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Association Between the Use of Oral Contraceptives and Patient‐Reported Outcomes in an Early Arthritis Cohort
Author(s) -
Albrecht Katinka,
Callhoff Johanna,
Buttgereit Frank,
Straub Rainer H.,
Westhoff Gisela,
Zink Angela
Publication year - 2016
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.22667
Subject(s) - medicine , cohort , rheumatoid arthritis , arthritis , odds ratio , body mass index , cohort study , inflammatory arthritis , physical therapy
Objective To evaluate the association between exposure to oral contraceptives (OCs) and clinical outcomes in an early arthritis cohort. Methods Female patients with early inflammatory arthritis, ages 18–60 years, who were enrolled in an early arthritis cohort and had no exposure to hormone replacement were studied (n = 273). Associations between OC exposure (current/past/never) and disease activity, treatment, and patient‐reported outcomes, including the Rheumatoid Arthritis Impact of Disease Score (RAID), the Rheumatoid Arthritis Disease Activity Index (RADAI), the Profile of Mood and Discomfort (PROFAD), and the Hannover Functional Assessment (FFbH), were studied over 2 years. Linear mixed models adjusted for age, body mass index, parity, smoking, and education were used. Results Eighteen percent of patients had never used OCs, 63% had used OCs in the past, and 19% currently used OCs. After adjustment, the current/past OC use was associated with better RAID, PROFAD, RADAI, and FFbH scores at 12 months ( P < 0.05 for all) compared to never use. Longitudinally over 2 years, the mean RAID scores were significantly better in women with current/past OC use ( P < 0.001). Actual inflammatory markers were not associated with OC use. Glucocorticoids were used by a higher percentage of OC never users than by current/past users ( P = 0.08), especially in patients with impaired function (FFbH <70: odds ratio 4.2 [95% confidence interval 1.6–11]). Conclusion For past as well as current use, OCs seem to moderate patient‐reported outcomes in inflammatory arthritis. Protective effects may be induced via central nervous pathways rather than through the suppression of peripheral inflammation.