Table 5.
Prior studies investigating the relationship between PHT and RA incidence and severity*
| Author (ref.), year | Trial design | PHT stratification | Results | |
|---|---|---|---|---|
| RA incidence | ||||
| Vandenbroucke (12), 1986 |
Case-control | Substitution hormones/substitution estrogens |
Protective: OR 0.32 (95% CI 0.16, 0.64) | |
| Carette (14), 1989 | Case-control | Never users/past users/current users |
Protective: past users OR 0.95 (95% CI 0.56, 1.60) |
|
| Protective: current users OR 0.89 (95% CI 0.49, 1.63) |
||||
| Hernandez-Avila (18), 1990 |
Prospective cohort | Never users/past users/current users |
Protective: past users OR 0.7 (95% CI 0.5, 1.2) |
|
| Not protective: current users OR 1.3 (95% CI 0.9, 2.0) |
||||
| Spector (15), 1991 | Case-control | ERT per person-years | Not protective: OR 1.08 (95% CI 0.30, 6.75) |
|
| Koepsell (16), 1994 | Case-control | E-alone/E+P | Not protective: E-alone RR 0.97 (95% CI 0.62, 1.53) |
|
| Not protective: E+P RR 0.81 (95% CI 0.45, 1.45) |
||||
| Merlino (19), 2003 | Cohort | Never users/past users/current users |
Not protective: past users RR 1.47 (95% CI 1.04, 2.06) |
|
| Not protective: current users RR 1.02 (95% CI 0.61, 1.72) |
||||
| Doran (17), 2004 | Case-control | Never users/any users/current users |
Not protective: any users OR 1.26 (95% CI 0.81, 1.96) |
|
| Not protective: current users OR 1.67 (95% CI 0.81, 3.41) |
||||
| Karlson (20), 2004 | Prospective cohort | Never users/past users/current users |
Not protective: past users RR 1.3 (95% CI 1.0, 1.6) |
|
| Not protective: current users RR 1.0 (95% CI 0.8, 1.3) |
||||
| RA severity | ||||
| Bijlsma (21), 1987 | 12-week double-blind crossover |
E-alone vs. placebo | Improved 30-meter walking time (P = 0.03) |
|
| Van den Brink (25), 1993 |
52-week double-blind placebo-controlled |
E+P vs. placebo | Worse pain VAS at 12 months (P = 0.01) |
|
| Hall (23), 1994 | 6-month single-blind placebo-controlled |
E+P vs. placebo | No difference in noncompliers; improvement in articular index (P < 0.001), pain score (P < 0.05), and morning stiffness (P < 0.001) in compliers |
|
| MacDonald (24), 1994 | 48-week double-blind placebo-controlled |
Estrogen patches ± progestin vs. placebo |
Improvement in Nottingham Health Care Profile (P < 0.01) |
|
| D'Elia (22), 2003 | 2-year single-blind placebo-controlled |
E+P (2 types) or E-alone vs. placebo |
Improvement in ESR (P = 0.025), DAS28 (P = 0.036), Larsen score (P = 0.026) |
|
*
PHT = postmenopausal hormone therapy; RA = rheumatoid arthritis; OR = odds ratio; 95% CI = 95% confidence interval; ERT = estrogen replacement therapy; E-alone = estrogen alone; E+P = estrogen plus progestin; RR = relative risk; VAS = visual analog scale; ESR = erythrocyte sedimentation rate; DAS28 = Disease Activity Score in 28 joints.