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Oral contraceptives may be protective against progression of inflammatory arthritis
Past and current use of oral contraceptives appeared to have a protective effect with better patient-reported outcomes in patients with inflammatory arthritis, according to recently published research.
Researchers studied data from 273 women with rheumatoid arthritis (RA) and were enrolled in the Course and Prognosis of Early Arthritis cohort. Fifty women from the cohort were neither current nor former recipients of oral contraceptive, while 170 women used oral contraceptive in the past and 53 women were receiving oral contraceptives at the time of inclusion. Women who received oral contraceptives tended to be younger and were less likely to be mothers or smokers. Women who had never received oral contraceptives tended to have lower levels of education. Linear, mixed models were used to adjust for age, BMI and markers of disease activity.
Of the overall cohort, the duration of oral contraceptive use was reported among 176 patients. Investigators found no association between duration of use and baseline DAS28 scores or the frequency of intervention with glucocorticoids.
Current or past use of oral contraceptives was not associated with erythrocyte sedimentation rate (ESR), C-reactive protein or swollen joint counts, but correlation was observed with the Rheumatoid Arthritis Impact of Disease score, the Prole of Mood and Discomfort, the Patient Health Questionnaire Depression Scale, the total joint count of the Rheumatoid Arthritis Disease Activity Index, and the Hannover Functional Assessment commonly used in Germany, after investigators adjusted their findings for age, education and BMI.
At all time points and regardless of adjustments, women who had past oral contraceptive use had a mean 0.4 units lower in DAS28 scores, and results remained significant after adjusting for baseline DAS28. No impact was observed between oral contraceptive use and smoking, ESR, swollen joint count or educational level. However, the mean total joint count during the 2 years of study and patient global health scores were improved with current or past oral contraceptive use.
Patients who had not received oral contraceptives were more likely to receive glucocorticoids with an odds ratio of 1.6, while no association was seen between oral contraceptive use and the use of conventional or biologic disease-modifying antirheumatic drugs. – by Shirley Pulawski
Disclosures: The researchers report the receipt of an unconditional grant from Pfizer, Germany.