AB0255 Does menopause affect disease activity of rheumatoid arthritis(RA)? an analysis from the ninja cohort in 2016

Abstract

BackgroundEarly menopause may be a risk of developing RA1. Although there are many reports about menopause and the onset of RA, it is not yet clear how the disease activity of RA differs for each generation including menopause.ObjectivesTo clarify how disease activity differs for each generation, especially in menopausal period.MethodsUsing the Japanese large RA cohort database (NinJa:National database of Rheumatic Diseases in Japan) of 2016, we divided 12257 RA females into three groups of age (under 44 years old=1, 45 to 55 years old=2, defined as a menopausal group, over 56 years old=3) and analysed them cross-sectionally. We conducted a one-way ANOVA on disease activity indexes such as Tender joint count (TJC), Swollen joint count (SJC), DAS28, HAQ-DI.ResultsTable 1 shows the number of people per group, the duration of disease, the titer of RF/ACPA, and the proportion of drugs used. The average usage of prednisone and the use of biologics was the most common in group 1. In table 2, TJC was the largest in group 2 (p<0.01). Furthermore, the difference between groups seen in TJC tends to be larger than TJC 28. There was no significant difference in SJC (SJC28) between three groups. Other disease activity indicators (ESR, CRP, DAS 28, HAQ-DI) were the largest in group 3 (p<0.01) and the percentage of Boolean remission was also lowest in group 3 (p=0.02).Abstract AB0255 – Table 1Characteristics of the three age groupsgroup123P-value Number of patients107116999487Symptom duration, years8.210.515.4p<0.01RF titer, (IU/mL)186233254p=0.06ACPA titer, (U/mL)90102132p<0.01On NSAIDs use, n(%)392 (36%)710 (41%)3668 (38%)p<0.01Daily mean prednisone dose, (mg/day)4.313.953.86p=0.01On DMARDs, n(%)984 (91%)1623 (95%)8835 (93%)p<0.01On a biologic, n(%)435 (40%)550 (32%)2570 (27%)Abstract AB0255 – Table 2Comparisons of values for disease outcomes of the three age groupsTender joint count(TJC), mean1.652.171.97p<0.01 Tender joint count(28 joints, TJC28), mean1.171.481.44p=0.01Swollen joint count(SJC), mean1.351.491.52p=0.23Swollen joint count(28 joints, SJC28), mean1.051.191.20p=0.12ESR, mean, (mm/h)17.318.829.7p<0.01CRP, mean, (mg/dl)0.320.370.58p<0.01DAS28, mean2.512.783.12p<0.01HAQDI score, mean0.250.420.77p<0.01Proportion in Boolean remission, n(%)351 (32%)485 (28%)2145 (22%)p=0.02ConclusionsThis study shows that TJC may increase during menopause, unlike other disease activity indicators. Especially in group 2, it is possible that the joints which can’t be evaluated at TJC 28 are affecting the results because in TJC, compared with TJC 28, there is a larger group difference. Although further studies are needed, an increase in TJC may reflect menopausal joint symptoms.Reference[1] Pikwer M, et al. Ann Rheum Dis. 2012Mar;71(3):378–81.Disclosure of InterestNone declared