Sir -The prognosis and survival rates of patients with systemic lupus erythematosus (SLE) have improved over the years1; thus, an increasing number of women with SLE are reaching the age of menopause. In addition, the use of cyclophosphamide therapy and the disease itself increase the risk of premature ovarian failure in these patients.2 Therefore, as our LUMINA (Lupus in Minorities: Nature versus Nurture) cohort matures, we have been intrigued by the accrual of damage in our postmenopausal women. Previously, we have examined damage accrual in our cohort patients whose disease started before and after the menopause and concluded that it was age rather than the menopause that accounted for damage accrual in the postmenopausal women.3 With a larger number of LUMINA cohort patients, and more years of observation having occurred, we sought to re-examine this matter. We, therefore, examined the role of menopause versus age by regressing age on menopause so that the effect of menopause per se could be better determined.The current analyses were limited to the women in the LUMINA cohort. Briefly, at entry into the cohort (T0), patients had disease duration ≤5 years, were ≥16 years of age and were of defined ethnicity (Hispanic from Texas and Puerto Rico, African American, or Caucasian).

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