Age, Menopausal State at Presentation Influence Course of Rheumatoid Arthritis

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Age, Menopausal State at Presentation Influence Course of

Rheumatoid Arthritis

WESTPORT, CT (Reuters Health) Sept 07 - Both higher age and

postmenopausal status at presentation are significant in the

progression of early rheumatoid arthritis (RA), leading to a

faster disease course in women, according to a report in the

Journal of Rheumatology for August.

The researchers explain that, among adult Caucasians, " women

are more frequently afflicted with RA than men " at a ratio

of 2:1 or 3:1, and it is generally acknowledged that there

is a difference in disease progression between women and

men. " There is, however, no agreement in whether women or

men have a more severe disease course, " state the

researchers.

Dr. Piet L. C. M. van Riel from the University Medical

Center St. Radboud in Nijmegen, the Netherlands, and

associates used the Disease Activity Score to determine the

influence of menopausal state, sex and age on progression

and outcome of early RA in men and women matched for age.

The investigators rated the disease progress of 209 women

and 123 men, ages 17 to 53, over 6 years of followup.

Compared with male patients, radiographic joint destruction

was higher in the female patients at baseline, and physical

disability was significantly worse. Postmenopausal women had

significantly worse physical disability than premenopausal

women at baseline and at 3 years. Older men had greater

radiographic joint destruction and were more physically

disabled than younger men at all timepoints in the study.

At 3 years, female sex and higher age were the overall best

predictors for worse Disease Activity Score, the researchers

found.

" In future research, menopausal state and the interaction

term between age and menopausal state should be taken into

account when explaining RA outcome variables, " they

conclude, as " older patients who are at the same time

postmenopausal have even more severe disease in terms of

joint destruction and physical disability. "

J Rheumatol 2001;28:1809-1816.