Navigation Links
Ovarian function and fertility preserved in women with severe systemic lupus erythematosus

Paris, France, Thursday 12 June 2008: Ovarian function can be preserved and disease activity controlled in women with severe systemic lupus erythematosus (SLE) when treated with a 6-month course of cyclophosphamide (CYC), a chemotherapy drug, followed by the immunosuppressant mycophenolate mofetil (MMF), according to a new study presented today at EULAR 2008, the Annual Congress of the European League Against Rheumatism in Paris, France.

SLE, a complex and unpredictable autoimmune disease, is characterised by chronic inflammation and damage of body tissues, including the heart, lungs, kidneys, joints, and/or nervous system. It is most common in women and, although long-term survival has dramatically improved over time with better diagnosis and treatment options, one of the challenges in managing the disease is to minimise the side-effects of treatments such as the disruption of ovarian function and risks to fertility. Pulsed intravenous CYC, a chemotherapeutic agent, is a standard therapy for SLE but may also be associated with ovarian failure in addition to other adverse effects.

Dr Katerina Laskari, the presenting author of the study, led by Professor Athanasios G Tzioufas in the Department of Pathophysiology of the National and Kapodistrian University of Athens, said: "Although the prognosis for people with SLE has considerably improved over the years, a patient's quality of life can all too often be seriously impaired by the toxicity of many commonly-used treatments. Preserving ovarian function is a very important consideration in treating women with SLE of child-bearing age, who are already burdened by the difficult nature and impact of the disease itself."

In this retrospective evaluation of 61 postmenopausal women with SLE treated for lupus nephritis (n=58), autoimmune hemolytic anemia (n=1) and central nervous system involvement (n=2), 39 patients received prolonged treatment with 1g/m2 intravenous (IV) CYC pulses (group A) for a median time of 24 months and 22 patients received 5-7 monthly 1g/m2 IV CYC pulses, followed by 2g/day MMF for a median time of 32 months (group B).

Results showed that disease activity was equally controlled using either treatment regimen (p=0.76 and p=0.31 for disease remission and relapse respectively), although patients in group A had a 4-fold higher risk of developing amenorrhea (absence of menstruation) compared with those in group B (p=0.001). 56% (n=22) of women in group A and 14% (n=3) in group B developed amenorrhea, while sustained amenorrhea developed in 51% (n=20/39) of women in group A vs 4% (n=1) in group B. 14% (3/22) of women in group A and 67% (2/3) in group B resumed menstruation following cessation of therapy.

Age (p<0.001), cumulative CYC dose (p=0.001) and anti-Ro antibodies (p=0.002) were significant in terms of amenorrhea. Sustained amenorrhea was related to both the form of treatment (p=0.006) and the age of the patients (p=0.026). The median total CYC dose until amenorrhea was 11 gr (range 2-29.5) and 3.7 gr (range 2-6.75) in group A and B respectively (p=0.036).

The median age of women with amenorrhea was 36 years (range 19-46) in group A and 33 years (range 27-45) in group B (p=0.71). It is of note that all patients aged >31 years developed amenorrhea with the long course CYC treatment and 94% did not resume menses until the end of follow up, whereas only 1 patient aged 45 years developed permanent amenorrhea with the short course CYC treatment.

SLE disease duration and ECLAM (European Consensus Lupus Activity Measurement) score were not significantly different in terms of amenorrhea (p≥0.05).


Contact: Rory Berrie / Camilla Dormer
European League Against Rheumatism

Related medicine news :

1. A Knock-Out Match: Kelly Ripa and Molly Sims Team Up to Fight Ovarian Cancer
2. Coveting the Latest Clutch? Bid on a Bag and Help Fight Ovarian Cancer
3. Seattle-Based Marsha Rivkin Center for Ovarian Cancer Research Appoints Nancy Sclater, Executive Director
4. Stored Ovarian Tissue Needs Testing Before Re-Implantation
5. Cancer could return unless stored ovarian tissue undergoes adequate testing before re-implantation
6. Drug compound leads to death of ovarian cancer cells resistant to chemotherapy
7. FASgen Diagnostic Tests Identify Ovarian Cancer Progression and Apoptosis
8. Specialized Care for Ovarian Cancer Improves Outcomes
9. Recurrent low-grade carcinoma of the ovary less responsive to chemo than more common ovarian cancers
10. Advanced-stage ovarian cancer patients with BRCA live longer, may respond better to treatment
11. Gleevec May Disrupt Ovarian Function
Post Your Comments:
(Date:11/24/2015)... , ... November 24, 2015 , ... With Thanksgiving right ... is sharing safety tips to help protect your family and vehicle. , According to ... the 2013 Thanksgiving holiday weekend. Amica is sharing the following safety tips from the ...
(Date:11/24/2015)... Abington, PA (PRWEB) , ... November 24, 2015 ... ... announce that it has been designated an Aetna Institute of Quality® Bariatric Surgery ... information about the quality and cost of health care services available to its ...
(Date:11/24/2015)... (PRWEB) , ... November 24, 2015 , ... ... award for its exceptional customer service: the TrustDale certification. The award recognizes good ... Baltimore stone honing , tile and grout, and hard surface restoration company ...
(Date:11/24/2015)... (PRWEB) , ... November 24, 2015 , ... Autism Speaks, ... the global movement driven by social media and the generosity of people around the ... encourage their social media networks to give – and share the personal stories behind ...
(Date:11/24/2015)... ... ... her life, Don Peck’s mother wondered if she was a descendant of Samuel Fuller, a ... a 25-year search for information, Don and his aunt discovered that she was not, in ... out, it was Don’s father who was descended from not one, but four passengers on ...
Breaking Medicine News(10 mins):
(Date:11/24/2015)... , Nov. 24, 2015  In the pharmaceutical ... in an effort to quickly uncover new insights, tactics ... --> --> However, organizations ... market research project and ensure that all rules and ... industry standards. Another major barrier to efficiently launching market ...
(Date:11/24/2015)... , Nov. 24, 2015  DILON Diagnostics and GE ... an agreement for DILON to distribute GE,s Discovery NM750b ... globe. The signing of this distribution agreement will provide Dilon,s ... Breast Imaging system and is considered an initial step ... healthcare solutions for clinicians and their patients. ...
(Date:11/24/2015)... 2015   HeartWare International, Inc . (NASDAQ: ... support technologies that are revolutionizing the treatment of advanced ... Officer Doug Godshall is scheduled to present ... Conference on December 1, 2015 at 3:00 p.m. ET.  ... New York . ...
Breaking Medicine Technology: