Abstract：
This retrospective cohort study aimed to investigate the impact of menopausal hormone therapy (MHT) on the incidence of rheumatoid arthritis (RA) in postmenopausal women and to examine the effects of each specific MHT drug.
In this Korean population-based cohort study, 452,124 women aged > 40 years who consulted a healthcare provider for menopause were evaluated from January 1, 2011, to December 31, 2014. After propensity score matching, 138,991 pairs were included in the MHT and non-MHT groups. Participants were followed up until December 31, 2020. RA was defined according to the International Classification of Diseases, 10th edition, limited to seropositive RA (M05).
RA developed in 567 (0.4 %) of the 138,424 patients in the MHT group. The RA risk in the MHT group was not significantly increased compared with that of controls (hazard ratio [HR] 1.12, 95 % confidence interval [CI] 0.998-1.256). However, MHT use for ≤ 3 years was associated with an increased risk of RA (HR 1.277, 95 % CI 1.127-1.447). When estrogen/progestogen was used, the HR was 1.24 (95 % CI 1.05-1.46), whereas when tibolone was used, the HR was 1.33 (95 % CI 1.13-1.57).
The use of MHT did not show a significant impact on the development of RA in postmenopausal women. However, a subanalysis that specifically examined the duration of MHT revealed a noteworthy increase in the risk of RA during the initial 3 years of MHT use.
In this Korean population-based cohort study, 452,124 women aged > 40 years who consulted a healthcare provider for menopause were evaluated from January 1, 2011, to December 31, 2014. After propensity score matching, 138,991 pairs were included in the MHT and non-MHT groups. Participants were followed up until December 31, 2020. RA was defined according to the International Classification of Diseases, 10th edition, limited to seropositive RA (M05).
RA developed in 567 (0.4 %) of the 138,424 patients in the MHT group. The RA risk in the MHT group was not significantly increased compared with that of controls (hazard ratio [HR] 1.12, 95 % confidence interval [CI] 0.998-1.256). However, MHT use for ≤ 3 years was associated with an increased risk of RA (HR 1.277, 95 % CI 1.127-1.447). When estrogen/progestogen was used, the HR was 1.24 (95 % CI 1.05-1.46), whereas when tibolone was used, the HR was 1.33 (95 % CI 1.13-1.57).
The use of MHT did not show a significant impact on the development of RA in postmenopausal women. However, a subanalysis that specifically examined the duration of MHT revealed a noteworthy increase in the risk of RA during the initial 3 years of MHT use.
摘要：
目的：这项回顾性队列研究旨在研究绝经后激素治疗（MHT）对绝经后妇女类风湿关节炎（RA）发病率的影响，并研究每种特定MHT药物的作用。
方法：在这项基于韩国人群的队列研究中，从2011年1月1日至2014年12月31日，对因更年期而咨询医疗保健提供者的452,124名年龄>40岁的女性进行了评估。在倾向得分匹配后，138,991对被包括在MHT和非MHT组中。参与者被随访到2020年12月31日。RA是根据国际疾病分类定义的，第10版,仅限于血清阳性RA（M05）。
结果：在MHT组138,424例患者中，有567例（0.4％）发生了RA。与对照组相比，MHT组的RA风险没有显着增加（风险比[HR]1.12，95％置信区间[CI]0.998-1.256）。然而,MHT使用≤3年与RA风险增加相关(HR1.277,95%CI1.127-1.447)。当使用雌激素/孕激素时，HR为1.24（95%CI1.05-1.46），而当使用替勃龙时，HR为1.33（95%CI1.13-1.57）。
结论：使用MHT对绝经后妇女RA的发展没有显著影响。然而,一项专门检查MHT持续时间的亚分析显示,在使用MHT的最初3年期间,RA风险显著增加.
方法：在这项基于韩国人群的队列研究中，从2011年1月1日至2014年12月31日，对因更年期而咨询医疗保健提供者的452,124名年龄>40岁的女性进行了评估。在倾向得分匹配后，138,991对被包括在MHT和非MHT组中。参与者被随访到2020年12月31日。RA是根据国际疾病分类定义的，第10版,仅限于血清阳性RA（M05）。
结果：在MHT组138,424例患者中，有567例（0.4％）发生了RA。与对照组相比，MHT组的RA风险没有显着增加（风险比[HR]1.12，95％置信区间[CI]0.998-1.256）。然而,MHT使用≤3年与RA风险增加相关(HR1.277,95%CI1.127-1.447)。当使用雌激素/孕激素时，HR为1.24（95%CI1.05-1.46），而当使用替勃龙时，HR为1.33（95%CI1.13-1.57）。
结论：使用MHT对绝经后妇女RA的发展没有显著影响。然而,一项专门检查MHT持续时间的亚分析显示,在使用MHT的最初3年期间,RA风险显著增加.
