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© 1989 British Society for Rheumatology

Can Oestrogens be Used as Adjuvant Therapy in Female Patients with Rheumatoid Arthritis?

H. R. van den Brink and J. W. J. Bijlsma

Department of Rheumatology, University Hospital Utrecht Box 16250, 3500 CG Utrecht, The Netherlands

Correspondence to Dr. van den Brink


  Abstract

In this review the arguments for a relation between female sex hormones and rheumatoid arthritis are discussed. Clinical evidence includes a relation between disease activity and menstrual cycle and a clear decrease in disease activity during pregnancy. A protective effect of oral contraceptives on the development of rheumatoid arthritis is claimed. There are conflicting data with regard to the plasma levels of sex hormones in women with rheumatoid arthritis. In vitro gonadal hormones suppress T-lymphocyte proliferation, while B-lymphocyte differentiation is enchanced by oestrogens and diminished by testosterone. Some pilot studies suggest that oestrogens may ameliorate disease activity in women with active rheumatoid arthritis. Presently we are conducting a randomized, double-blind trial comparing oestrogens with placebo as adjuvant therapy in women with rheumatoid arthritis.


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