AB0593 EARLY MENOPAUSE IS ASSOCIATED WITH WORSE PATIENT-REPORTED OUTCOMES IN POSTMENOPAUSAL-ONSET PATIENTS WITH RHEUMATOID ARTHRITIS: A CROSS-SECTIONAL STUDY
Authors: Y. Yang, P. W. Jia, H. W. Zheng, J. Pan, Z. M. Ouyang, Y. W. Zou, J. D. MA, L. F. Chen, K. M. Yang, L. Dai
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Rheumatoid arthritis (RA) is a female predominant autoimmune disease. The peak incidence coincides with menopause years in female RA. However, the exact interval between the age of RA onset and menopause was unclear in RA. Early menopause (EM, menopause age ≤ 45 years) was associated with almost 2.4-fold risk of subsequent development of RA. Since symptoms of somatoform autonomic dysfunction arose from menopause transition, post-menopause especially EM might exert a negative impact on disease characteristics especially patient-reported outcomes (PROs) of RA. However, published data were controversial. <h3>Objectives:</h3> This study aims to illustrate the distribution of time interval between age of RA onset and menopause and assess the differences of disease characteristics especially PROs between RA patients with natural EM and usual menopause (UM, menopause age &gt; 45 years). <h3>Methods:</h3> This cross-sectional study included post-menopausal RA patients from an observational RA cohort which conducted at the Department of Rheumatology and Immunology, Sun Yat-Sen memorial Hospital, Guangdong, China between January, 2015 and October, 2023. RA patients were divided into EM and UM groups. PROs were assessed, including patient global assessment of disease activity (PtGA), pain visual analogue scale (VAS) and Stanford health assessment questionnaire disability index (HAQ-DI). PROs-associated indicators included 28-joint tender joint count (TJC28) and provider global assessment of disease activity (PrGA). The interval time (years) from RA onset to menopause was calculated by age of menopause minus age of RA onset. Patients with first arthritis symptom occurred at 1 year after natural menopause were categorized into patients with RA onset after menopause, otherwise, those were categorized into patients with RA onset before menopause. <h3>Results:</h3> ① Among 557 post-menopausal patients enrolled, their peak RA-onset age was 51-55 years, while the peak menopause age was 46-50 years. Their mean age of menopause was 49.0 ± 4.2 years, while the peak age of menopause was 46-50 years. Both the age of RA onset and menopause showed unimodal distribution. The incidence peak of RA was 5 years after menopause (Figure 1A and B). ②There were 98 (17.6%) EM patients. Compared with UM patients, RA patients with EM had worse PROs and PROs-associated indicators, higher C reactive protein and CDAI (all <i>P</i> &lt; 0.05, Table 1), but not radiographic indicators (all <i>P</i> &gt; 0.05). ③ Among patients with RA onset after menopause, EM patients (18.0%) were characterized with higher TJC28, PrGA, PtGA, HAQ-DI and higher CDAI than those with UM (all <i>P</i> &lt; 0.05), but not inflammatory and radiographic indicators (all <i>P</i> &gt; 0.05). ④Among patients with RA onset before menopause, there were no differences of PROs and PROs-associated indicators, functional or radiographic indicators between patients with EM and UM. <h3>Conclusion:</h3> Our results supported that the peak years of RA onset in women coincided with the menopausal transition, which was demonstrated after 5 years of natural menopause. RA patients with EM especially in those with postmenopausal-onset RA had worse PROs, but neither inflammation nor radiographic damage. Therefore, improvement of self-management and psychosocial supports based on the well-control of RA disease activity would be more important and beneficial for EM patients with RA. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>