AB0178 Menopause Is A Predictor for The Development of Anti-Citrullinated Protein Antibodies in Women at Risk for Rheumatoid Arthritis

BackgroundMany controversies exist about the role of sex hormones and reproductive factors in the development of rheumatoid arthritis (RA). Post-menopause is a period of important hormonal and immunologic changes and has been associated with increased risk of seronegative-RA (1). Earlier age at menopause has been associated with increased risk of RA (2), therefore factors related to menopause may be relevant for the development of preclinical phases of RA.ObjectivesTo study the association between reproductive and menopausal factors and the risk of development systemic autoimmunity associated with RA, in particular of anti-citrullinated protein antibodies (ACPA), in women at increased risk for RA.MethodsThis is a nested cohort study within an ongoing prospective study of individuals genetically at risk of developing RA, namely first degree relatives of patients with RA (FDRs). Individuals without clinical evidence of RA were enrolled, and followed-up yearly with clinical and laboratory assessments. We included all women with available ACPA status (anti-CCP 2, 3.1 or 3.0). Reproductive and menopausal factors were self-reported. We operationally defined perimenopausal women as those with recent menopause (