Disease activity during the premenopausal and postmenopausal periods in women with systemic lupus erythematosus.

Abstract

PURPOSE:

Cyclophosphamide-induced ovarian failure has been reported to be protective against flares of systemic lupus erythematosus (SLE). We studied whether patients with SLE experience a decrease in disease activity after natural menopause.

SUBJECTS AND METHODS:

We studied 30 SLE patients with natural menopause who had been observed at least 2 years before and after menopause and who did not receive hormone replacement therapy or danazol. Menopause was defined as the date of the last self-reported menstrual period. Disease activity was assessed retrospectively by medical chart review using standard measures (the SLE disease activity index) during the immediate premenopausal and postmenopausal periods, and 2 (n = 30 patients), 3 (n = 19), and 4 (n = 13) years before and after menopause. We also compared the use of health services and medications.

RESULTS:

Patients were studied for a mean (+/- SD) of 6.4 +/- 1.7 years (premenopausal, 3.3 +/- 0.9 years; postmenopausal, 3.2 +/- 0.9 years). During the premenopausal periods, the mean disease activity score was 2.3 +/- 2.3 (range, 0 to 9 on a 0 to 105 scale), compared with 2.3 +/- 2.9 (range, 0 to 12; P = 0.37) after menopause. The maximum disease activity score was somewhat greater in the premenopausal period (7.9 +/- 6.0 [range, 0 to 22] vs. 5.8 +/- 5.1 [range, 0 to 22]; P = 0.04). The incidence rates of flares (0.56 per year vs. 0.43 per year, P = 0.20) and severe flares (0.17 per year vs. 0.12 per year, P = 0.33) were similar in the premenopausal and postmenopausal periods. Differences in disease activity scores (mean and maximum) and the number of visits to a rheumatologist's office were only significant when the fourth year before menopause was compared with the fourth year after menopause.

CONCLUSIONS:

Disease activity is mild during the premenopausal and postmenopausal periods in women with SLE. A modest decrease, especially in the maximum disease activity, is seen after natural menopause.

• Authors: J Sánchez-Guerrero, A Villegas, A Mendoza-Fuentes, J Romero-Díaz, G Moreno-Coutiño, M C Cravioto
• Journal: The American journal of medicine (Am J Med) Vol. 111 Issue 6 Pg. 464-8 (Oct 15 2001) ISSN: 0002-9343 [Print] United States
• PMID: 11690572 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Inflammatory Agents
• Antirheumatic Agents
• Immunosuppressive Agents
• Chloroquine
• Prednisone

Topics

• Anti-Inflammatory Agents (metabolism)
• Antirheumatic Agents (metabolism)
• Chloroquine (metabolism)
• Cohort Studies
• Disease Progression
• Emergency Service, Hospital
• Female
• Hospitalization
• Humans
• Immunosuppressive Agents (metabolism)
• Lupus Erythematosus, Systemic (metabolism)
• Medical Records
• Middle Aged
• Patient Acceptance of Health Care
• Postmenopause (metabolism)
• Prednisone (metabolism)
• Premenopause (metabolism)
• Retrospective Studies