Yuk Jin-Sung, Seo Yong-Soo, Im Yo Han, Kim Ji Hyoun
Department of Obstetrics and Gynecology, School of Medicine, Inje University Sanggye Paik Hospital, Seoul, Republic of Korea.
Department of Internal Medicine, Chungbuk National University Hospital, 776, 1 Sunhwan-ro, Seowon-gu, Cheongju-si, Chungcheongbuk-do 28644, Republic of Korea.
Semin Arthritis Rheum. 2023 Dec;63:152280. doi: 10.1016/j.semarthrit.2023.152280. Epub 2023 Oct 13.
This retrospective cohort study aimed to investigate the impact of menopausal hormone therapy (MHT) on the incidence of rheumatoid arthritis (RA) in postmenopausal women and to examine the effects of each specific MHT drug.
In this Korean population-based cohort study, 452,124 women aged > 40 years who consulted a healthcare provider for menopause were evaluated from January 1, 2011, to December 31, 2014. After propensity score matching, 138,991 pairs were included in the MHT and non-MHT groups. Participants were followed up until December 31, 2020. RA was defined according to the International Classification of Diseases, 10th edition, limited to seropositive RA (M05).
RA developed in 567 (0.4 %) of the 138,424 patients in the MHT group. The RA risk in the MHT group was not significantly increased compared with that of controls (hazard ratio [HR] 1.12, 95 % confidence interval [CI] 0.998-1.256). However, MHT use for ≤ 3 years was associated with an increased risk of RA (HR 1.277, 95 % CI 1.127-1.447). When estrogen/progestogen was used, the HR was 1.24 (95 % CI 1.05-1.46), whereas when tibolone was used, the HR was 1.33 (95 % CI 1.13-1.57).
The use of MHT did not show a significant impact on the development of RA in postmenopausal women. However, a subanalysis that specifically examined the duration of MHT revealed a noteworthy increase in the risk of RA during the initial 3 years of MHT use.
这项回顾性队列研究旨在调查绝经后激素治疗（MHT）对绝经后女性类风湿关节炎（RA）发病率的影响，并检验每种特定MHT药物的效果。
在这项基于韩国人群的队列研究中，对2011年1月1日至2014年12月31日期间因绝经问题咨询医疗服务提供者的452,124名40岁以上女性进行了评估。在倾向评分匹配后，MHT组和非MHT组纳入了138,991对。参与者随访至2020年12月31日。RA根据《国际疾病分类》第10版进行定义，仅限于血清学阳性RA（M05）。
MHT组138,424名患者中有567名（0.4%）发生了RA。与对照组相比，MHT组的RA风险没有显著增加（风险比[HR]1.12，95%置信区间[CI]0.998 - 1.256）。然而，使用MHT≤3年与RA风险增加相关（HR 1.277，95%CI 1.127 - 1.447）。使用雌激素/孕激素时，HR为1.24（95%CI 1.05 - 1.46），而使用替勃龙时，HR为1.33（95%CI 1.13 - 1.57）。
MHT的使用对绝经后女性RA的发生没有显著影响。然而，一项专门研究MHT使用时长的亚分析显示，在使用MHT的最初3年期间，RA风险有显著增加。
