The effect of golimumab on haemoglobin levels in patients with rheumatoid arthritis, psoriatic arthritis or ankylosing spondylitis
Department of Medicine, Division of Rheumatology
Medical Subject Headings
Adult; Anemia; Antibodies, Monoclonal; Antirheumatic Agents; Arthritis; Arthritis, Psoriatic; Arthritis, Rheumatoid; C-Reactive Protein; Dose-Response Relationship, Drug; Double-Blind Method; Female; Hemoglobins; Humans; Inflammation Mediators; Male; Middle Aged; Randomized Controlled Trials as Topic; Spondylitis, Ankylosing; Tumor Necrosis Factor-alpha
Musculoskeletal Diseases | Rheumatology | Skin and Connective Tissue Diseases
OBJECTIVE: To evaluate the effect of golimumab on haemoglobin levels in patients with RA, PsA or AS.
METHODS: Secondary analysis was performed on integrated data from five randomized controlled studies: three RA, one PsA and one AS (2303 patients total). Golimumab 50 or 100 mg was injected s.c. every 4 weeks with or without MTX. Control groups received placebo injections plus MTX or background therapy. Patients with haemoglobin levels below the age- and sex-specific normal ranges were considered to have anaemia. Ferritin levels were used to distinguish anaemia of mixed aetiology ( > /= 15 and < 60 ng/ml) and anaemia of inflammation ( > /= 60 ng/ml). Changes from baseline to weeks 14 and 24 in haemoglobin level were compared between treatment groups using an analysis of variance on the van der Waerden normal scores.
RESULTS: At baseline, 21% of RA patients, 9% of PsA patients and 15% of AS patients had anaemia. Of these, 24%, 57% and 25%, respectively, had anaemia of inflammation. The median increase from baseline to week 14 in the haemoglobin level of anaemic patients was 0.3 g/dl in the control group and 0.9 g/dl in the golimumab group (P < 0.001). Haemoglobin levels improved within the subgroups of patients with anaemia of mixed aetiology (control, 0.4 g/dl vs golimumab, 0.7 g/dl) (P = 0.305) and with anaemia of inflammation (0.2 vs 1.4 g/dl, respectively) (P < 0.001).
CONCLUSION: Compared with the control group, patients receiving golimumab treatment had significantly improved haemoglobin levels, particularly among patients with anaemia of inflammation.
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Citation: Furst DE, Kay J, Wasko MC, Keystone E, Kavanaugh A, Deodhar A, Murphy FT, Magnus JH, Hsia EC, Hsu B, Xu S, Rahman MU, Doyle MK. The effect of golimumab on haemoglobin levels in patients with rheumatoid arthritis, psoriatic arthritis or ankylosing spondylitis. Rheumatology (Oxford). 2013 Oct;52(10):1845-55. doi: 10.1093/rheumatology/ket233. Epub 2013 Jul 9. PubMed PMID: 23838027; PubMed Central PMCID: PMC3775295. Link to article on publisher's site
Furst, Daniel E.; Kay, Jonathan; Wasko, Mary Chester; Keystone, Edward; Kavanaugh, Arthur; Deodhar, Atul; Murphy, Frederick T.; Magnus, Jeanette H.; Hsia, Elizabeth C.; Hsu, Benjamin; Xu, Stephen; Rahman, Mahboob U.; and Doyle, Mittie K., "The effect of golimumab on haemoglobin levels in patients with rheumatoid arthritis, psoriatic arthritis or ankylosing spondylitis" (2013). Rheumatology Publications and Presentations. 104.