{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T22:59:53Z","timestamp":1789340393719,"version":"build-2803163510"},"reference-count":33,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2018,4,25]],"date-time":"2018-04-25T00:00:00Z","timestamp":1524614400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006483","name":"AbbVie","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006483","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp;amp; Research"],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To study low blood hemoglobin concentrations as a predictor of radiographic damage progression in patients with rheumatoid arthritis (<jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Post hoc analyses were performed in patients from the <jats:styled-content style=\"fixed-case\">PREMIER<\/jats:styled-content> trial with early <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content> undergoing 2 years of adalimumab (<jats:styled-content style=\"fixed-case\">ADA<\/jats:styled-content>), methotrexate (<jats:styled-content style=\"fixed-case\">MTX<\/jats:styled-content>), or <jats:styled-content style=\"fixed-case\">ADA<\/jats:styled-content> + <jats:styled-content style=\"fixed-case\">MTX<\/jats:styled-content> combination therapy. Low disease activity was defined as a score &lt;3.2 on the 28\u2010joint Disease Activity Score using the C\u2010reactive protein level (<jats:styled-content style=\"fixed-case\">DAS<\/jats:styled-content>28\u2010<jats:styled-content style=\"fixed-case\">CRP<\/jats:styled-content>), and clinical response by the American College of Rheumatology criteria for 20% improvement at week 24. Baseline or mean hemoglobin concentrations over time, or anemia as defined using sex\u2010specific World Health Organization criteria, were analyzed in mixed\u2010effects models for longitudinal data in men and women as predictors of progressive joint damage, as measured by the modified total Sharp\/van der Heijde score (\u0394<jats:styled-content style=\"fixed-case\">SHS<\/jats:styled-content>). Data were adjusted for treatment and other patient characteristics, including the <jats:styled-content style=\"fixed-case\">DAS<\/jats:styled-content>28\u2010<jats:styled-content style=\"fixed-case\">CRP<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Baseline hemoglobin was inversely associated with \u0394<jats:styled-content style=\"fixed-case\">SHS<\/jats:styled-content> in adjusted analyses (<jats:italic>P<\/jats:italic> &lt; 0.05 for both sexes). Baseline anemia predicted greater \u0394<jats:styled-content style=\"fixed-case\">SHS<\/jats:styled-content> in <jats:styled-content style=\"fixed-case\">MTX<\/jats:styled-content>\u2010treated patients over 104 weeks, and in <jats:styled-content style=\"fixed-case\">ADA<\/jats:styled-content>\u2010 and combination\u2010treated patients over 26 weeks. Lower hemoglobin concentrations over time, as well as time with anemia, were associated with greater damage progression (<jats:italic>P<\/jats:italic> &lt; 0.001). The effect of low hemoglobin concentrations on joint damage progression remained significant, even in patients achieving low disease activity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Low hemoglobin is a <jats:styled-content style=\"fixed-case\">DAS<\/jats:styled-content>28\u2010<jats:styled-content style=\"fixed-case\">CRP<\/jats:styled-content>\u2010independent predictor of radiographic joint damage progression in <jats:styled-content style=\"fixed-case\">MTX<\/jats:styled-content>\u2010treated patients with early <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content>. This effect decreases over time in <jats:styled-content style=\"fixed-case\">ADA<\/jats:styled-content>\u2010 and combination\u2010treated patients, and in clinical responders irrespective of treatment modality.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.23427","type":"journal-article","created":{"date-parts":[[2017,9,26]],"date-time":"2017-09-26T16:16:47Z","timestamp":1506442607000},"page":"861-868","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Low Hemoglobin and Radiographic Damage Progression in Early Rheumatoid Arthritis: Secondary Analysis From a Phase <scp>III<\/scp> Trial"],"prefix":"10.1002","volume":"70","author":[{"given":"Burkhard","family":"M\u00f6ller","sequence":"first","affiliation":[{"name":"University Hospital of Bern Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"Everts\u2010Graber","sequence":"additional","affiliation":[{"name":"University Hospital of Bern Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Florentinus","sequence":"additional","affiliation":[{"name":"AbbVie North Chicago Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yihan","family":"Li","sequence":"additional","affiliation":[{"name":"AbbVie North Chicago Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hartmut","family":"Kupper","sequence":"additional","affiliation":[{"name":"AbbVie Deutschland Ludwigshafen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Axel","family":"Finckh","sequence":"additional","affiliation":[{"name":"University Hospital of Geneva Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,4,25]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-204573"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keh297"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.30129"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.38012"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)61751-1"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.51.2.177"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2012-202709"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-203718"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2008.08.002"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.21519"},{"key":"e_1_2_8_12_1","first-page":"302","article-title":"The prevalence of anaemia in the world","volume":"38","author":"DeMaeyer E","year":"1985","journal-title":"World Health Stat Q"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2007.084459"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.10190"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(199810)41:10<1845::AID-ART17>3.0.CO;2-K"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2016-eular.2015"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.20217"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/ar4323"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bcmd.2013.09.004"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra041809"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2012-202119"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V80.7.1639.1639"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2002-01-0136"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2012-202735"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)15640-7"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.30263"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-204172"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-204769"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2015.09.001"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2010.139535"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2011.153734"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/36.2.225"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOR.0b013e328329f84f"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOR.0000000000000167"}],"container-title":["Arthritis Care &amp; 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