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No Benefit to Rheumatoid Arthritis Found with Hormone Replacement Therapy 2-29-08
WASHINGTON, Feb. 29 -- Postmenopausal hormone therapy neither reduces the
risk of rheumatoid arthritis nor eases the severity of the condition's symptoms,
researchers here reported.
Participants in the Women's Health Initiative randomized to estrogen plus
progestin were less likely to develop arthritis than those taking placebo, but
the difference was not statistically significant, (HR 0.74, 95% CI 0.51 to
1.10), found Brian Walitt, M.D., M.P.H., of the Washington Hospital Center, and
colleagues.
Hormone replacement also did not reduce swelling or prevent new joint pain in
pre-existing rheumatoid arthritis, they reported in the March 15 issue of
Arthritis & Rheumatism.
The Women's Health Initiative "is the only placebo-controlled trial to evaluate
the effect of [postmenopausal hormone therapy] on the initial development of
RA," Dr. Walitt said.
The WHI recruited 27,347 postmenopausal women who were randomized to
estrogen-progestin or placebo if they had intact uteri or to estrogen or placebo
for women who had surgical menopause.
The trial, funded by the National Heart, Lung, and Blood Institute, was halted
when the monitoring committee determined that the active treatment was
associated with increased risk of several conditions, including breast cancer,
stroke, and deep vein thrombosis, while offering no cardiovascular benefit.
It was the sixth randomized trial to evaluate the effect of hormone replacement
on perceived severity of rheumatoid arthritis.
But because of its size and duration, which was 7.1 years in the estrogen only
arm and 5.6 years in the estrogen-progestin arm, the WHI offered a "unique
opportunity" to examine the effects of postmenopausal hormone replacement
therapy on RA.
The authors concluded "there was no statistically significant evidence" to
support the use of hormone replacement to reduce risk of rheumatoid arthritis or
to ease symptoms.
But they said the "results do demonstrate trends suggesting that [postmenopausal
hormone therapy] may protect against developing RA. In our Kaplan-Meier plots,
we note that there is separation between the placebo and the
[estrogen/progestin] arms at two years and what appears to be divergence at four
years."
The trend, they wrote, was more apparent with unopposed estrogen use.
There were, however, no significant interaction effects, which limited the
prognostic utility of those trends.
The authors identified 63 prevalent cases of RA and 105 incident cases among
study participants. So the prevalence of RA was about half of the expected rate
(0.5% to 1%) -- a possible limitation.
The authors said, too, that the study relied on self-reporting of disease
states, another limitation.
Comment: Please Note the study did not use progesterone but progestin. Progestin comes from horse urine and has no benefit in the human body. Natural Bio-identical progesterone does reduce inflammatory interleukins, and prostaglandins. Natural Bio-identical progesterone cream in conjunction with Organic Evening Primrose oil and Molecularly distilled fish oil; work better than steroids or tumor necrosis factor alpha (TNFα) blockers.
Rheumatoid arthritis is a autoimmune disorder and anything you can do to lessen the body's immune response is helpful in stopping the spread of this disease. Remove food allergies, chemical allergies, and bodily toxicities (heavy metals, drug residues). Colon toxicity plays a very strong role in RA. Bella Mira Perfect Enzymes taken on an empty stomach 3 times a day removes toxicity in the blood and joints and reverses RA.