Noncontraceptive Hormones and Rheumatoid Arthritis in Perimenopausal and Postmenopausal Women

Vandenbroucke, Jan P.; Witteman, Jacqueline C. M.; Valkenburg, H. A.; Boersma, J.; Cats, A.; Festen, Johannes J. M.; Hartman, Arend P.; Huber-Bruning, O.; Rasker, Johannes J.; Weber, J. C. P.

doi:10.1001/jama.1986.03370100093024

Cited by 88 publications

(7 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Most of the previous studies have not observed an association [ 12 , 13 , 19 – 26 ]. Our results are in accordance with a report by Vandenbroucke et al [ 29 ] where current use of substitution hormones was associated with a decreased risk of RA. Our results are also in line with a previous case-control study, where a decreased risk of RA among current users of estrogen plus progestin was found and, as in our study, no association for current users of estrogen only was observed [ 22 ].…”

Section: Discussionsupporting

confidence: 94%

“…The use of postmenopausal hormone (PMH) therapy for menopause related symptoms in relation to RA risk has been explored in several studies, most of them showing no association [ 12 , 13 , 19 – 26 ] while a few have reported an increased [ 27 ] or decreased risk of developing RA [ 28 , 29 ]. One report has indicated that the use of PMH among women carrying the HLA-DRB1 shared epitope (SE) alleles may protect against the development of criterium-defined RA in a population of women with early undifferentiated arthritis, and that this prevention is associated with a reduction of antibodies to citrullinated peptides (ACPA) [ 28 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Postmenopausal hormone therapy and the risk of rheumatoid arthritis: results from the Swedish EIRA population-based case-control study

et al. 2015

View full text Add to dashboard Cite

To study the association between postmenopausal hormone therapy (PMH) use and the risk of rheumatoid arthritis (RA) stratifying the cases by the presence/absence of antibodies against citrullinated peptides (ACPA). A subset of the Epidemiological Investigation of RA (EIRA), a population-based case-control study, comprising postmenopausal women aged 50–70 living in Sweden, between 2006 and 2011 was analysed (523 cases and 1057 controls). All participants answered an extensive questionnaire, including questions regarding PMH use and potential confounders (education, smoking, BMI, oral contraceptives, reproductive factors). We calculated odds ratios (OR) of developing ACPA-positive/-negative RA, with 95 % confidence intervals (CI) and adjusted for age, residential area and smoking. Current users of PMH had a decreased risk of ACPA-positive RA compared with never users (OR 0.6, 95 % CI 0.3–0.9). The decreased risk was observed mainly in the age-group 50–59 years (OR 0.3, 95 % CI 0.1–0.8) but not in the age-group 60–70 years (OR 0.8, 95 % CI 0.4–1.4). Among current users of a combined therapy (estrogen plus progestogens) an OR of 0.3 (95 % CI 0.1–0.7) of ACPA-positive RA was observed, while no significant association was found among women who used estrogen only (OR 0.8, 95 % CI 0.5–1.6). No association between PMH use and ACPA-negative RA was found. PMH use might reduce the risk of ACPA-positive RA in post-menopausal women over 50 years of age, but not of ACPA-negative RA. The negative influence of this treatment on the risk of other chronic conditions cannot be overlooked.

show abstract

Section: Discussionsupporting

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Postmenopausal hormone therapy and the risk of rheumatoid arthritis: results from the Swedish EIRA population-based case-control study

et al. 2015

View full text Add to dashboard Cite

show abstract

“…Figure 1 shows the flowchart of literature inclusion and exclusion. We identified 47 publications for full-text evaluation, of which 30 publications were further excluded because they did not fulfill the inclusion criteria (ie, conference abstracts,34–42 meta-analyses/reviews,50–58 letters to editor/comments,59 cross-sectional studies,29,30 providing insufficient data,28 involving the same study population or overlapped data,8,31–33 involving family cases,13,17 reporting the relationship between noncontraceptive hormones and RA among perimenopausal and postmenopausal women,11 and using OCs users with less than one patient as reference9). Therefore, our meta-analysis was based on 17 publications, including 12 case-control and five cohort studies published between 1982 and 2010 4,7,10,12,14–16,18–27.…”

