive protein (CRP) levels, fatigue (visual analog scale [VAS]), physical function (Bath Ankylosing Spondylitis Functional Index [BASFI]), and disease activity were evaluated at baseline and week 24. Anemia was defined as a hemoglobin level <12 gm/dl for women and <13 gm/dl for men.
At baseline, 11 placebo group patients (16.2%) and 37 infliximab group patients (19.7%) had anemia. Of these, more infliximab-treated patients achieved normal hemoglobin levels at week 24 compared with patients receiving placebo (70.3% versus 27.3%; P = 0.0155). Infliximab-treated patients had significant improvements in mean hemoglobin concentration (0.7 gm/dl versus −0.3 gm/dl), BASFI score (−2.1 versus −0.2), and fatigue VAS score (−2.4 versus −0.4) compared with placebo patients (P < 0.001). Multiple regression analyses showed that improvements in hemoglobin level were significantly and independently associated with improvements in physical function and fatigue. Infliximab-treated patients with elevated CRP or IL-6 levels at baseline were more likely than those with low levels to have improvement in hemoglobin levels.
Infliximab treatment significantly decreased the proportion of AS patients with anemia and improved hemoglobin levels compared with placebo. Improvement in hemoglobin level was independently associated with improvements in physical function and fatigue.