Division of Rheumatology & Immunology, Duke University Medical Center (DUMC), Box 2918, Durham, NC, 27710, USA.
Global Healthy Living Foundation, CreakyJoints, Upper Nyack, NY, USA.
Clin Rheumatol. 2019 Apr;38(4):1207-1212. doi: 10.1007/s10067-018-04420-1. Epub 2019 Jan 16.
Rheumatoid arthritis (RA) and psoriatic arthritis (PsA) are common in women of childbearing age and are often treated with teratogenic medications. In this study, we assessed contraceptive methods in young women with RA or PsA and correlated contraceptive method efficacy with use of concomitant rheumatic medications. We combined the data from several cross-sectional surveys of women under the age of 40 with RA or PsA. Two surveys recruited participants from a clinic setting (RA and PsA Clinic Surveys), and the third survey recruited participants from CreakyJoints.org , an online forum for patients with inflammatory arthritis (CreakyJoints Survey). Of the 164 women included, 138 had RA (67 in RA Clinic Survey, 71 in CreakyJoints Survey) and 26 had PsA (19 in PsA Clinic Survey, 7 in CreakyJoints Survey). Use of specific contraceptive and rheumatic medications were similar between the clinic and online surveys. In the pooled analysis of the Clinic and CreakyJoints survey data, women with RA and PsA reported similar utilization of highly effective contraception methods (31.9% RA, 34.6% PsA) and effective methods (31.2% RA, 30.8% PsA), but different utilization of ineffective methods (35.5% RA, 11.5% PsA) and no methods (1.5% RA, 23.1% PsA), p = 0.0002. These proportions remained similar across subgroups taking methotrexate, anti-TNF biologics, and novel medications. Approximately two thirds of women with RA and PsA reported using effective or highly effective methods of contraception, though women with PsA were more likely to report no methods of contraception.
类风湿关节炎(RA)和银屑病关节炎(PsA)在育龄妇女中很常见,常使用致畸药物治疗。本研究评估了年轻 RA 或 PsA 女性的避孕方法,并将避孕方法的效果与同时使用的风湿药物进行了相关性分析。我们合并了几项年龄在 40 岁以下的 RA 或 PsA 女性的横断面研究的数据。两项调查从诊所招募参与者(RA 和 PsA 诊所调查),第三项调查从 CreakyJoints.org 招募参与者,这是一个为炎症性关节炎患者设立的在线论坛(CreakyJoints 调查)。在纳入的 164 名女性中,138 名患有 RA(RA 诊所调查中有 67 名,CreakyJoints 调查中有 71 名),26 名患有 PsA(PsA 诊所调查中有 19 名,CreakyJoints 调查中有 7 名)。诊所和在线调查中使用的特定避孕和风湿药物相似。在诊所和 CreakyJoints 调查数据的汇总分析中,RA 和 PsA 女性报告了相似的高效避孕方法(31.9% RA,34.6% PsA)和有效方法(31.2% RA,30.8% PsA)的使用情况,但低效方法(35.5% RA,11.5% PsA)和无方法(1.5% RA,23.1% PsA)的使用情况不同,p=0.0002。这些比例在服用甲氨蝶呤、抗 TNF 生物制剂和新型药物的亚组中保持相似。大约三分之二的 RA 和 PsA 女性报告使用了高效或高效的避孕方法,但 PsA 女性更有可能报告没有避孕方法。