A study recently published in RMD Open, a BMJ publication, suggests that HRT may be associated with an increased risk of rheumatoid arthritis.

Rheumatoid arthritis (RA) is more prevalent in women than men. The prospective cohort study used data collected from UK Biobank participants.  Whilst the results of the study are interesting, the clinical significance is limited, as it would be in any observational study.

The authors identified an increase in risk of RA associated with menarche occurring over the age of 14, menopause occurring below the age of 45, women having 4 or more children and in women who had had a hysterectomy or oophorectomy. In addition, they claim an increase in the relative risk of women developing RA in association with use of HRT (RR 1.46). However, they acknowledge a conflicting effect of hormone status on the risk of RA developing.

Whilst reproductive factors may influence the risk of women developing RA, it is important to recognise the effect of other factors, including genetics. The British Menopause Society advises caution in relation to the interpretation of this data and recommends that clinicians continue to provide holistic care to women, particularly those experiencing early menopause.

Newer biological treatment options have reduced the risk of irreversible joint damage occurring and women with RA should not be prevented from accessing HRT if they need it.

To find out more, please go to the RMD Open website.