RESEARCH - Effects of postmenopausal hormone therapy on RA

[Guest guest]

Arthritis Rheum. 2008 Feb 29;59(3):302-310 [Epub ahead of print]

Effects of postmenopausal hormone therapy on rheumatoid arthritis: The

women's health initiative randomized controlled trials.

Walitt B, Pettinger M, Weinstein A, Katz J, Torner J, Wasko MC,

BV; Women's Health Initiative Investigators.

Washington Hospital Center, Washington, DC.

OBJECTIVE: To study the effects of postmenopausal hormone therapy

(PHT) on the incidence and severity of rheumatoid arthritis (RA).

METHODS: The Women's Health Initiative randomized controlled trials

evaluated the effects of unopposed estrogen (E-alone) and estrogen

plus progestin (E+P) compared with placebo on a diverse set of health

outcomes over 7.1 and 5.6 years, respectively. RA cases were

identified using historical and medication data. The hazard of

developing RA was estimated using proportional hazards regression

models. Disease symptom severity was estimated using the Short Form 36

(SF-36) and self-reported joint pain scores at baseline and after 1

year. Mean changes in severity were compared using linear regression

models. RESULTS: Of the 27,347 participants, 63 prevalent cases and

105 incident cases of RA were identified. A nonsignificant reduction

in the risk of developing RA (hazard ratio 0.74; 95% confidence

interval [95% CI] 0.51, 1.10) was noted with PHT use. PHT use led to

improved SF-36 scores in unadjusted analyses (percent change 12.5%;

95% CI -24.45, -0.57) but not after adjustment for relevant covariates

(P = 0.33). Nonsignificant improvements in joint pain scores were seen

with PHT use (odds ratio [OR] 4.10; 95% CI 0.83, 20.20). PHT did not

improve swelling (OR 1.27; 95% CI 0.08, 19.63) or prevent new joint

pains (OR 0.72; 95% CI 0.11, 4.68) in RA participants.

CONCLUSION: There were no statistically significant differences in the

risk of developing RA or the severity of RA between the PHT and

placebo groups.

PMID: 18311749

http://www.ncbi.nlm.nih.gov/pubmed/18311749

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