Association between low-dose pulsed intravenous cyclophosphamide therapy and amenorrhea in patients with systemic lupus erythematosus: A case-control study

BMC Women's Health

Research Article

Tokiko Kanno¹  Sayumi Baba¹  Yasushi Kawaguchi¹  Tomoko Sugiura¹  Takahisa Gono¹  Yasuhiro Katsumata¹  Hisashi Yamanaka¹  Masako Hara¹ 

[1] Institute of Rheumatology, Tokyo Women's Medical University, 10-22 Kawada-cho, 162-0054, Shinjuku-ku, Tokyo, Japan;

关键词: Systemic Lupus Erythematosus;    Systemic Lupus Erythematosus Patient;    Amenorrhea;    Premature Ovarian Failure;    Active Systemic Lupus Erythematosus;   

DOI  :  10.1186/1472-6874-11-28

 received in 2011-02-08, accepted in 2011-06-10,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundThe risk for amenorrhea following treatment of systemic lupus erythematosus (SLE) patients with low-dose intravenous cyclophosphamide (IVCY) has not been fully explored. Our objective was to ascertain the incidence of amenorrhea following treatment with low-dose IVCY and the association between amenorrhea and the clinical parameters of SLE.MethodsA case-control retrospective study of premenopausal women ≤ 45 years old who had been treated for SLE with low-dose IVCY (500 mg/body/pulse) plus high-dose glucocorticoids (0.8-1.0 mg/kg/day of prednisolone; IVCY group) or glucocorticoids alone (0.8-1.0 mg/kg/day of prednisolone; steroid group) in our hospital from 2000 through 2009 was conducted using a questionnaire survey and medical record review.ResultsTwenty-nine subjects in the IVCY group and 33 subjects in the steroid group returned the questionnaire. A multivariate analysis revealed that age at initiation of treatment ≥ 40 years old was significantly associated with amenorrhea [p = 0.009; odds ratio (OR) 10.2; 95% confidence interval (CI) 1.8-58.7]. IVCY treatment may display a trend for association with amenorrhea (p = 0.07; OR 2.9; 95% CI 0.9-9.4). Sustained amenorrhea developed in 4 subjects in the IVCY group and 1 subject in the steroid group; all of these patients were ≥ 40 years old. Menses resumed in all subjects < 40 years old, irrespective of treatment.ConclusionsAlthough low-dose IVCY may increase the risk for amenorrhea, our data suggest that patients < 40 years old have a minimum risk for sustained amenorrhea with low-dose IVCY treatment. A higher risk for sustained amenorrhea following treatment with IVCY is a consideration for patients ≥ 40 years old.

【 授权许可】

Unknown   
© Baba et al; licensee BioMed Central Ltd. 2011. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.