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Influence of hormone replacement therapy on disease progression and bone mineral density in rheumatoid arthritis

D'Elia, Helena Forsblad; Larsen, Arvi; Mattsson, Lars-Åke; Waltbrand, Eva; Kvist, Göran; Mellstrom, Dan; Saxne, Tore LU ; Ohlsson, Claes; Nordborg, Elisabeth and Carlsten, Hans (2003) In Journal of Rheumatology 30(7). p.1456-1463
Abstract
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... (More)
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. (Less)
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author
organization
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Contribution to journal
publication status
published
subject
in
Journal of Rheumatology
volume
30
issue
7
pages
1456 - 1463
publisher
J Rheumatol Publ Co
external identifiers
  • pmid:12858441
  • scopus:0038166889
ISSN
0315-162X
language
English
LU publication?
yes
id
f6d16673-b02d-4983-9ef9-033c62525390 (old id 1126939)
date added to LUP
2008-06-10 11:25:11
date last changed
2018-05-29 11:10:11
@article{f6d16673-b02d-4983-9ef9-033c62525390,
  abstract     = {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 &lt; 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.},
  author       = {D'Elia, Helena Forsblad and Larsen, Arvi and Mattsson, Lars-Åke and Waltbrand, Eva and Kvist, Göran and Mellstrom, Dan and Saxne, Tore and Ohlsson, Claes and Nordborg, Elisabeth and Carlsten, Hans},
  issn         = {0315-162X},
  language     = {eng},
  number       = {7},
  pages        = {1456--1463},
  publisher    = {J Rheumatol Publ Co},
  series       = {Journal of Rheumatology},
  title        = {Influence of hormone replacement therapy on disease progression and bone mineral density in rheumatoid arthritis},
  volume       = {30},
  year         = {2003},
}