OBJECTIVE:Hormone replacement therapy (HRT) is known to exert a positive effect in preventing bone loss and a beneficial effect on the disease activity in rheumatoid arthritis (RA). We evaluated the effects of HRT on bone mineral density (BMD) and on the course of established RA. METHODS:Eighty-eight postmenopausal women with RA were randomly allocated to receive HRT, vitamin D3, and calcium supplementation or vitamin D3 and calcium supplementation alone for 2 years. The effects of additional HRT on laboratory and clinical measures of disease activity, quality of life, and BMD and on radiographic joint damage were investigated. RESULTS: Treatment with HRT suppressed signs of inflammation as shown by reduction in erythrocyte sedimentation rate (ESR) (p = 0.025) and an elevation in hemoglobin concentration (p = 0.007), a better clinical outcome assessed by response on the Disease Activity Score 28 (DAS28) (p = 0.036), increased BMD in the forearm, proximal femur and spine (p < 0.01), and retarded (p = 0.026) progression of joint destruction among patients with radiological progressive disease. No significant effect on quality of life was seen. CONCLUSION: Two years of HRT in women with active RA had significant ameliorating effects on inflammation, DAS28 response, and BMD and was associated with slower progression of radiological joint destruction. The mechanisms by which HRT exerts its effects remain to be elucidated. We suggest HRT can be used in addition to conventional therapy in the management of postmenopausal patients with RA.
RCT Entities:
OBJECTIVE: Hormone replacement therapy (HRT) is known to exert a positive effect in preventing bone loss and a beneficial effect on the disease activity in rheumatoid arthritis (RA). We evaluated the effects of HRT on bone mineral density (BMD) and on the course of established RA. METHODS: Eighty-eight postmenopausal women with RA were randomly allocated to receive HRT, vitamin D3, and calcium supplementation or vitamin D3 and calcium supplementation alone for 2 years. The effects of additional HRT on laboratory and clinical measures of disease activity, quality of life, and BMD and on radiographic joint damage were investigated. RESULTS: Treatment with HRT suppressed signs of inflammation as shown by reduction in erythrocyte sedimentation rate (ESR) (p = 0.025) and an elevation in hemoglobin concentration (p = 0.007), a better clinical outcome assessed by response on the Disease Activity Score 28 (DAS28) (p = 0.036), increased BMD in the forearm, proximal femur and spine (p < 0.01), and retarded (p = 0.026) progression of joint destruction among patients with radiological progressive disease. No significant effect on quality of life was seen. CONCLUSION: Two years of HRT in women with active RA had significant ameliorating effects on inflammation, DAS28 response, and BMD and was associated with slower progression of radiological joint destruction. The mechanisms by which HRT exerts its effects remain to be elucidated. We suggest HRT can be used in addition to conventional therapy in the management of postmenopausal patients with RA.
Authors: Lidia Ibáñez; Maria José Alcaraz; Nuria Maicas; David Guede; José Ramón Caeiro; Marije I Koenders; Wim B van den Berg; Maria Luisa Ferrándiz Journal: Inflammation Date: 2011-12 Impact factor: 4.092
Authors: U Islander; M C Erlandsson; T Chavoshi; C Jochems; S Movérare; S Nilsson; C Ohlsson; J-A Gustafsson; H Carlsten Journal: Clin Exp Immunol Date: 2005-02 Impact factor: 4.330
Authors: Tuulikki Sokka; Sergio Toloza; Maurizio Cutolo; Hannu Kautiainen; Heidi Makinen; Feride Gogus; Vlado Skakic; Humeira Badsha; Tõnu Peets; Asta Baranauskaite; Pál Géher; Ilona Ujfalussy; Fotini N Skopouli; Maria Mavrommati; Rieke Alten; Christof Pohl; Jean Sibilia; Andrea Stancati; Fausto Salaffi; Wojciech Romanowski; Danuta Zarowny-Wierzbinska; Dan Henrohn; Barry Bresnihan; Patricia Minnock; Lene Surland Knudsen; Johannes Wg Jacobs; Jaime Calvo-Alen; Juris Lazovskis; Geraldo da Rocha Castelar Pinheiro; Dmitry Karateev; Daina Andersone; Sylejman Rexhepi; Yusuf Yazici; Theodore Pincus Journal: Arthritis Res Ther Date: 2009-01-14 Impact factor: 5.156