AB0234 Oral contraceptives, menopause and rheumatoid arthritis in korean women: a nationwide study

Background

Rheumatoid arthritis (RA) is a chronic autoimmune inflammatory disease with a multifactorial etiology. Hormonal factors, ethnicity and their interaction may result in the development of RA.

Objectives

We investigated the effects of oral contraceptives (OCs) and menopause on RA in South Korea women using nationwide data.

Methods

Data were collected from the 2008–2012 Korea National Health and Nutrition Examination Surveys. A total of 17,890 eligible participants were included. As there were significant differences in baseline characteristics between the patients on OCs and those not taking OCs, we used propensity score-matching to adjust for such differences. We calculated the odds ratios (ORs) and 95% confidence intervals (95% CIs) of OCs leading to RA development.

Results

The peak incidence of RA was between 50–59 years old. The overall rate of OC usage was 16.5% and mean duration of OC using was 18.41±28.78 (ranged from 0 to 360) months. Before propensity score-matching, using multivariable logistic regression adjusted for traditional risk factors, taking OC was a significantly associated with RA development (OR 1.18, 95% CI 1.18–1.19, p <0.001). After propensity score-matching, taking OCs was not associated with RA (OR 1.05, 95% CI 0.83–1.34, p <0.001). Menopausal status showed strongly significant increase in the risk of RA.

Conclusions

There was an association between menopausal status and RA development in South Korean women. However, usage of OCs did not show significant effects on the development of RA.

References

Pikwer M, Bergstrom U, Nilsson JA, Jacobsson L, Berglund G, Turesson C. Breast feeding, but not use of oral contraceptives, is associated with a reduced risk of rheumatoid arthritis. Ann Rheum Dis 2009;68:526–30. Hazes JM, van Zeben D. Oral contraception and its possible protection against rheumatoid arthritis. Ann Rheum Dis 1991;50:72–4. Pullerits R, d9Elia HF, Tarkowski A, Carlsten H. The decrease of soluble RAGE levels in rheumatoid arthritis patients following hormone replacement therapy is associated with increased bone mineral density and diminished bone/cartilage turnover: a randomized controlled trial. Rheumatology (Oxford) 2009;48:785–90. Doran MF, Crowson CS, O9Fallon WM, Gabriel SE. The effect of oral contraceptives and estrogen replacement therapy on the risk of rheumatoid arthritis: a population based study. J Rheumatol 2004;31:207–13.

Disclosure of Interest

None declared