Session Information
Session Type: Abstract Submissions (ACR)
Background/Purpose: The importance of hormonal/reproductive factors has been hypothesized to contribute to the risk of Rheumatoid arthritis (RA), but the literature is somewhat contradictory. The use of postmenopausal hormone (PMH) has previously been observed to provide increased [1], decreased [2], as well as no association [3] with the risk of RA. The aim of the present work was to study the association between the use of PMH and the risk of developing RA in postmenopausal women (aged 50-70), by stratifying the cases according to presence/absence of antibodies to citrullinated peptides (ACPA).
Methods: Data from the Swedish population-based EIRA (Epidemiological Investigation of RA) case-control study was analyzed. In total, 380 incident postmenopausal female cases, aged 50-70 years, and 780 randomly selected controls (matched by age and residential area) were included between 2006-2009. Of the cases, 239 (62.9%) were ACPA-positive. The use of PMH was assessed by means of an identical questionnaire answered by the participating cases and controls. Current and past users of PMH were compared with never users to obtain odds ratios (ORs) with 95% confidence intervals (CI) by means of unconditional logistic regression models.
Results: A decreased risk of developing ACPA-positive RA was observed among current users compared with never users of PMH (OR 0.5, 95% CI 0.3-0.9). Among past users of PMH no association was found when comparing with never users (OR 1.2, 95% CI 0.8-1.7). For ACPA-negative RA no association was found among current (OR 1.0, 95% CI 0.6-1.8) or past (OR 1.2, 95% CI 0.8-2.0) users of PMH.
Conclusion: Our results indicate that current use of PMH is associated with a decreased risk of ACPA-positive RA in postmenopausal women aged 50-70, but has no association with the risk of ACPA-negative RA. The striking difference in the results for ACPA-positive and ACPA-negative RA adds further evidence to the notion that RA consists of two different entities with partly different etiology. Further research is needed in order to explore the biological mechanisms behind our findings.
References
1. Merlino LA, Cerhan JR, Criswell LA et al. (2003) Estrogen and other female reproductive risk factors are not strongly associated with the development of rheumatoid arthritis in elderly women. Semin Arthritis Rheum 33, 72-82.
2. Vandenbroucke JP, Witteman JC, Valkenburg HA et al. (1986) Noncontraceptive hormones and rheumatoid arthritis in perimenopausal and postmenopausal women. JAMA 255, 1299-1303.
3. Walitt B, Pettinger M, Weinstein A et al. (2008) Effects of postmenopausal hormone therapy on rheumatoid arthritis: the women’s health initiative randomized controlled trials. Arthritis Rheum 59, 302-310.
Disclosure:
C. Orellana,
None;
S. Saevarsdottir,
None;
L. Klareskog,
None;
L. Alfredsson,
None;
C. Bengtsson,
None.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/postmenopausal-hormone-therapy-and-the-risk-of-rheumatoid-arthritis-results-from-the-swedish-eira-study/