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Journal of Clinical and Experimental Hematology

ISSN: 2834-3328

Original Research Open Access

Correlation of hemoglobin level and disease activity in rheumatoid arthritis, results from the kuwait registry for rheumatic diseases (KRRD)

Fatima Ali1,*, Faisal Alsayegh2, Ahmad Alsaber3, Adeeba Alherz4
  • 1Faculty of Medicine, Kuwait University, P.O. Box 24923, Safat 13110, Jabriya, Kuwait
  • 2Faculty of Medicine, Kuwait University, P.O. Box 24923, Safat 13110, Jabriya, Kuwait
  • 3College of Business and Economics, American University of Kuwait, P.O. Box 3323, Safat 13034, 15 Salem Al Mubarak Street, Salmiya, Kuwait
  • 4Ministry of Health, State of Kuwait, Jamal Abdel Nasser Street, Sulaibkhat, P.O. Box 5, Safat13001, Al Asimah (Capital), Kuwait
+ Affiliations - Affiliations

Corresponding Author

Fatima Ali, fatima.ali@ku.edu.kw

Received Date: November 02, 2025

Accepted Date: December 10, 2025

Citation:

Ali F, Alsayegh F, Alsaber A, Alherz A. Correlation of hemoglobin level and disease activity in rheumatoid arthritis, results from the Kuwait Registry for Rheumatic Diseases (KRRD). J Clin Exp Hematol. 2025;4(1):22-27.


Copyright: © 2025 Ali F, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Objectives: Anemia is a frequent extra-articular manifestation of rheumatoid arthritis (RA) and has been linked to increased disease activity and poorer outcomes. This study aimed to evaluate the association between hemoglobin (Hb) levels and RA disease activity in a Middle Eastern population.
Methods: A retrospective observational study was conducted using data from the Kuwait Registry for Rheumatic Diseases (KRRD), which includes adult RA patients meeting the ACR/EULAR criteria. Clinical and laboratory data were collected from six government hospitals across Kuwait between February 1, 2013, and February 1, 2023. Disease activity was assessed using DAS28, CDAI, and SDAI scores. Anemia was defined by WHO criteria (Hb <13 g/dL in males and <12 g/dL in females).
Results: Of the 1,968 registered patients, 1,775 were included in the final analysis. Anemia was present in 48.5% (n=860) of patients. Anemic individuals had significantly higher DAS28 and CDAI scores compared to those with normal Hb (p<0.001 and p=0.002, respectively), and higher HAQ disability scores (p<0.001). Multivariate analysis showed that anemia was independently associated with joint swelling, high HAQ scores, joint deformities, and positive anti-CCP titers.
Conclusion: This large population-based study from Kuwait confirms a strong association between low hemoglobin levels and higher RA disease activity. Monitoring anemia may offer additional insight into disease severity and guide more targeted RA management strategies in Middle Eastern populations.

Keywords

Anemia, Rheumatoid arthritis, DAS28, Kuwait, Middle East and North Africa

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