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J M Hazes

Publications and source records attributed to J M Hazes.

87 records · Page 5Linked to original sources
PubMed1990

Reduction of the risk of rheumatoid arthritis among women who take oral contraceptives.

Discrepant results among investigations of the association between oral contraceptive use and rheumatoid arthritis (RA) have been ascribed to shortcomings in the study methods. In the present study, we obtained detailed information on oral contraceptive use in 135 young women with confirmed definite or classic RA of recent onset and in 378 controls with soft tissue rheumatism or osteoarthritis. All patients had at least 2 years of followup to confirm the consistency of the diagnosis. Oral contraceptive use at any time before disease onset was reported by 70% of the RA patients and 85% of the controls; the latter figure corresponded to general population data for The Netherlands. This yielded a relative risk for RA of 0.39 among those who had ever used oral contraceptives and 0.58 for those using oral contraceptives at the time of symptom onset. The preventive effect of oral contraceptive use on the risk of RA was found to be independent of the dose, duration of use, or presence of HLA-DR4. The strongest protection was seen in women with a family history of RA and in women ages 31-40 at symptom onset. The conflicting results in the literature are discussed, and a possible biologic mechanism for this phenomenon is suggested.

Adult↗
PubMed1990

Diminished incidence of severe rheumatoid arthritis associated with oral contraceptive use.

It has been suggested that the negative association between rheumatoid arthritis (RA) and oral contraceptive (OC) use might be limited to the more severe forms of RA. To investigate this further, we studied 121 consecutive female patients with definite RA, 52 female patients with probable RA, and 378 female controls. All patients had RA symptoms of recent onset. After a mean followup period of 6 years, patients with definite RA were classified as having either a severe disease course (n = 76) or a mild disease course (n = 45). The negative association between OC use prior to the onset of RA symptoms and the development of RA was limited to those patients with definite RA who had a severe disease course. We therefore conclude that OC use prior to the onset of RA symptoms is only associated with a reduction in the incidence of severe RA. This may explain the divergent results of previous studies.

Adult↗
PubMed1990

Pregnancy and the risk of developing rheumatoid arthritis.

There have been conflicting reports on, and no plausible biologic explanation for, a protective effect of oral contraceptive (OC) use on the development of rheumatoid arthritis (RA). Therefore, we investigated aspects of behavior related to OC use that could explain the preventive effect of OC on the onset of RA. In the present case-control study, past pregnancy, age at first pregnancy, and pregnancies with adverse outcome were studied as possible risk factors for RA. Interview information on reproductive variables was obtained from 135 young adult women with confirmed definite or classic RA of recent onset, and from 378 control patients with soft tissue rheumatic disorders or osteoarthritis. All patients had at least 2 years of followup to confirm the consistency of the diagnosis. We found a decreased risk of RA in women who had been pregnant. The risk of RA in women who had ever been pregnant compared with women who had never been pregnant was 0.49 (95% confidence interval 0.27-0.91). The earlier the first pregnancy, the lower the risk of RA. Pregnancy with adverse outcome (i.e., gestation less than 25 weeks) did not substantially change the risk of RA (relative risk 0.73, 95% confidence interval 0.50-1.07). The protective effect of pregnancy was independent of OC use, the presence of HLA-DR4, or a family history of RA. Immune modulation by female hormonal influences could be an explanation for the results of the present study.

Adult↗
PubMed1990

Lifestyle and the risk of rheumatoid arthritis: cigarette smoking and alcohol consumption.

In a search for aspects of behaviour related to oral contraceptive use which might explain the favourable effect of oral contraception on the onset of rheumatoid arthritis (RA), cigarette smoking and alcohol consumption were studied as possible risk factors. Information on cigarette smoking and alcohol consumption was obtained by interview at the first visit to the outpatient clinic of 135 young women with confirmed definite or classical RA of recent onset and 378 control patients with soft tissue rheumatism or osteoarthritis. The diagnosis in all patients was confirmed by at least two years of follow up. Of the patients with RA, 44/135 (33%) were current cigarette smokers compared with 181/378 (48%) of the controls. The percentage of smokers among the controls was similar to that of women smokers in the general population. The adjusted risk of RA in women who smoked at least one cigarette a day was 0.61 (95% confidence interval (CI) 0.42 to 0.89). Thirty one (23%) patients with RA and 137 (36%) controls were alcohol drinkers. The risk of RA in women who consumed alcohol at least once a day was 0.52 (95% CI 0.33 to 0.84). The low relative risk estimates for cigarette smoking and alcohol consumption were mutually independent and also independent of oral contraceptive use, the presence of the HLA-DR4 antigen, or a positive family history of RA. The low incidence of alcohol consumption in the patients with RA might be due to the discontinuation of alcohol consumption after disease onset. The low incidence of cigarette smoking in the patients might reflect a protective effect of cigarette smoking on RA onset, possibly induced by changes in the immune system.

