Re: RESEARCH - HRT beneficial in post-menopausal women with RA

December 6, 2004

HRT may be of some benefit- but I would warn anyone who is also on MTX and

prednisone. Both raise the homocysteine levels in the blood and along with even

low dose estrogen can significantly raise the chance of blood clots. I had two

pulmonary embolisms - and I believe they were due in large part to the drug

combinations.

-------------- Original message ----------------------

From: " " <Matsumura_Clan@...>

>

> Hormone Replacement Therapy Beneficial in Post-Menopausal Women with

> Rheumatoid Arthritis

>

> A DGReview of : " Influence of Hormone Replacement Therapy on Disease

> Progression and Bone Mineral Density in Rheumatoid Arthritis "

> Journal of Rheumatology

>

> 08/14/2003

> By Deanna M Green, PhD

>

> Women with rheumatoid arthritis (RA) who are receiving hormone

> replacement therapy (HRT) show greater improvements in disease activity,

> inflammation, bone mineral density, and radiological progression than

> women not receiving HRT, according to a recent Swedish study.

>

> Sex hormones, such as oestrogen, progesterone, and glucocorticosteroids,

> have been shown to affect the disease activity of patients with RA.

> Interestingly, the highest incidence of RA in women is observed during

> menopause when oestrogen levels are significantly reduced. HRT has been

> shown to increase bone mineral density (BMD) in women with RA, but its

> effects on disease activity and progression are unknown.

>

> Helena Forsblad D'Elia, MD, and colleagues at the Goteburg University,

> Sweden, analysed the effects of hormone replacement therapy in

> post-menopausal women with RA.

>

> The study consisted of 88 post-menopausal women (ages 45 to 65) with

> active RA who were randomised to receive calcium (500 mg) and vitamin D3

> (400 IU) either alone or in conjunction with HRT for two years. HRT

> consisted of micronised estradiol (2 mg) and noretisterone acetate (1

> mg). Disease activity, quality of life and BMD were assessed 12 and 24

> months after start of study.

>

> Overall, 65% of patients in the HRT group responded to treatment as

> compared to 40% of control patients. Response was determined by Disease

> Activity Score 28 (DAS28) which showed a more significant decrease in

> HRT patients than in controls.

>

> Despite this improvement in disease activity, measures of physical

> activity, quality of life and disability were similar between groups.

>

> Treatment with HRT also led to better control of inflammation as

> evidenced by a decrease in the erythrocyte sedimentation rate and an

> increase in haemoglobin levels in patients given HRT.

>

> Patients receiving HRT also showed significant increases in the BMD of

> the forearm (+3.6%), the total hip (+4.0%), and the lumbar spine

> (+7.1%), whereas control patients showed a reduction in BMD in each of

> these areas (-2.4%, -0.6%, and -0.8%, respectively).

>

> Furthermore, slower disease progression was associated with HRT in

> patients with increasing joint destruction as determined by radiographic

> analysis at entry and 1- and 2-year follow up.

>

> Five patients in the HRT group withdrew from the study in the first year

> due to hyperperspiration, hyperparathyroidism, nausea and weight gain

> associated with treatment.

>

> Dr. D'Elia concludes that " HRT containing estradiol and noretisterone

> acetate has a beneficial effect on disease activity, inflammation, BMD,

> and radiological progression in women with long-lasting RA. " She also

> emphasizes the importance of the BMD effect " since RA patients have

> increased risk of osteoporotic fractures known to be associated with low

> bone mineral content. "

>

> " HRT could be a valuable supplement to conventional therapy in the

> management of post-menopausal patients with RA, " she adds.

> J Rheumatol 2003 Jul;30:7:1456-63. " Influence of Hormone Replacement

> Therapy on Disease Progression and Bone Mineral Density in Rheumatoid

> Arthritis "

>

> http://www.docguide.com/news/content.nsf/news/8525697700573E1885256D6D006E34AB

>

> I'll tell you where to go!

>

> Mayo Clinic in Rochester

> http://www.mayoclinic.org/rochester

>

> s Hopkins Medicine

> http://www.hopkinsmedicine.org

>

December 6, 2004

oh boy! i am now taking MTX and prednisone and i have been taking premarin for

years... i just wrote down the info so i can call my doctor and ask if i can go

off premarin or at least start tapering off!

thanks, rae

Re: [ ] RESEARCH - HRT beneficial in post-menopausal women

with RA