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Message: Anemia of Chronic Inflammation/Anemia of Chronic Disease

While we wait with bated breath.

Sorry for repeated digressions. Just that i have been spending  a lot of time in hospital these days (not a patient myself). While doing so, cannot help but look around and wonder about other potential indications that I am seeing.

One is anemia of chronic disease, which is the second most common form of anemia.

About 1 million in the US suffer from it, and estimates are that patient population will grow. Based on what I have witnessed here, both solutions and expertise seem limited.

Recent data indicates that IL-6 inhibitors (which in turn reduce Hepcidin), as well as Hepcidin inhibitors are useful, but some have awful side effects.

I don't recall seeing data on Hepcidin per se, but definitely Apabetalone reduces IL-6 (which in turn should reduce hepcidin) and so far side effects are minimal.  Also - diabetics are among (but far from the only) patients susceptible to anemia of inflammation. Arthritic conditions, pressure ulcers, injuries, and a slew of other problems make people susceptible (stroke leading to immobilization leading to pressure ulcer leading to anemia of chronic inflammation, for instance).

The cascade from inflammaton to anemia is well described, see for example:

http://asheducationbook.hematologylibrary.org/content/2015/1/14.full

and

https://doi.org/10.1056/NEJMra1804281

Am wondering BOTH whether this could be another indication, AND whether analysis of existing patient pool might have a subset with anemia of chronic inflammation that may have been helped already during BETonMACE?

Would love to see those numbers if so. 

Would also love to see comparative numbers on amputation in treated and untreated groups, if there are enough to draw any conclusions.

Seems like maybe diabetic amputations could be reduced and complications of anemia of inflammation from other conditions could be mitigated. For instance, stage 4 pressure ulcers increase the risk of death with even in patients with identical comorbidities from two to five times, depending upon which article you read. One of the sources of complications and impediments to healing is the anemia of inflammation that results and is hard to treat as the body's ability to fight infection must also be supported.

Maybe taken altogether, more than the million or so listed could benefit - even from that perspective alone. Not as robust an audience as cardiovascular disease, but still worth a look, methinks.

 Anyway, GREAT luck to all!

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