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Rheumatology International

, Volume 18, Issue 5–6, pp 201–206 | Cite as

Recombinant human erythropoietin improves health-related quality of life in patients with rheumatoid arthritis and anaemia of chronic disease; utility measures correlate strongly with disease activity measures

  • H. R. M. Peeters
  • M. Jongen-Lavrencic
  • C. H. Bakker
  • G. Vreugdenhil
  • F. C. Breedveld
  • A. J. G. Swaak
ORIGINAL ARTICLE

Abstract

Treatment with recombinant human erythropoietin (r-hu-Epo) in patients with rheumatoid arthritis (RA) and anaemia of chronic disease (ACD) resulted in improvement of both anaemia and disease activity. Utilities represent a generic and comprehensive quality of life measure, capable of integrating domain-specific information into one overall value which a patient assigns to his state of health. Therefore, the effect of r-hu-Epo on quality of life was studied by measuring utilities, derived from the rating scale and standard gamble, in a 52-week placebo-controlled randomised double-blind study with r-hu-Epo in 70 patients with active RA and ACD. Furthermore, the relation between anaemia as assessed by haemoglobin levels (Hb), disease activity as assessed with the Disease Activity Score (DAS), and utilities was investigated. Compared to the placebo group, significant improvement of Hb (P<0.001), DAS (P = 0.01) and rating scale utilities (P = 0.002), but not of standard gamble utilities, was observed in the Epo group. Rating scale utilities correlated strongly with DAS (r = –0.47, P<0.01), Hb (r = 0.37, P<0.01) and changes in both DAS (r = –0.74, P<0.01) and Hb (r = 0.44, P<0.01). Both DAS and Hb contributed significantly to the variance in rating scale utilities (21% and 3% respectively) and to changes in rating scale utilities (43% and 3% respectively). Standard gamble utilities correlated less well with clinical disease variables than rating scale utilities did. These results indicate, that r-hu-Epo improves utility-derived health-related quality of life, most probably by improving both disease activity and anaemia. Utilities, particularly rating scale utilities, correlated well with conventional disease activity variables and proved sensitive to change. Utilities may be a useful tool for investigating quality of life in RA-patients.

Key words Rheumatoid arthritis Anaemia Erythropoietin Quality of life Utility 

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Copyright information

© Springer-Verlag Berlin Heidelberg 1999

Authors and Affiliations

  • H. R. M. Peeters
    • 1
  • M. Jongen-Lavrencic
    • 2
  • C. H. Bakker
    • 3
  • G. Vreugdenhil
    • 4
  • F. C. Breedveld
    • 5
  • A. J. G. Swaak
    • 6
  1. 1.Department of Rheumatology, Atrium Medical Center Heerlen, P.O. Box 4446, 6401 CX Heerlen, The Netherlands Fax: +31-45-5767246NL
  2. 2.Department of Internal Medicine, University Hospital Nijmegen, The NetherlandsNL
  3. 3.Health Research Council of The Netherlands, Rijswijk, The NetherlandsNL
  4. 4.Department of Internal Medicine, St. Joseph Hospital, Veldhoven, The NetherlandsNL
  5. 5.Department of Rheumatology, University Hospital Leiden, The NetherlandsNL
  6. 6.Department of Rheumatology, Zuiderziekenhuis, Rotterdam, The NetherlandsNL

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