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

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 ge neric and comprehensive quality of life measure, capable of integrating dom ain-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 w as studied by measuring utilities, derived from the rating scale and standa rd gamble, in a 52-week placebo-controlled randomised double-blind study wi th r-hu-Epo in 70 patients with active RA and ACD. Furthermore, the relatio n between anaemia as assessed by haemoglobin levels (Hb), disease activity as assessed with the Disease Activity Score (DAS), and utilities was invest igated. 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 st andard gamble utilities, was observed in the Epo group. Rating scale utilit ies 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 sc ale utilities (21% and 3% respectively) and to changes in rating scale util ities (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 qu ality of life, most probably by improving both disease activity and anaemia . Utilities, particularly rating scale utilities, correlated well with conv entional disease activity variables and proved sensitive to change. Utiliti es may be a useful tool for investigating quality of life in RA-patients.