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EULAR: IL-1 Receptor Antagonist Treatment Associated With Improvement Of Anemia In Rheumatoid Arthritis By Thomas Buckingham PRAGUE, CZECH REPUBLIC -- June 15, 2001 -- Treatment with the IL-1 receptor antagonist, anakinra, may improve anemia in patients with rheumatoid arthritis (RA), independent of its effects on articular disease activity, stated according to a study presented today by Dr. J. Kay at the European League Against Rheumatism (EULAR) Congress, Prague, Czech Republic. Anemia is present in up to 70 percent of patients with RA and usually correlates with disease activity. Interleukin (IL)-1 levels are elevated in serum and synovial tissue in RA inhibits erythropoiesis. Serum IL-1 levels are higher in anemic patients with RA than in those without anemia. The goal of this study was to determine if IL-1 receptor antagonist (IL-1ra) is associated with improvement of anemia in patients with rheumatoid arthritis. In a 24-week, double-blind, randomized, placebo-controlled multicenter study of IL-1ra therapy, they observed the effect of daily IL-1ra treatment in anemic patients with active, severe RA. Subjects (n = 472) received daily SC injections of placebo, 30, 75, or 150 mg anakinra for six months. Fifty (14.2 percent) of the IL-1ra-treated patients and 13 (10.7 percent) of the placebo-treated patients were anemic, defined as HCT </= 34 percent upon initiation of therapy. The mean hematocrit (hct) in patients treated with anakinra increased by 0.28 vol- percent over six months but decreased by 0.867 vol- percent in those on placebo (p < 0.001). Although the number of anemic patients enrolled in this trial was small, more patients treated with IL-1ra exhibited improvement in HCT after 24 weeks of drug than did patients receiving placebo. Remarkably, three of the seven IL-1ra-treated patients with >/= 6 vol- percent improvement in their HCT did not meet ACR20 response criteria. This suggests the possibility that IL-1ra therapy may improve anemia in RA patients independently of its effects on arthritis. Further studies of this agent are clearly needed to clarify its effects on erythropoiesis and the impact of these changes in HCT on overall clinical status and articular disease activity. SOURCE: PeerView Press E-mail this page to a friend or colleague! To print, use this version