St. John Fisher College, Wegmans School of Pharmacy, Rochester, New York, USA.
J Obstet Gynaecol Res. 2022 Feb;48(2):306-312. doi: 10.1111/jog.15097. Epub 2021 Dec 8.
Combined oral contraceptives are a common method of contraception and many females prefer them regardless of their medical history. The use in patients with rheumatoid and autoimmune disorders has not been extensively studied with previous reviews focusing on the safety component. This review seeks to address the effectiveness and benefits of utilizing combined oral contraceptives in females with rheumatoid arthritis (RA). Current literature regarding combined oral contraceptives was surveyed for its use in RA and two PubMed searches were conducted, yielding 202 and 142 results, respectively. Results were screened and analyzed for relevance to this review topic. Eighteen results, consisting of clinical trials, observational studies, patient cases, and meta-analyses were used in this narrative review. Historically, it was thought that females with an autoimmune disorder such as RA need to be on contraception due to the teratogenicity potential with disease-modifying therapy but no evidence exists about which type of contraception is the most effective and least interacting. Current evidence available shows no preference for types of contraception in this population, but it has been demonstrated that combination oral contraceptives may provide contraceptive benefits and have a potential for other benefits such as less disability and the prevention of disease progression. Although current evidence provides reasoning to believe combination oral contraceptives are safe and efficacious in patients with RA and may even offer additional benefits, further studies and clinical trials are needed to completely understand the role combination oral contraceptives play in this patient population.
口服避孕药是一种常见的避孕方法，许多女性无论其病史如何，都更喜欢使用它。以前的综述主要关注安全性方面，因此对于类风湿和自身免疫性疾病患者的使用情况尚未进行广泛研究。本综述旨在探讨在类风湿关节炎（RA）女性中使用口服避孕药的有效性和益处。针对口服避孕药在 RA 中的应用，对当前的文献进行了调查，并进行了两次 PubMed 搜索，分别产生了 202 项和 142 项结果。对结果进行筛选和分析，以确定其与本综述主题的相关性。本叙述性综述使用了 18 项结果，包括临床试验、观察性研究、病例报告和荟萃分析。从历史上看，人们认为患有 RA 等自身免疫性疾病的女性由于疾病修饰治疗的致畸性而需要避孕，但没有证据表明哪种避孕方法最有效且相互作用最小。目前的可用证据表明，该人群中对避孕方法没有偏好，但已证明复方口服避孕药可能提供避孕益处，并具有其他益处的潜力，例如减少残疾和预防疾病进展。尽管目前的证据表明，在 RA 患者中，复方口服避孕药是安全有效的，甚至可能提供额外的益处，但仍需要进一步的研究和临床试验来完全了解复方口服避孕药在这一患者群体中的作用。
