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Impact of disease activity and treatments on ovarian reserve in patients with rheumatoid arthritis in the ESPOIR cohort.
Valdeyron, Camille; Soubrier, Martin; Pereira, Bruno; Constantin, Arnaud; Morel, Jacques; Gaudin, Philippe; Combe, Bernard; Gremeau, Anne Sophie; Dejou-Bouillet, Lydie; Pouly, Jean Luc; Sapin, Vincent; Oris, Charlotte; Brugnon, Florence.
Afiliación
  • Valdeyron C; Assistance Medicale à la Procréation, CECOS, CHU Estaing, Clermont-Ferrand University, France.
  • Soubrier M; Rheumatology, CHU Gabriel-Montpied, Clermont-Ferrand University, France.
  • Pereira B; Biostatistics Unit (DRCI), CHU Clermont-Ferrand, France.
  • Constantin A; Rheumatology, CHU Purpan, Toulouse University, France.
  • Morel J; Rheumatology, CHU Montpellier, Montpellier University, France.
  • Gaudin P; Rheumatology, Sud Echirolles Hospital, CHU Grenoble Alpes, France.
  • Combe B; Rheumatology, CHU Montpellier, Montpellier University, France.
  • Gremeau AS; Assistance Medicale à la Procréation, CECOS, CHU Estaing, Clermont-Ferrand University, France.
  • Dejou-Bouillet L; Assistance Medicale à la Procréation, CECOS, CHU Estaing, Clermont-Ferrand University, France.
  • Pouly JL; Assistance Medicale à la Procréation, CECOS, CHU Estaing, Clermont-Ferrand University, France.
  • Sapin V; Biochemistry and Molecular Genetic, CHU Clermont-Ferrand, France.
  • Oris C; Biochemistry and Molecular Genetic, CHU Clermont-Ferrand, France.
  • Brugnon F; Assistance Medicale à la Procréation, CECOS, CHU Estaing, Clermont-Ferrand University, France.
Rheumatology (Oxford) ; 60(4): 1863-1870, 2021 04 06.
Article en En | MEDLINE | ID: mdl-33147613
OBJECTIVES: Patients with RA have a higher prevalence of infertility than the general population. This study sought to examine the impact of RA disease activity and treatments on ovarian reserve measured by serum anti-Müllerian hormone (AMH) levels in the ESPOIR cohort. We sought to better define the indications for fertility preservation. METHODS: Patients and serum analysis data were derived from the French national cohort ESPOIR. Enrolled patients (n = 102; 18-37-year-olds) fulfilled ACR/EULAR 2010 criteria for RA. Serum AMH levels were measured at T0, T6, T12, T24 and T36 months post-diagnosis. The impacts of RA activity (DAS28 and CRP level) and treatments (MTX only or with other medications) were evaluated at each study visit. RESULTS: A gradual decrease in patients' serum AMH levels was observed over time, in line with the descending curve described for healthy women. Serum AMH levels of RA patients in comparison with the values considered normal for age did not reveal any significant differences (P > 0.05). We did not observe any impact of RA treatments. We demonstrated an inverse correlation between AMH variation and disease activity (DAS28: r = -0.27, P = 0.003; CRP: r = -0.16, P = 0.06). CONCLUSION: This is the first study to determine serum AMH levels of a large cohort of RA patients over 36 months. Rapid disease activity control appears to be required to limit changes in the ovarian reserve. Fertility preservation is not likely to be necessary if inflammation is promptly controlled. CLINICALTRIALS.GOV IDENTIFIER: NCT03666091.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Artritis Reumatoide / Reserva Ovárica Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Adolescent / Adult / Female / Humans Idioma: En Revista: Rheumatology (Oxford) Asunto de la revista: REUMATOLOGIA Año: 2021 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Artritis Reumatoide / Reserva Ovárica Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Adolescent / Adult / Female / Humans Idioma: En Revista: Rheumatology (Oxford) Asunto de la revista: REUMATOLOGIA Año: 2021 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Reino Unido