Section: Resultsmentioning

confidence: 99%

Meta-analysis of oral contraceptives and rheumatoid arthritis risk in women

Qi¹,

Xin²,

Guo³

et al. 2014

TCRM

View full text Add to dashboard Cite

Background and objectivesEpidemiological investigations of the relationship between oral contraceptives and rheumatoid arthritis (RA) risk have reported controversial results. Therefore, a meta-analysis of case-control or cohort studies was performed to evaluate the role of oral contraceptives in relation to risk of developing RA.MethodsEligible studies were identified from databases PubMed and EMBASE by searching and reviewing references. Random effect models were utilized to summarize the relative risk (RR) estimates with 95% confidence intervals (CIs).ResultsA total of 12 case-control studies and five cohort studies were eligible for our analysis. No statistically significant association was observed between oral contraceptives and RA risk (RR=0.88, 95% CI=0.75–1.03). In the subgroup of geographic area, a decreased risk of borderline significance was observed for oral contraceptive users in European studies (RR=0.79, 95% CI=0.62–1.01), but this association did not emerge in the North American studies group (RR=0.99, 95% CI=0.81–1.21). No evidence for publication bias was detected (P for Egger’s test =0.231).ConclusionOur results of meta-analysis do not support the hypothesis of a protective effect of oral contraceptives on the risk for RA in women.

show abstract

“…67,68 Although no data in MS have been reported about the long-term effects of oral contraception, in RA the effects of oral contraception have been debated. No definite conclusion could be drawn, since a beneficial effect has been documented in some earlier studies, 69,70 while in others oral contraception had no effect. 71,72 This may reflect the reduced amount of oestrogen in more recent oral contraceptives and the use of synthetically modified oestrogen.…”

Section: Oestrogenmentioning

confidence: 89%

The influence of sex hormones on cytokines in multiple sclerosis and experimental autoimmune encephalomyelitis: a review

et al. 2005

View full text Add to dashboard Cite

The female predominance of multiple sclerosis (MS) has suggested that hormonal differences between the sexes must confer some protective effect on males or enhance the susceptibility of females to this disease. There has been evidence that gonadal hormones can modulate the immune response regulated by antigen presenting cells and T cells. These cells control the immune response by the production of interacting pro- and anti-inflammatory cytokines. The first include the acute phase pro-inflammatory cytokines of the innate immune response as well as the T-helper 1 (Th1) cytokines, while the later contain the Th2 cytokines as well as the suppressor cytokines. There is some evidence that MS and experimental autoimmune encephalitis (EAE) are Th1 cell-mediated diseases. For this reason many studies have been done to influence the pro-inflammatory cytokine production of these Th1 cells in favour of an anti-inflammatory immune response as mediated by Th2 cells. However the role of the regulatory T cells in this context is not clearly understood. Here we review the studies concerning the role of sex hormones on the cytokine production in relation to the disease course of MS and EAE and in particular in the light of the recent revival of the regulatory T cells and their suppressive cytokines.

show abstract

Noncontraceptive Hormones and Rheumatoid Arthritis in Perimenopausal and Postmenopausal Women

Cited by 88 publications

References 21 publications

Postmenopausal hormone therapy and the risk of rheumatoid arthritis: results from the Swedish EIRA population-based case-control study

Postmenopausal hormone therapy and the risk of rheumatoid arthritis: results from the Swedish EIRA population-based case-control study

Meta-analysis of oral contraceptives and rheumatoid arthritis risk in women

The influence of sex hormones on cytokines in multiple sclerosis and experimental autoimmune encephalomyelitis: a review

Contact Info

Product

Resources

About