Disease Activity In Women Research Articles

Hormone replacement therapy and chronic graft-versus-host disease activity in women treated with bone marrow transplantation for hematologic malignancies.

Several lines of experimental evidence suggest that sex hormones may influence the development and activity of chronic graft-versus-host disease (cGVHD), which frequently occurs in patients undergoing allogeneic bone marrow transplantation (ABMT). Following ABMT, young women are commonly treated with hormone replacement therapy (HRT) because of irreversible gonadal failure. It seemed therefore worthwhile to investigate the effects of this therapy on the activity of cGVHD. Premenopausal women treated with ABMT for hematological malignancies between January 1997 and December 2000 were evaluated for cGVHD activity. They were divided into two groups, depending on whether or not they were treated with HRT. Seventy-one women qualified for the present study: 39 received HRT (treated group), while 32 did not (controls). In both groups of patients, cGVHD activity score was comparable before the start of HRT. No differences were observed in cGVHD activity score between the HRT group and controls after 3, 6, 12, and 24 months from the start of HRT. Furthermore, HRT did not induce any increase in the cGVHD activity score in the treated group of patients at any time from the start of HRT. According to present data, HRT did not appear to influence the activity of cGVHD in young women who underwent ABMT for hematological malignancies. Therefore, we can safely propose this therapy for women with gonadal failure after ABMT.

Adjuvant oestrogen therapy does not improve disease activity in postmenopausal patients with rheumatoid arthritis.

To investigate whether oestrogens can be used as treatment to diminish disease activity in women with rheumatoid arthritis. Forty postmenopausal female patients with active rheumatoid arthritis participated in a placebo-controlled, double-blind study on the possible beneficial effect of adjuvant treatment of oestradiol on disease activity. Thirty three patients completed 52 weeks of treatment with 2 mg oestradiol-valerate or placebo. No statistically significant difference was found in and between both treatment groups with regard to articular indices, pain score by visual analogue scale, erythrocyte sedimentation rate and health questionnaire on daily activities before, during and at the end of the study. This first randomised prospective placebo-controlled study shows no beneficial effect of oestrogens on disease activity in postmenopausal female patients with rheumatoid arthritis.

Can oestrogens be used as adjuvant therapy in female patients with rheumatoid arthritis?

In this review the arguments for a relation between female sex hormones and rheumatoid arthritis are discussed. Clinical evidence includes a relation between disease activity and menstrual cycle and a clear decrease in disease activity during pregnancy. A protective effect of oral contraceptives on the development of rheumatoid arthritis is claimed. There are conflicting data with regard to the plasma levels of sex hormones in women with rheumatoid arthritis. In vitro gonadal hormones suppress T-lymphocyte proliferation, while B-lymphocyte differentiation is enhanced by oestrogens and diminished by testosterone. Some pilot studies suggest that oestrogens may ameliorate disease activity in women with active rheumatoid arthritis. Presently we are conducting a randomized, double-blind trial comparing oestrogens with placebo as adjuvant therapy in women with rheumatoid arthritis.