PO:08:117 | Association between the use of oral contraceptives and the development of rheumatoid arthritis: a systematic review and meta-analysis

Annalisa Marino¹, Damiano Currado^1|2, Onorina Berardicurti^1|2, Marta Vomero², Lyubomyra Kun¹, Letizia Pia Di Corcia², Erika Corberi², Francesca Trunfio², Francesca Saracino², Ludovica Lamberti², Leonardo Frasca², Angelo Battista³, Marta Alfano⁴, Silvia Schiavone⁵, Roberto Giacomelli^1|2, Luca Navarini^1|2. | ¹Clinical and Research Section of Rheumatology and Clinical Immunology, Fondazione Campus Bio-Medico, Roma; ²Rheumatology and Clinical Immunology, Department of Medicine, University of Rome Campus Biomedico, School of Medicine, Roma; ³Department of Maternal Science, Paediatric Emergency Service, Sapienza University of Rome, Roma; ⁴Department of Experimental Medicine, Sapienza University of Rome, Roma; ⁵Department of Orthopaedics and Traumatology, Policlinico Tor Vergata Foundation, Roma, Italy

Background. Rheumatoid arthritis (RA) is a chronic inflammatory joint disease that significantly impacts patients' quality of life, particularly affecting women. Although previous research has suggested that oral contraceptive (OC) use might influence the risk of developing RA, earlier meta-analyses have yielded inconsistent results. Given these conflicting findings and the emergence of new data, we performed an updated systematic review and meta-analysis of observational studies to clarify the association between OC use and RA risk. 

Materials and Methods. A systematic literature review and meta-analysis were conducted by searching MedLine (via PubMed), Scopus, and Cochrane databases up to March 2025. Observational studies examining the relationship between OC use and RA risk were included. Odds ratios (OR) and corresponding 95% confidence intervals (CI) were calculated. Additionally, cumulative meta-analysis was performed to assess temporal trends in risk estimates over time.

Results. Our analysis demonstrated that ever use (current or prior use) of OCs is associated with a statistically significant reduction in RA risk (OR 0.80, 95% CI 0.70-0.91). In contrast, the associations for current use (OR 0.59, 95% CI 0.34-1.02) and past use (OR 0.83, 95% CI 0.69-1.01) were less definitive, likely due to substantial heterogeneity among studies. Cumulative meta-analysis revealed a modest temporal trend toward a protective effect of OC use.

Conclusions: This meta-analysis supports a protective association between current or prior OC use and the development of RA, highlighting the potential role of hormonal factors in RA pathogenesis. CONCLUSIONI This meta-analysis supports a protective association between current or prior OC use and the development of RA, highlighting the potential role of hormonal factors in RA pathogenesis.