Adult↗
PubMed1989

Oral contraceptive treatment for rheumatoid arthritis: an open study in 10 female patients.

Ten female patients (median age 37 years, range 23-45) with active rheumatoid arthritis (RA) (nine seropositive, one seronegative, seven erosive, three non-erosive) were treated during 6 months with one of the earlier, i.e. higher dosed, oral contraceptives (Lyndiol, each tablet containing 2.5 mg lynestrenol and 0.05 mg ethinyloestradiol). None of the patients had been previously treated with a disease modifying drug. In one patient therapy with Lyndiol was stopped within 14 days after the start because of vomiting. Three out of the remaining nine patients stopped the therapy after 3 months because of inefficacy. Erythrocyte sedimentation rate (ESR) deteriorated during the study. Except for the number of swollen joints no clinical or laboratory parameters improved. We conclude that Lyndiol has no disease modifying effect in rheumatoid arthritis.

Adult↗
PubMed1989

DR4 prevalence related to the age at disease onset in female patients with rheumatoid arthritis.

The prevalence of HLA-DR4 in relation to age at disease onset was calculated in 226 consecutive female patients with definite or classical rheumatoid arthritis (RA). A slight increase in the prevalence of DR4 with age at RA onset was found. This appeared to be due to the low percentage of rheumatoid factor (RF) positivity in the youngest age groups; the DR4 prevalence in the RF positive patients was constant for all decades--that is, approximately 60%. A previously reported declining trend of DR4 prevalence in women with RA in relation to age of RA onset may be due to the disease heterogeneity of the patients included in that study.

Adolescent↗
PubMedDate not supplied

The onset of rheumatoid arthritis in relation to pregnancy and childbirth.

It has been suggested that the onset of RA symptoms is reduced during pregnancy and increased in the postpartum period. In the present study symptom onset in relation to the pregnancy prior to disease onset was compared between 135 young RA patients with definite RA and 378 controls with soft tissue rheumatism or osteoarthritis. Two RA patients developed symptoms during pregnancy versus 9 controls (odds ratio OR = 0.64). In the 3 months postpartum 5 RA patients and 5 controls developed symptoms (OR = 3.37). These results show the same trend as those of previous studies, i.e. a decrease in the onset of RA during pregnancy and an increased onset of RA after delivery. These findings might be explained by a delayed clinical onset of RA that started during pregnancy, analogous with the ameliorating effect of pregnancy on the course of existing RA and the flare-up of disease activity in the postpartum period.

Adult↗
PubMedDate not supplied

Levels of circulating cellular fibronectin are increased in patients with rheumatoid vasculitis.

OBJECTIVE: To investigate whether serum levels of circulating cellular fibronectin (cFN) are increased in patients with rheumatoid arthritis (RA) complicated by vasculitis. METHODS: Levels of serum cFN were determined by an enzyme-linked immunosorbent assay (ELISA) in 26 RA patients with histologically proven vasculitis of recent onset (RV) and were compared to the levels in 47 RA patients with extraarticular manifestations of recent onset but no histological evidence of vasculitis (RA+), 43 patients with uncomplicated RA (RA-), 16 patients with systemic lupus erythematosus and active disease (SLE), 30 patients with active Crohn's disease (CD), 21 young healthy controls (yHC) and 17 elderly healthy controls (eHC). Plasma levels of cFN and von Willebrand factor antigen were also determined in the RA patients. RESULTS: In RV patients, the median cFN level was significantly (P = 0.01) higher compared to that of RA+ patients, and was also significantly (P < 0.0000) higher compared to the cFN level in the RA-, SLE, CD, yHC and eHC groups. When compared to eHC, the cFN level was significantly higher in RA+ (P = 0.008); it was also higher in RA-, although not significantly (P = 0.42). 77% of the RV patients, 55% of the RA+ patients, and 37% of the RA-patients had a cFN level > 2 SD above the mean level for eHC. At an optimal cut-off titre the sensitivity of the cFN ELISA in discriminating RV patients from RA+ patients was 90%, the specificity was 46% and the accuracy was 68%. Plasma levels of cFN correlated significantly (r = 0.62; P < 0.001) with the von Willebrand factor antigen levels. CONCLUSIONS: Increased levels of serum cFN are present in patients with RA, and are frequently found in RA patients with extraarticular manifestations, particularly in those with vasculitis.

Adolescent↗