Effect of oral contraceptive pills on rheumatoid arthritis disease activity in women: A randomized clinical trial

Amini, Leila; Kalhor, Mehri; Haghighi, Anoushe; Seyedfatemi, Naiemeh; Hosseini, Fatemah

doi:10.14196/mjiri.32.61

Cited by 7 publications

(4 citation statements)

References 21 publications

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“…The effect of OCs was more pronounced on the DAS28 score; current users of OCs had significantly low DAS28 scores in comparison to past users and both of them had a lower score when compared with non-users. Our findings agree with Amini et al who found that the activity and severity of rheumatoid arthritis can be improved by oral contraceptive pills [30]. Also, Brouwer et al reported that oral contraceptives are considered the best option for RA patients as they positively affect the disease activity [31].…”

Section: Discussionsupporting

confidence: 92%

“…Fayed et al found that RA patients who are using combined oral contraceptives have the lowest disease severity in comparison to the other methods of contraception [32]. However, using OCs did not have any significant effect on ESR; this agrees with Amini et al [30], and it also had no significant effect on ACPA and RF titers in all studied groups.…”

Section: Discussionsupporting

confidence: 57%

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Impact of oral contraceptives and breastfeeding on disease activity in a sample of Egyptian rheumatoid arthritis patients

Elsayed

Henry

Elfadl

2020

Egypt Rheumatol Rehabil

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Background Women are more affected by rheumatoid arthritis (RA) than men and the incidence of RA in women increases around the age of menopause indicating that hormonal factors may have a role in disease pathogenesis and progression. Despite several studies on the role of sex hormones and oral contraceptives (OCs) in RA patients, the effect of combined oral contraceptives on RA disease activity is still controversial, and since few studies have been performed in Egypt on this issue so we aimed to study the effect of OCs, breastfeeding, and prolactin on disease activity and their relation to the titer of autoantibodies in female Egyptian RA patients. Results One hundred twenty married female RA patients were classified into three groups based on the OCs use (n = 40 each); current, past and non-users and according to lactation into three groups; lactating using OCs (n = 22), lactating not using OCs (n = 30), and non-lactating (n = 68). Our patients were using combined estrogen-progestin oral contraceptives. Clinical manifestations, disease activity, and laboratory findings were determined. The clinical manifestations including arthritis, and morning stiffness were significantly reduced in current users in comparison to past and non-users. Mean DAS28 was reduced significantly (p < 0.05) in current and past users of OCs. Also, using OCs during lactation reduced the clinical manifestations significantly. Lactating women who were not using OCs had significantly high DAS28 and ESR (p < 0.05) in comparison to lactating using OCs and non-lactating. On the other hand, using OCs reduced serum prolactin significantly. Lactating women not using OCs had significantly high serum prolactin (p < 0.05) and (p < 0.001) in comparison to lactating using OCs and non-lactating respectively which was correlated with DAS28 score. Conclusion Oral contraceptives may be considered in RA female patients not only as a suitable birth control method but also it has a controlling effect on disease activity even during lactation. Message Oral contraceptives ameliorate disease activity in RA patients

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 57%

Impact of oral contraceptives and breastfeeding on disease activity in a sample of Egyptian rheumatoid arthritis patients

Elsayed

Henry

Elfadl

2020

Egypt Rheumatol Rehabil

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“…These identified factors can induce anti-RA drug resistance, as seen with methotrexate, naproxen, dexamethasone, and other anti-RA drugs. [5][6][7][8] Experimental and clinical studies show that the dysregulation of sex hormones influences immune reactivity in RA patients. These hormonal and immunological perturbations contribute to the influx of more lymphocytes and monocytes in the synovial fluids of female individuals than in their male counterparts and higher antigen-presenting activity and mitogenic responses.…”

Section: Impact Statementmentioning

confidence: 99%

Indigenous Nigeria medicinal herbal remedies: A potential source for therapeutic against rheumatoid arthritis

Arunsi

Chioma

Etusim

et al. 2022

Exp Biol Med (Maywood)

