Disease Activity in Rheumatoid Arthritis Patients Stratified by Hemoglobin Levels: A Multi-center Study.

Q2 Medicine

Oman Medical Journal Pub Date : 2024-09-30 eCollection Date: 2024-09-01 DOI:10.5001/omj.2024.101

Maryam Salah Al-Mazedi, Rajesh Rajan, Adeeba Al-Herz, Ahmad Alsaber, Mohammed Al-Jarallah, Raja Dashti, Parul Setiya, Khulood Saleh, Adel Al-Awadhi, Waleed Al-Kandari, Eman Hasan, Khaled Mokaddem, Aqeel Ghanem, Ahmad Alenizi, Kobalava D Zhanna, Laura Al Obaid

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Abstract

Objectives: Hemoglobin (Hb) level and its relation to rheumatoid arthritis (RA) is multifactorial. The primary aim of this study was to examine the association between Hb levels and disease activity in patients with RA.

Methods: This retrospective study obtained data from adult RA patients with Hb reports from the Kuwait Registry for Rheumatic Diseases. Patients were recruited from four public hospitals in Kuwait between February 2013 and February 2022. The cohort was stratified into two groups: Hb ≤ 110 g/L and Hb > 110 g/L. Demographic, treatment, clinical, and laboratory characteristics were used to compare the two Hb groups. Multivariate and univariate statistical analyses were used to analyze the data.

Results: The total number of patients visited (N_v) was 11 393 and consecutive patients with RA diagnoses and Hb data (N_p) were 1584. Both N_v and N_p were included in the study. Of these, 72.5% (n = 8260) had high Hb levels and 27.5% (n = 3133) had low Hb levels. The average age of the cohort was 55.9 ± 12.5 years. Logistic regression analysis revealed that a greater number of non-Kuwaiti patients had anemia than Kuwaiti patients [adjusted odds ratio (aOR) = 1.34, 95% CI: 1.16-1.56; p < 0.001). Patients who received biologic treatment were more likely to be non-anemic [aOR = 1.33, 95% CI: 1.23-1.45; p < 0.001). Additionally, the study demonstrated that patients with anemia had greater odds of acquiring Disease Activity Score -28 joint count (DAS-28) ≥ 3.2 versus DAS-28 < 3.2 [aOR = 0.74, 95% CI: 0.61-0.90; p = 0.002].

Conclusions: Lower Hb levels in RA are an independent predictor of disease activity.

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由血红蛋白水平分层的类风湿性关节炎患者疾病活动性：一项多中心研究

目的：血红蛋白（Hb）水平及其与类风湿关节炎（RA）的关系是多因素的。本研究的主要目的是研究类风湿关节炎患者Hb水平与疾病活动性之间的关系。方法：这项回顾性研究获得了科威特风湿病登记处报告的成年类风湿性关节炎Hb患者的数据。患者于2013年2月至2022年2月期间从科威特的四家公立医院招募。该队列分为两组：Hb≤110 g/L和Hb > 110 g/L。人口统计学、治疗、临床和实验室特征用于比较两组Hb。采用多变量和单变量统计分析对数据进行分析。结果：总访诊人数（Nv）为11 393人，连续诊断为RA的患者和Hb数据（Np）为1584人。Nv和Np都包括在研究中。其中，72.5% (n = 8260) Hb水平高，27.5% (n = 3133) Hb水平低。患者平均年龄55.9±12.5岁。Logistic回归分析显示，非科威特患者比科威特患者有更多的贫血[校正优势比(aOR) = 1.34, 95% CI: 1.16-1.56；P < 0.001)。接受生物治疗的患者非贫血的可能性更大[aOR = 1.33, 95% CI: 1.23-1.45；P < 0.001)。此外，研究表明，贫血患者获得疾病活动评分-28关节计数(DAS-28)≥3.2的几率大于DAS-28 < 3.2的几率[aOR = 0.74, 95% CI: 0.61-0.90；P = 0.002]。结论：RA中较低的Hb水平是疾病活动性的独立预测因子。

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