Oral contraceptives may reduce the risk of rheumatoid arthritis, according to a recent report published by Hadizadeh et al in Rheumatology. In a prospective study, investigators used the UK Biobank to analyze data from 236,602 patients taking oral contraceptives and 102,466 patients receiving hormone therapy for menopause with the goal of determining whether exogenous sex hormones may impact the risk of rheumatoid arthritis in patients who are of reproductive age and older. The investigators discovered that ever-users [hazard ratio [HR] = 0.89, 95% confidence interval [CI] = 0.82–0.96), current users (HR = 0.81, 95% CI = 0.73–0.91), and former users (HR = 0.92, 95% CI = 0.84–1.00) of oral contraceptives had a decreased risk of developing rheumatoid arthritis compared with never-users. Conversely, ever-users (HR = 1.16, 95% CI = 1.06–1.26) and former users (HR= 1.13, 95% CI = 1.03–1.24) of menopausal hormone therapy were found to be at an increased risk of developing late-onset rheumatoid arthritis compared with never-users. The investigators emphasized that their findings highlight the potential inverse effect of exposure to different exogenous sex hormones on the risk of rheumatoid arthritis. In a companion press release on the findings from Uppsala University, the investigators concluded: “Our study is a step forward in understanding the complex interaction between hormone use and rheumatoid arthritis [and] may lead to better-informed recommendations [for female patients] who have a heightened risk of … rheumatoid arthritis.”
October 26, 2023