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Rheumatoid arthritis (RA) is a debilitating disease associated with locomotion impairment, and conventional therapeutic drugs are not optimal for managing RA. There is an avalanche of medications used for the management of RA. Still, studies have shown that they are associated with severe side effects, including hepatotoxicity, retinopathy, and cardiotoxicity disorders of the central nervous system (CNS), skin, blood, and infections. Complementary and alternative medicine (CAM) is currently gaining attention as a novel panacea for managing debilitating diseases, such as RA. Nigerian folk herbal remedies are replete with a plethora of curative medicine, albeit unvalidated scientifically but with seemingly miraculous provenance. Studies of the identification of bioactive compounds present in these botanicals using advanced spectral analytical techniques have enhanced our understanding of the role of Nigerian herbal remedies in the treatment and management of RA. Interestingly, experimental studies abound that the bioactive compounds present in the extracts of plant botanicals protected animals from the development of RA in different experimental models and reduced the toxicity associated with conventional therapeutics. Validated mechanisms of RA amelioration in human and animal models include suppression of the expression of NF-κB, IL-1β, TNF-α, IL-6, IL-8, IL-17, IL-23, chemokines, TGF-β, RANKL, RANK, iNOS, arginase, COX-2, VEGFA, VEGFR, NFATC1, and TRAP in the synoviocytes. Decreased ROS, NO, MDA, carbonyl groups, and PGE2 in the synovial fluid increased the expression of PPARα/γ; antioxidant and anti-inflammatory molecules also improve RA etiology. In this mini-review, we discuss the global burden of RA, the novel role of plant-based botanicals as potential therapeutics against signaling pathways in RA. Also addressed is the possible repurposing/reprofiling of plant botanicals to increase their therapeutic index among RA patients that patronize traditional healers in Nigeria with a global projection.

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“…Exogenous hormone use in the form of oral contraceptives (OC) has been previously linked to the development and progression of several immune-mediated diseases, such as Crohn's disease [1,2], rheumatoid arthritis [3], and systemic lupus erythematosus [4][5][6]. Nevertheless, the exact mechanism underlying these observations has not been fully established.…”

Section: Introductionmentioning

confidence: 99%

Longitudinal analysis of the impact of oral contraceptive use on the gut microbiome

Hua

Cao

Morgan

et al. 2022

Journal of Medical Microbiology

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Introduction. Evidence has linked exogenous and endogenous sex hormones with the human microbiome. Hypothesis/Gap statement. The longitudinal effects of oral contraceptives (OC) on the human gut microbiome have not previously been studied. Aim. We sought to examine the longitudinal impact of OC use on the taxonomic composition and metabolic functions of the gut microbiota and endogenous sex steroid hormones after initiation of OC use. Methodology. We recruited ten healthy women who provided blood and stool samples prior to OC use, 1 month and 6 months after starting OC. We measured serum levels of sex hormones, including estradiol, progesterone, sex hormone-binding globulin (SHBG), and total testosterone. Shotgun metagenomic sequencing was performed on DNA extracted from faecal samples. Species and metabolic pathway abundances were determined using MetaPhlAn2 and HUMAnN2. Multivariate association with linear models was used to identify microbial species and metabolic pathways associated with OC use and endogenous levels of sex hormones. Results. The percentage variance of the microbial community explained by individual factors ranged from 9.9 % for age to 2.7 % for time since initiation of OC use. We observed no changes in the diversity or composition of the gut microbiome following OC initiation. However, the relative abundance of the biosynthesis pathways of peptidoglycan, amino acids (lysine, threonine, methionine, and tryptophan), and the NAD salvage pathway increased after OC initiation. In addition, serum levels of estradiol and SHBG were positively associated with Eubacterium ramulus, a flavonoid-degrading bacterium. Similarly, microbes involving biosynthesis of l-lysine, l-threonine, and l-methionine were significantly associated with lower estradiol, SHBG, and higher levels of total testosterone. Conclusion. Our study provides the first piece of evidence supporting the association between exogenous and endogenous sex hormones and gut microbiome composition and function.

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Effect of oral contraceptive pills on rheumatoid arthritis disease activity in women: A randomized clinical trial

Cited by 7 publications

References 21 publications

Impact of oral contraceptives and breastfeeding on disease activity in a sample of Egyptian rheumatoid arthritis patients

Impact of oral contraceptives and breastfeeding on disease activity in a sample of Egyptian rheumatoid arthritis patients

Indigenous Nigeria medicinal herbal remedies: A potential source for therapeutic against rheumatoid arthritis

Longitudinal analysis of the impact of oral contraceptive use on the gut microbiome

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