Læknablaðið - 15.10.1992, Blaðsíða 16

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LÆKNABLAÐIÐ
Table I. Clinical features of ten patients with rheumatoid arthritis and one patient with ankylosing spondylitis
undergoing six weeks treatment with recombinant human erythropoietin.
Case no Disease Sex/Age duration (years) (years) Serology X-ray Extra articular symptoms Function class Ritchie index Antirheumatic medications
1 F/69 31 RF+ Y None i 12 Sulphasalazine, f, §
2 F/35 10 RF+ Y None n 16 Auranofin (Ridaura®)
3 F/76 29 RF+, ANA+ Y Amyloidosis. Renal insuff. iii 11 t, §
4 F/70 17 RF+, ANA+ Y Sec Sjögren’s syndrome n 20 Azathioprine, f, §
5 F/56 22 RF+, ANA+ Y Rh. nodules. Cut. vasculitis n 11 Natr. aurothiomalat, f, §
6 M/42 10 Neg Y None in 14 Natr. aurothiomalat, f, §
7 F/21 15 Neg Y None n 19
8 M/79 3 RF+ Y None n 3 t, §
9 F/77 28 RF+ Y Sec Sjögren's syndrome ii 13 Azathioprine, f, §
10 F/56 11 RF+ Y Rh. nodules n 14 Sulphasalazin, §
11 M/47* 18 Neg AS Amyloidosis. Renal Insuff. in -
* = Patient with ankylosing spondylitis.
RF+ = Positive rheumatoid factor; ANA+ = Positive antinuclear antibody (titer>1/25).
X-ray: Roentgenological erosions yes (Y) or no (N); ankylosing spondylitis (AS).
f Patients taking corticosteroids.
§ Patients receiving nonsteroidal anti-inflammatory drugs.
Table II. Laboratory features of ten patients with rheumatoid arthritis and of one patient with ankylosing spondylitis
before undergoing a six week treatment period with recombinant human erythropoietin.
Patients (n=11) Reference
mean SD (range) values
Hemoglobin (g/l) Female (n=8) 95 ±6.8 (81-103) 113-134
Male (n=3) 88 ±11 (75- 97) 134-166
Hematocrit (%) Female (n=8) 30 ±3.0 (24- 34) 35- 44
Male (n=3) 28 ±0.4 (27- 28) 40- 49
MCV (Mm3) 89 ±11 (72-109) 70- 98
MCH (pg) 29 ±5 (20- 37) 28- 35
MCHC (g/l) 315 ±19 (281-339) 320-360
Reticulocytes (%) 1.9 ±0.8 (0.2-3.4) 0.2- 2.0
White-blood cells (109/1) 7.7 ±2.7 (4.3-13.1) 4- 9
Platelets (109/1) 394 ±181 (227-841) 150-400
ESR (mm/h) 76 ±42 (23-145) 2- 15
Haptoglobin (g/l) 3.8 ±2.3 (1.9-10.0) 0.2- 1.4
Serum iron (yxmol/l) 6.3 ±3.8 (2.0-12.8) 11- 35
Serum transferrin (y+mol/l) 44.1 ±18 (29- 85) 45- 72
Serum ferritin (/zg/l) 334 ±445 (10-1353) 10-240
Serum erythropoietin 19.5 ±12 (6.1-43.0) 3.3- 13.5
MCV = mean corpuscular volume
MCH = mean corpuscular hemoglobin
MCHC= mean corpuscular hemoglobin concentration.
modifying antirheumatic drugs=DMARD), sjö
sjúklingar með lágskammta barksterum og níu
sjúklingar tóku reglubundið bólgueyðandi lyf
önnur en barkstera (NSAID) (tafla I). Tveir
sjúklingar höfðu bólgumýlildi (secundary
amyloidosis) með skertri nýmastarfsemi
(s-kreatínin 350 /xmol/1 og 280 /rmol/1
(normalgildi: 64-106 /imol/1)). Aðrar klínískar
upplýsingar em sýndar í töflu I.
Allir sjúklingamir höfðu virkan sjúkdónt með
hækkað sökk, C-reaktíft prótín (CRP) og þeir
voru einnig háir á Ritchie kvarða (tafla II).
Meðferðaráœtlun: Sjúklingamir
voru rannsakaðir við göngudeild
gigtlækningadeildar Akademíska sjúkrahússins
í Uppsölum, Svíþjóð. Einungis voru teknir til
rannsóknar sjúklingar með stöðuga virkni í
gigtarsjúkdómnum. Engin breyting var gerð á
gigtarlyfjameðferð meðan á rannsókn stóð.
Allir sjúklingar fengu 50 alþjóðlegar
einingar/kg undir húð fimm vikudaga af rh-
EPO (Recormon®, Boehringer Mannheim,
Mannheim, Þýskalandi) þ.e. 250 einingar/kg
á viku. Hámarks dagskammtur var 4000
alþjóðlegar einingar og sjúklingar sem