June 8, 2012
World
Study results show
these patients are 50% less likely to develop
severe rheumatoid arthritis.
Berlin, Germany, June 8 2012 : A new study
presented today at EULAR 2012, the Annual
Congress of the European League Against
Rheumatism, shows that early menopause predicts
a milder form of rheumatoid arthritis (RA). New
insights on factors influencing RA are good news
for sufferers of the chronic inflammatory
disease that currently affects over 2 million
women in Europe. 1,2
The study, based on 134 incident RA cases, found
that patients aged over 45 years with a history
of early menopause were 50% less likely to
develop severe RA (16% versus 35%) and more
likely to develop a mild/moderate rheumatoid
factor (RF) negative phenotype (58% versus 20%).
There was no major difference in RA severity
depending on oral contraceptive use or history
of breast feeding. This study highlights that
hormonal changes may influence pathways that are
distinct from those leading to severe,
progressive disease.
Dr. Mitra Pikwer from Skåne University
Hospital, Sweden, and lead study author
commented: "We already know that hormonal
factors may influence the risk of RA, but this
is the first study we know of that investigates
the impact of menopausal age on the severity of
RA. This is an important breakthrough, both in
helping us understand the impact that hormones
may have on the development of this disease and
potentially also in helping us predict the
long-term prognosis for our patients."
The study identified patients who answered a
questionnaire in a community based health survey
(conducted between 1991 and 1996) and later
developed RA. Information on hormonal predictors
including breastfeeding history, history of oral
contraceptive use and menopausal age (early
menopause ≤45 years or normal/late menopause
> 45 years) was obtained via the
questionnaire. By a structured review of the
patients medical records, relevant information
such as use of disease modifying anti-rheumatic
drugs (DMARDs) including biological treatment,
radiographic erosions, rheumatoid factor (RF)
status as well as Health Assessment
Questionnaire (HAQ*) data was collected. These
variables were added to the SPSS TwoStep Cluster
Analysis in order to reveal natural groupings of
RA severity.
RA is a chronic inflammatory disease with female
predominance. Hormonal factors such as
breast-feeding history, use of oral
contraceptives and menopausal age have all been
suggested to influence the risk of RA. As yet
the underlying mechanisms and their impact on
disease progression are unknown.
