Anemia in Malaysian women with rheumatoid arthritis

• Main Authors: Hussein, Heselyn, Othman, AZ, Shahar, Mohammad Arif
• Format: Article
• Language: English; English
• Published: Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd 2014
• Subjects: R Medicine (General); RC Internal medicine
• Online Access: http://irep.iium.edu.my/36731/1/Anemia_in_Malaysian_Women_with_Rheumatoid_Arthritis.pdf; http://irep.iium.edu.my/36731/6/aplar0298.pdf; http://irep.iium.edu.my/36731/

Aim: To determine the prevalence of anaemia among women with rheumatoid arthritis (RA) and determine its association between disease activity and disease modifying anti-rheumatic drugs (DMARDs)in a two-centre study between National University Malaysia Medical Centre and Putrajaya Hospital. Methods: This was a cross-sectional study involving female patients with established RA. Those with and without anaemia were compared in terms of RA disease activity and DMARDs received. Results: Sixty-two women with established RA were analysed. The prevalence of anaemia in our centres was 25.8%. Majority of patients have mild anaemia and none had severe anaemia. Patients with moderate and severe disease activity have a significantly higher prevalence of anaemia compared to those in remission and low disease activity (p = 0.026). Pre-menopausal women comprise two-thirds of the study population (67.7%) and 32.3% were postmenopausal women. The Hb levels between these two groups were statistically non-significant (Hb 12.37 +/- 1.05 versus 12.50 +/- 0.91 g/dL respectively with a P-value of 0.640). Majority of DMARDs do not have any association with anemia except for those on anti-TNF who had a higher prevalence of anemia (P-value of 0.039). Conclusion: There was a significant association between anaemia and disease activity with more significant anaemia in active disease compared to those in remission. Menstrual history did not have any association with anaemia. There was no association of DMARDs with anaemia except for anti-TNF. Although anti-TNF has been shown to significantly improve Hb levels in RA patients, in our study those on anti-TNF were more likely to have anaemia. This was because they had more active disease and more severe anaemia due to the disease, rather than anti-TNF alpha causing anaemia. Patients with anaemia have more active diseaes and anaemia will likely respond if the disease is controlled.