Effect of menopause hormone therapy on disease progression in systemic lupus erythematosus: A systematic review

Khafagy, Ayatallah M.; Stewart, K.I.; Christianson, Mindy S.; Tao, Ye; Blanck, Jaime Friel; Shen, Wen

doi:10.1016/j.maturitas.2015.03.017

Cited by 12 publications

(13 citation statements)

References 31 publications

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“…Due to research limitations of randomized control trials which included predominantly patients with negative aPL, definite conclusions cannot be made regarding the safety and efficacy of HRT use in APS-related SLE. Among SLE subjects, there have been no reports which demonstrate an increased risk of severe exacerbations within 24 months of HRT, though an increased risk of minor to moderate flares may be observed [ 28 , 29 ].…”

Section: Risks and Benefits Of Hormone Replacement Therapymentioning

confidence: 99%

Clinical implications of systemic lupus erythematosus without and with antiphospholipid syndrome in peri- and postmenopausal age

Grygiel-Górniak

Limphaibool

Puszczewicz

2018

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Antiphospholipid syndrome (APS) in patients with systemic lupus erythematosus (SLE) displays a severe disease sub-phenotype with vascular manifestations ranging from peripheral thrombosis to neurologic and ophthalmic symptoms. The prevalence of morbidities including thrombosis, renal lesions, and cognitive impairment contributes to a higher risk of organ damage and a reduced quality of life in patients. In addition to the clinical heterogeneity, the diagnostic challenge is heightened in elderly patients as APS-related SLE is primarily diagnosed in young females. Many patients reach menopause due to the clinical association of premature menopause and improvements in diagnostic and therapeutic strategies in recent years. Although obstetric morbidity is not a concerning feature of the disease within this age group, a number of manifestations which may contribute to a decreased quality of life are present and must therefore not be disregarded. An improved prognosis derives from successful therapeutic regimens with minimal adverse effects in individual patients. The multifaceted management involves patient evaluation and risk stratification, followed by thromboprophylaxis efforts through the correction of modifiable risk factors, lifestyle recommendations, and pharmacological therapy. This review highlights the role of estradiol in the disease pathogenesis as well as the clinical complications and management of APS-related SLE in perimenopausal and postmenopausal patients.

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Section: Risks and Benefits Of Hormone Replacement Therapymentioning

confidence: 99%

Clinical implications of systemic lupus erythematosus without and with antiphospholipid syndrome in peri- and postmenopausal age

Grygiel-Górniak

Limphaibool

Puszczewicz

2018

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“…However, these data were collected at a time when such therapy was much more common than at the present. Estrogen or combined estrogen-progesterone therapy 39 is associated with increased mild to moderate flares of SLE, but not with severe flares 37 . New data is available that may suggest possible mechanisms of SLE flares with hormonal therapy.…”

Section: Systemic Lupus Erythematosus (Sle)mentioning

confidence: 99%

“…This topic has been studied and reviewed extensively 36,37 . Evidence from the Nurses’ Health Study, a large prospective cohort study, shows a 2-fold increased risk of SLE for women treated with post-menopausal hormone replacement 38 .…”

Section: Systemic Lupus Erythematosus (Sle)mentioning

confidence: 99%

Menopause and Rheumatic Disease

Talsania

Scofield

2017

Rheumatic Disease Clinics of North America

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Abstract/Synopsis Menopause occurs naturally in women at about age 50. There is a wealth of data concerning the relationship of menopause to systemic lupus erythematosus, rheumatoid arthritis and osteoarthritis, while there are limited data concerning other rheumatic diseases. Age at menopause may affect the risk and course of rheumatic diseases. Osteoporosis, an integral part of inflammatory rheumatic diseases, is made worse by menopause. Hormone replacement therapy has been studied and its effects are varied depending upon the disease and even different manifestations within the same disease. Cyclophosphamide can induce early menopause but there is underlying decreased ovarian reserve in rheumatic diseases.

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“…On the contrary, it was concluded that there was a more significant damage accrual in affected organs from individual flares [12]. Khafagy et al studied the direct relationship between exogenous estrogen through hormone therapy and its effect on the progression of SLE [13]. This study performed a systematic review to assess the impact of hormone therapy on the occurrence of flares in menopausal patients with SLE [13].…”

Section: Relationship Between Systemic Lupus Erythematosus and Menopausementioning

confidence: 99%

“…Khafagy et al studied the direct relationship between exogenous estrogen through hormone therapy and its effect on the progression of SLE [13]. This study performed a systematic review to assess the impact of hormone therapy on the occurrence of flares in menopausal patients with SLE [13]. According to the results and conclusion of the study, SLE patients who use hormone therapy may have an increased risk of developing mild/moderate flares [13].…”

Section: Relationship Between Systemic Lupus Erythematosus and Menopausementioning

confidence: 99%

Do Menopause and Aging Affect the Onset and Progression of Rheumatoid Arthritis and Systemic Lupus Erythematosus?

Shah

Elshaikh

Lee

et al. 2020

Cureus

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Rheumatoid arthritis and systemic lupus erythematosus (SLE) are autoimmune diseases that are commonly seen in the female population. Rheumatoid arthritis mainly consists of distal symmetrical deforming polyarthritis. SLE patients have immune complexes that damage the organs and systems of the body, and this can present with one or more symptoms including the characteristic malar rash, serositis, lupus nephritis, photosensitivity, and arthritis of large joints. The onset and progression of the diseases are affected by physiological processes that occur in the body such as menopause and aging. The studies used as evidence were found in the PubMed, ScienceDirect, ProQuest, Taylor & Francis Online, Wiley Online Library, Ovid, and Oxford Academic databases. By analyzing these studies, the effects of aging and menopause on rheumatoid arthritis and SLE were revealed. In relation to menopause and aging, it was found that there was a progression of disease in women who had rheumatoid arthritis. However, aging and menopause caused the progression of SLE to decrease in women. An earlier age of onset of menopause was correlated with an increased chance of developing rheumatoid arthritis and SLE. Furthermore, while some studies showed that a later onset of SLE caused an increase in the progression of the disease, other studies showed that a later onset of SLE led to a decrease in the progression of the disease. Due to the prevalence of rheumatoid arthritis and SLE in females, we believe that the effects of menopause, age, and other factors on these two diseases should be examined in future studies.

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Effect of menopause hormone therapy on disease progression in systemic lupus erythematosus: A systematic review

Cited by 12 publications

References 31 publications

Clinical implications of systemic lupus erythematosus without and with antiphospholipid syndrome in peri- and postmenopausal age

Clinical implications of systemic lupus erythematosus without and with antiphospholipid syndrome in peri- and postmenopausal age

Menopause and Rheumatic Disease

Do Menopause and Aging Affect the Onset and Progression of Rheumatoid Arthritis and Systemic Lupus Erythematosus?

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