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Hormonal replacement therapy may reduce the risk for RA in women with early arthritis who carry HLA-DRB1 *01 and/or *04 alleles by protecting against the production of anti-CCP: Results from the ESPOIR cohort.
  1. Carine Salliot (carinesalliot{at}gmail.com)
  1. Rheumatology B, Cochin Hospital, France
    1. Claire Bombardier
    1. Division of Rheumatology, Mount Sinai Hospital, Canada
      1. Alain Saraux
      1. Department of Rheumatology, University Hospital, Brest, France
        1. Bernard Combe
        1. Department of Rheumatology, Lapeyronnie University Hospital, France
          1. Maxime Dougados
          1. Rheumatology B, Cochin Hospital, France

            Abstract

            Objective: To assess the effect of reproductive factors, especially hormonal replacement therapy (HRT) and its interaction with HLA-DRB1 *01 and/or *04 alleles on the diagnosis of RA and the presence of anti-CCP in women included in the ESPOIR cohort (early arthritis cohort).

            Methods: 568 patients were included in the analyses. Analyses were performed using logistic regression.

            Results: HRT would reduce the risk for RA due to the HLA-DRB1 *01 and/or *04 alleles: from OR=1.88 (95%CI 1.32-2.68, p<0.000) for HLA-DRB1 *01 and/or *04 alleles alone to OR=1.07 (0.51-2.26, p=0.85) in women who carry HLA-DRB1 *01 and/or *04 alleles and who received a HRT. One explanation would be the protective effect of HRT on the presence of anti-CCP (OR=0.43, 95%CI 0.24-0.77, p<0.006). Other reproductive factors such as the number of pregnancies, menopause, and age of the menopause, age of the menarche and a history of pregnancy with poor outcome were not associated with the diagnosis of RA and the presence of anti-CCP.

            Conclusion: HRT may reduce the risk of RA due to HLA-DRB1 *01 and/or *04 alleles by protecting against the production of anti-CCP.

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