Page 79 - Fertility in Women with Rheumatoid Arthritis Vruchtbaarheid van vrouwen met reumatoïde artritis

AMH in RA – early RA
Figure 1. (A) Serum anti-Müllerian hormone (AMH) levels in women with recent onset rheumatoid arthritis at time of diagnosis (T0) are comparable to a healthy control population. (B) Serum AMH levels in women with recent onset rheumatoid arthritis six months after diagnosis (T6), differentiating between patients who did or did not receive methotrexate (MTX) treatment during these six months. The lines represent the 10th, 50th and 90th percentile lines of predicted AMH values in healthy controls.
AMH six months after diagnosis 5 Blood samples were available for both visits in 53 patients. The mean value of DAS28
decreased signi cantly during six months from 4.54±1.29 to 3.02±1.38 (p<0.001), as
did CRP levels (7.0 (4.0-18.0) to 5.0 (2.0-9.4) mg/L, p=0.008).
AMH levels at T6 were signi cantly lower than at T0 (1.92 (0.84-3.75) and 2.57 (0.90- 5.30) μg/L respectively, p<0.001). AMH levels at T6 were not different from those in controls (p=0.741). Five women (9%) had AMH levels below the 10th percentile of controls.
At T6, there was neither a signi cant correlation between CRP levels and AMH (r=- 0.170, p=0.247), nor between DAS28 and AMH (r=0.084, p=0.563).
Thirty-one out of 53 women (58%) were prescribed MTX at the rst visit in dosages of 7.5-25 mg/week (mean dosage 20 mg/week). These women had signi cantly higher CRP levels (8.0 (5.0-26.0) mg/L, p=0.022) and DAS28 values (4.91±1.38, p=0.009) at T0 than those who did not receive MTX (CRP 4.5 (2.0-11.0) mg/L and DAS28 4.04±0.96). The proportion of RF positive women was higher in the MTX group (68% versus 23%, p=0.002). At T0, age (p=0.139), BMI (p=0.804), symptom duration (p=0.346) and age- adjusted AMH levels (p=0.229) showed no signi cant difference between the two groups.
After six months of treatment, age-adjusted AMH levels did not differ signi cantly between MTX users and patients not using MTX (p=0.287). The proportional change
77