RESEARCH - RF seropositivity is inversely associated with oral contraceptive use in women without RA

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Published Online First: 25 July 2006. doi:10.1136/ard.2006.060004

ls of the Rheumatic Diseases 2007;66:267-269

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CONCISE REPORT

Rheumatoid factor seropositivity is inversely associated with oral

contraceptive use in women without rheumatoid arthritis

Shailaja S Bhatia 1,*, Darcy S Majka 2,*, M Kittelson 1, Lezlie A

Parrish 3, D Ferucci 4, D Deane 3, P Arend 3,

n Rewers 5, V Holers 3, Jill M Norris 1

1 Department of Preventive Medicine and Biometrics, University of

Colorado at Denver and Health Sciences Center, Denver, Colorado, USA

2 Division of Rheumatology, Northwestern University, Feinberg School

of Medicine, Chicago, Illinois, USA

3 Division of Rheumatology, University of Colorado at Denver and

Health Sciences Center, Denver, Colorado, USA

4 Office of Alaska Native Health Research, Alaska Native Tribal Health

Consortium, Anchorage, Alaska, USA

5 Barbara Center for Childhood Diabetes, University of Colorado

at Denver and Health Sciences Center, Denver, Colorado, USA

ABSTRACT

Objectives: To examine whether oral contraceptive use is associated

with the presence of serum rheumatoid factor in women of reproductive

age without rheumatoid arthritis.

Methods: 304 women selected from parents of children who were at

increased risk of developing type 1 diabetes were studied, because

they were enriched with the human leucocyte antigen-DR4 allele, a

susceptibility marker for both type 1 diabetes and rheumatoid

arthritis. Participants visited a clinic where blood was drawn for

rheumatoid factor testing, and exposure data were collected via

questionnaires. A medical history and joint examination were performed

to rule out rheumatoid arthritis. Participants and examiners were

unaware of the participants' rheumatoid factor status at the time of

examination and questionnaire.

Results: Use of oral contraceptives at any time was inversely

associated with rheumatoid factor positivity (adjusted odds ratio (OR)

0.2, 95% confidence interval (CI) 0.07 to 0.52) independent of age,

education and smoking. Smoking 20 pack-years was also associated with

rheumatoid factor positivity (adjusted OR 56.38, 95% CI 4.31 to

736.98) compared with never smoking. Smoking 1–19 pack-years was not

associated with a positive rheumatoid factor.

Conclusions: Our results suggest that oral contraceptive use, and

possibly cigarette smoking, act early in the development of the immune

dysregulation that occurs in rheumatoid arthritis.

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Read the entire article here:

http://ard.bmj.com/cgi/content/full/66/2/267

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