POS0386 HORMONAL REPLACEMENT THERAPY IN POST-MENOPAUSAL WOMEN WITH HAND OSTEOARTHRITIS: RESULTS FROM THE DIGICOD COHORT
Authors: A. Latourte, J. Recoules, P. Richette, J. Sellam, F. Rannou, E. Maheu, F. Berenbaum
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> The incidence of hand osteoarthritis (OA) increases in perimenopausal women (i.e., around the age of 50), and the burden is significantly higher in women than in men, suggesting a role for estrogens in the pathogenesis of hand OA. To date, some studies suggest that estrogens could have a protective role in knee or hip OA [1], and data on hand OA are inconclusive. <h3>Objectives:</h3> The aim of this study was to investigate the effect of hormone replacement therapy (HRT) on clinical and radiographic features of hand OA. <h3>Methods:</h3> DIGICOD is a prospective cohort of 426 patients (aged 35 years or older) with symptomatic hand OA according to the ACR criteria [2]. In this cross-sectional study, baseline demographic, clinical and radiographic data of post-menopausal women were compared according to their use of HRT (ever). Clinical outcomes included number of joints with pain (spontaneous or at palpation), nodes, synovitis, pain intensity at rest or on mobilization (0-100 mm visual analogical scale [VAS]), aesthetic discomfort (0-100 mm VAS), grip strength (kg), AUStralian/CANadian Hand Osteoarthritis Index (AUSCAN) for pain, stiffness, function (0-100). Radiographic outcomes included the sum of Kellgren-Lawrence (KL) grades in both hands, the number of joints with a KL grade ≥ 2 and the number of erosive joints according to the Verbruggen-Veys anatomical scoring system. We first performed univariate analyses, and a multivariable logistic regression model adjusted for age, body mass index and variables with a p-value &lt; 0.20 in univariate analyses was used when possible. <h3>Results:</h3> This study included 357 women (83.8% of the total sample; mean ± SD age = 66.7 ± 7.1), and of whom 339 (95.0%) were post-menopausal (mean ± SD age = 67.4 ± 6.4), and 57 (16.8%) reported current or past use of HRT. HRT use was associated with a significantly lower number of spontaneously painful joints (0.7 ± 1.5 vs. 1.8 ± 3.6, p= 0.02), but the number of painful joints at palpation was similar in both groups (4.0 ± 3.4 vs. 5.0 ± 4.9, p = 0.16). We also observed a non-significant trend for a lower number of swollen joints (0.8 ± 2.1 vs. 1.3 ± 2.0, p = 0.06), a lower number of nodes (7.1 ± 4.6 vs. 8.4 ± 5.0, p = 0.07), and a higher grip strength (26.1 ± 13.8 kg vs. 23.3 ± 10.3 kg, p = 0.06). In the multivariable model, disease duration (15.4 ± 9.9 vs. 13.1 ± 9.8 years, p = 0.02) and the number of spontaneously painful joints (p=0.02) were significantly associated with HRT use. There was no difference in radiographic outcomes. <h3>Conclusion:</h3> HRT is associated with a lower number of painful joints in post-menopausal women with hand OA. These findings warrant further studies of the clinical efficacy of HRT in post-menopausal women with symptomatic hand OA. <h3>REFERENCES:</h3> [1] Female reproductive factors and risk of joint replacement arthroplasty of the knee and hip due to osteoarthritis in postmenopausal women: a nationwide cohort study of 1.13 million women. Eun Y, Yoo JE, Han K et al. Osteoarthritis Cartilage 2022;30(1):69-80. [2] The DIGICOD cohort: A hospital-based observational prospective cohort of patients with hand osteoarthritis - methodology and baseline characteristics of the population. Sellam J, Maheu E, Crema MD et al. Joint Bone Spine 2021;88(4):105171. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>