In a nutshell
This paper evaluates the effect of tocilizumab (Actemra) compared with other biologic therapies in improving anemia in rheumatoid arthritis patients.
Some background
Anemia (low number of red blood cells and hemoglobin, the oxygen-carrying component of blood) is a complication in rheumatoid arthritis. Biologics (drugs that target particular components involved in the disease development) are used to treat rheumatoid arthritis, and have been found to increase hemoglobin levels. Tocilizumab is a type of biologic; it is an interleukin 6 (IL-6) receptor (protein involved in the immune system). Since IL-6 is involved in the development of anemia, it is thought that tocilizumab might improve anemia more effectively than other biologic therapies.
Methods & findings
Patients with rheumatoid arthritis taking biologic therapy for more than 12 weeks were studied. Biologics studied were: tocilizumab, infliximab (Remicabe), etanercept (Enbrel), adalimumab (Humira), golimumab (Simponi), and abatacept (Orencia). Hemoglobin levels were measured, with anemia defined as a hemoglobin level less than 12.0 in women and less than 13.0 in men. Iron levels, kidney function and disease activity (how active rheumatoid arthritis is) were also measured.
Of 147 patients studied, 19.0% were treated with tocilizumab, 15.6% were treated with etanercept, 18.4% were treated with infliximab, 6.1% were treated with adalimumab, 19.0% were treated with golimumab, and 21.8% were treated by abatacept. Patients were divided into a tocilizumab group and a non-tocilizumab group.
At the start of study, anemia was present in 53.6% of those receiving tocilizumab and 47.9% of those receiving other biologics. After more than 3 months, the increase of heoglobin levels was greater in patients receiving tocilizumab compared with those receiving other biologic therapies, with a 1.1 g/dl increase compared to 0.3 g/dl increase.
After consideration of other or confounding factors, tocilizumab was still found to be associated with an increase in hemoglobin levels compared to other biologics.
The bottom line
The authors concluded that hemoglobin level significantly increases after tocilizumab therapy compared with non-tocilizumab biologic therapies.
What’s next?
If suffering from rheumatoid arthritis-associated anemia, discuss with your doctor the possibility of using tocilizumab therapy.
Published By :
PLOS ONE
Date :
May 30, 2014
