Early menopause predicts a milder form of rheumatoid arthritis

Berlin, Germany, June 8 2012 : A new study presented today at EULAR 2012, the Annual Congress of the European League Against Rheumatism, shows that early menopause predicts a milder form of rheumatoid arthritis (RA). New insights on factors influencing RA are good news for sufferers of the chronic inflammatory disease that currently affects over 2 million women in Europe. 1,2

The study, based on 134 incident RA cases, found that patients aged over 45 years with a history of early menopause were 50% less likely to develop severe RA (16% versus 35%) and more likely to develop a mild/moderate rheumatoid factor (RF) negative phenotype (58% versus 20%). There was no major difference in RA severity depending on oral contraceptive use or history of breast feeding. This study highlights that hormonal changes may influence pathways that are distinct from those leading to severe, progressive disease.

Dr. Mitra Pikwer from Skåne University Hospital, Sweden, and lead study author commented: "We already know that hormonal factors may influence the risk of RA, but this is the first study we know of that investigates the impact of menopausal age on the severity of RA. This is an important breakthrough, both in helping us understand the impact that hormones may have on the development of this disease and potentially also in helping us predict the long-term prognosis for our patients."

The study identified patients who answered a questionnaire in a community based health survey (conducted between 1991 and 1996) and later developed RA. Information on hormonal predictors including breastfeeding history, history of oral contraceptive use and menopausal age (early menopause ≤45 years or normal/late menopause > 45 years) was obtained via the questionnaire. By a structured review of the patients medical records, relevant information such as use of disease modifying anti-rheumatic drugs (DMARDs) including biological treatment, radiographic erosions, rheumatoid factor (RF) status as well as Health Assessment Questionnaire (HAQ*) data was collected. These variables were added to the SPSS TwoStep Cluster Analysis in order to reveal natural groupings of RA severity.

RA is a chronic inflammatory disease with female predominance. Hormonal factors such as breast-feeding history, use of oral contraceptives and menopausal age have all been suggested to influence the risk of RA. As yet the underlying mechanisms and their impact on disease progression are unknown.

Abstract Number: FRI0087

*HAQ (Health Assessment Questionnaire) is a patient questionnaire that measures function and health-related quality of life through measuring a patient's ability to perform everyday tasks.

1. Bevan S, Quadrello T, McGee R et al. Fit for work? Musculoskeletal disorders in the European workforce. http://www.fundacionabbott.es/saludytrabajo/descargas/Fit_for_Work_pan_European_report.pdf

2. Englund M, Jöud A, Geborek P et al. Prevalence and incidence of rheumatoid arthritis in southern Sweden 2008 and their relation to prescribed biologics. Rheumatology 2010; 49: 1563-9

NOTES TO EDITORS:

For further information on this study, or to request an interview with the study lead, please do not hesitate to contact the EULAR congress Press Office in Hall 6 on the 3rd floor of the Congress Centre during EULAR 2012 or on:

Email: eularpressoffice@cohnwolfe.com

Candice Debleu: Onsite tel: +44 7894 386 425

• The European League Against Rheumatism (EULAR) is the organisation which represents the patient, health professional and scientific societies of rheumatology of all the European nations
• In line with The European Union of Medical Specialists (UEMS), EULAR defines rheumatology as including rheumatic diseases of the connective tissue, locomotor and musculoskeletal systems
• EULAR aims to promote, stimulate and support the research, prevention, treatment and rehabilitation of rheumatic diseases. With 45 scientific member societies, 36 PARE organisations and 10 health professionals associations, EULAR underscores the importance of combating rheumatic diseases not only by medical means, but also through a wider context of care for rheumatic patients and a thorough understanding of their social and other needs
• Diseases of the bone and joints such as rheumatoid arthritis and osteoarthritis cause disability in 4-5% of the adult population and are predicted to rise as people live longer
• EULAR 2012 is set to be the biggest rheumatology event in Europe with over 15,000 scientists, physicians, allied health professionals, and related audiences in attendance from over 115 countries. Over the course of the congress, more than 275 oral and 1400 poster abstract presentations will be featured, with 1,010 invited speaker lectures taking place in 190 sessions
• To find out more about the activities of EULAR, visit: www.eular.org