Deshiré Alpizar-Rodriguez1, Rüdiger B Mueller2, Burkhard Möller3, Jean Dudler4, Adrian Ciurea5, Pascal Zufferey6, Diego Kyburz7, Ulrich A Walker7, Ines von Mühlenen8, Pascale Roux-Lombard9, Michael Mahler10, Celine Lamacchia1, Delphine S Courvoisier1, Cem Gabay1, Axel Finckh1. 1. Division of Rheumatology, Department of Internal Medicine Specialties, University Hospitals of Geneva, Geneva. 2. Division of Rheumatology, Immunology and Rehabilitation, Kantonsspital St Gallen, St Gallen. 3. Department of Rheumatology, University Hospital of Bern, Bern. 4. Department of Rheumatology, Kantonsspital Fribourg, Fribourg. 5. Department of Rheumatology, University Hospital Zurich, Zurich. 6. Department of Rheumatology, Lausanne University Hospital, Lausanne. 7. Department of Rheumatology, University Hospital and University of Basel. 8. Rheumatology Office, Rheuma-Basel, Basel, Switzerland. 9. Division of Immunology and Allergy, Department of Internal Medicine Specialties, University Hospitals of Geneva, Geneva, Switzerland. 10. Inova Diagnostics, San Diego, CA, USA.
Abstract
Objectives: To analyse the association between female hormonal factors and the development of systemic autoimmunity associated with RA in women at increased risk for RA, namely first-degree relatives of patients with RA (RA-FDRs). Methods: In an ongoing cohort study of RA-FDRs, we analysed all women with available ACPA status. The primary outcome was ACPA positivity. The predictors of interest were female hormonal factors, such as oral contraceptives, breastfeeding, post-menopausal status, early post-menopausal period and total number of ovulatory years. Results: A total of 768 female RA-FDRs were analysed, of which 42 (5%) had developed ACPA positivity. ACPA-positive women were older (52 vs 44 years, P = 0.001). Hormonal factors significantly and independently associated with the presence of ACPA were the post-menopausal (P < 0.001) and the early post-menopausal periods (P = 0.040). Conclusions: In women at increased risk of RA, characteristic systemic autoimmunity was associated with menopause, suggesting that the acute decline in ovarian function might contribute to the development of autoimmunity associated with RA and potentially to the increased risk of RA in women.
Objectives: To analyse the association between female hormonal factors and the development of systemic autoimmunity associated with RA in women at increased risk for RA, namely first-degree relatives of patients with RA (RA-FDRs). Methods: In an ongoing cohort study of RA-FDRs, we analysed all women with available ACPA status. The primary outcome was ACPA positivity. The predictors of interest were female hormonal factors, such as oral contraceptives, breastfeeding, post-menopausal status, early post-menopausal period and total number of ovulatory years. Results: A total of 768 female RA-FDRs were analysed, of which 42 (5%) had developed ACPA positivity. ACPA-positive women were older (52 vs 44 years, P = 0.001). Hormonal factors significantly and independently associated with the presence of ACPA were the post-menopausal (P < 0.001) and the early post-menopausal periods (P = 0.040). Conclusions: In women at increased risk of RA, characteristic systemic autoimmunity was associated with menopause, suggesting that the acute decline in ovarian function might contribute to the development of autoimmunity associated with RA and potentially to the increased risk of RA in women.
Authors: Heather M Berens; Kristen J Polinski; Ted R Mikuls; Sonia Khatter; Justin August; Ashley Visser; Michael Mahler; Michael H Weisman; James R O'Dell; Richard M Keating; Jane H Buckner; Peter K Gregersen; Jill M Norris; V Michael Holers; Kevin D Deane; M Kristen Demoruelle Journal: J Rheumatol Date: 2019-04-15 Impact factor: 4.666
Authors: Kristin E Burke; Ashwin N Ananthakrishnan; Paul Lochhead; Po-Hong Liu; Ola Olen; Jonas F Ludvigsson; James M Richter; Shelley S Tworoger; Andrew T Chan; Hamed Khalili Journal: Gastroenterology Date: 2018-08-23 Impact factor: 22.682
Authors: Laure Brulhart; Deshiré Alpízar-Rodríguez; Michael S Nissen; Pascal Zufferey; Ileana Ciubotariu; Gregory Fleury; Ilias Lazarou; Cem Gabay; Axel Finckh Journal: RMD Open Date: 2019-08-23