Burning Question of Hormones: Breastfeeding, Contraceptives, & Menopause in Rheumatoid Arthritis

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Effects of hormones on Rheumatoid Arthritis severity

city lights in moving carIn a search for understanding of the influence of hormones on the course of Rheumatoid Disease, Swedish investigators examined “Early menopause and severity of rheumatoid arthritis in women over 45 years of age,” Arthritis Research & Therapy. Do hormones influence the severity of Rheumatoid Arthritis? Are there hormonal predictors for severity of disease?

Rheumatoid Arthritis severity and hormonal changes

The researchers found early menopause to be “associated with mild type of RA among women with disease onset after 45 years of age.” Early menopause could become an indicator for a milder course of Rheumatoid Arthritis. They suggest that “hormonal changes may influence pathways that are distinct from those leading to severe, progressive disease.”

Significant findings about hormones, menopause and Rheumatoid Arthritis:

  • Early menopause is associated with a mild seronegative RA phenotype.
  • Breastfeeding history and former use of oral contraceptives did not influence the severity of RA.
  • Hormonal changes may influence pathways leading to a mild type of rheumatoid arthritis.

A fascinating thing to me about this study: use of phenotypes

This study encourages me because acknowledging and examining phenotypes with Rheumatoid Arthritis is crucial to progress in understanding Rheumatoid Disease. I have a lot more to say about Rheumatoid Disease phenotypes, but for today, please put this word on your vocabulary list of key terms in Rheumatoid Disease research. Phenotype simply refers to those with similar characteristics. They could be grouped together in research as we search for more effective treatments, for example.

Of course since Rheumatoid Arthritis is such a heterogeneous disease, it makes more sense to study people according to phenotype. The study authors also acknowledge that Rheumatoid Disease may one day be demonstrated to be a group of diseases identifiable as several phenotypes. This is something I’ve often said over the past 3 years, but have seen few reports about. They authors footnote one recent study on the matter: “Precipitating and perpetuating factors of rheumatoid arthritis immunopathology: linking the triad of genetic predisposition, environmental risk factors and autoimmunity to disease pathogenesis,” Best Practice & Research Clinical Rheumatology.

Milder RA population than average in this study?

  • Diagnosed at the average age of 63
  • Only 60% are anti-CCP positive
  • Only 1/3 prescribed prednisone at diagnosis
  • Average number of DMARDSs used being only 2
  • Only 28% having ever used a biological treatment

Just my 2 cents worth; no extra charge. Certain aspects of the study population (above) of were notable to me. Some of the data above seem to be unlike the general RA population. Most of these data would statistically associate with milder RA so the population in the study may have a larger than average representation of mild RA. However, since “moderate RA” was combined into a group with “mild RA,” that is not as clear. It would make sense though since there has been shown to be a milder course of RA that occurs in older people.

Recommended reading

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Kelly Young. All rights reserved.

This entry was posted on Friday, August 24th, 2012 at 12:15 pm and is filed under RA Education. You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed.

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