Menopause and rheumatoid arthritis (up to date)

Background:Rheumatoid arthritis (RA) is a female predominant autoimmune disease. The peak incidence coincides with menopause years in female RA. However, the exact interval between the age of RA onset and...

Rheumatoid arthritis and heart disease: the chicken and the egg?

AB0577 Systemic autoimmune vasculitis in rheumatoid arthritis – a postmortem clinicopathologic study of 161 patients

AB0237 Gradation of Changes in Axial and Peripheral Skeleton with Respect To The Age at Rheumatoid Arthritis (RA) Onset

SAT0145 Features of patients with rheumatoid arthritis whose debut joint is a foot or ankle joint: a 5,479 cases study from the iorra cohort

Women will hardly ever get their first signs of rheumatoid arthritis (RA) during pregnancy, whereas the onset of RA seems to cluster in the postpartum period. This clinical and epidemiological observation may be explained by a postponement of the onset of symptomatic RA by pregnancy, which is in line with the observed amelioration of disease activity in women with established RA. Up to 75% of women with RA improve during pregnancy, starting in the first or second trimester with maximum improvement during the third trimester of pregnancy. More than 90% of these patients will experience a flare of their disease within two to six months after delivery. Women who have ever been pregnant have a lower risk of developing RA, particularly when they had their first pregnancy at an early age. Several biological mechanisms have been put forward to explain the favourable effect of pregnancy on the onset and course of RA, but there is still no fully satisfactory explanation. The profound hormonal shifts (e.g. increased estrogens, progesterone and corticosteroids) have been implicated in the favourable effect of pregnancy through their effect on the immune system. Pregnancy is an immunological challenge requiring immunological protection or tolerance for the partly non-self fetus. Cellular immunity is decreased during pregnancy, which may play a role in the positive effect of pregnancy in RA. Pregnancy is associated with decreased production of TH1 associated cytokines (IL2, interferon gamma), increased production of TH2 associated cytokines (IL-4, IL-10), and decreased production of proinflammatory cytokines (TNF alpha, IL-12). Alterations in the glycosylation of IgG have also been put forward as a possible explanation. The question why not all women improve during pregnancy is still not answered by the above mechanisms. There is some evidence that HLA disparity between mother and fetus will play a role in the suppression of autoimmunity, which will differ between different pregnancies. A better understanding in how pregnancy exerts its effect on the onset and course of RA will help to unravel possible immunological mechanisms in RA and may lead to more effective treatments.

Women with low quality of life by cervantes-short form scale choose menopausal hormone therapy

FRI0126 Who Is at Greater Risk for Myocardial Infarction in Rheumatoid Arthritis?

BackgroundIncreased comorbidity and mortality in rheumatoid arthritis (RA) patients are highly due to cardiovascular disease (CVD). The etiology of this increased morbidity and mortality in patients with RA compared with...

Background:Rheumatoid arthritis (RA) patients are at higher risk of cardiovascular diseases (CVD) of which carotid intima-media thickness (cIMT) serves as a non-invasive surrogate marker. Previously, we published that our RA...

Bilateral oophorectomy and premature menopause

ObjectiveEarly menopause (EM, age ≤ 45 years) is associated with an increased risk of developing rheumatoid arthritis (RA). We aimed to investigate its impact on disease characteristics in RA patients.MethodsThis cross-sectional study included natural post-menopausal RA patients from an observational RA cohort recruited between January 2015 and October 2023. Demographic characteristics and clinical data were collected. Patients were divided into EM and usual menopause (UM, menopause age > 45 years) groups. Patients-reported outcomes (PROs, included patient global assessment of disease activity [PtGA], pain visual analogue scale [VAS] and Stanford health assessment questionnaire disability index [HAQ-DI]), and PROs-associated indicators (included 28-joint tender joint count [TJC28] and provider global assessment of disease activity [PrGA]) were assessed.ResultsAmong 1427 female RA patients, 557 natural post-menopausal RA patients were enrolled. The peak menopause age was between 46 and 50 years, with RA incidence peaking 5 years post-menopause. Compared with UM patients, RA patients with natural EM (n = 98,17.6%) exhibited more serious disease, including worse PROs and PROs-associated indicators, as well as higher C-reactive protein (CRP, all P < 0.05). Among 344 (61.8%) patients with RA onset after menopause, EM patients (n = 62, 18.0%) were characterized with worse PROs and PROs-associated indicators than those with UM patients (all P < 0.05), but no difference in inflammatory makers. Multivariate linear regression showed that menopause age was independently and negatively associated with PROs, including PtGA (β = -0.872, 95% CI -1.619, -0.125), HAQ-DI (β = -0.646, 95% CI -1.059, -0.233) in RA patients especially in those onset after menopause (PtGA [β = -1.028, 95% CI -2.022, -0.034]; HAQ-DI [β = -0.916, 95% CI -1.461, -0.370]).ConclusionEarly menopause impacts on PROs independent of inflammation in patients with RA especially in those with postmenopausal-onset RA, which imply the importance of differentiation of non-inflammatory disease activity.

Preventing rheumatoid arthritis: Lessons from that of type 1 diabetes

Long-term air pollution exposure and cardiovascular disease progression in rheumatoid arthritis: A prospective cohort study using multi-state model analysis.

THU0673 CARDIOVASCULAR DISEASE AS A RISK FACTOR FOR DEVELOPMENT OF RHEUMATOID ARTHRITIS – A DANISH FOLLOW-UP STUDY