Oral contraceptives and systemic lupus erythematosus

Petri, Michelle; Robinson, Courtland

doi:10.1002/art.1780400504

Cited by 108 publications

(35 citation statements)

References 68 publications

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“…8 Women diagnosed with SLE are often advised to discontinue the combined oral contraceptive pill (COCP), 9 and the effect of oral contraceptives on the incidence and level of activity of SLE has been a focus of research for some years. 10,11 Other methods of contraception may theoretically also pose problems. Little is known about the effect of progestogen-only preparations (PoP) in SLE, and with regard to barrier methods many women and their doctors are concerned that these may exacerbate the dermatological manifestations of the condition in some women, although there is no published evidence to support this.…”

Section: Systemic Lupus Erythematosusmentioning

confidence: 99%

Contraceptive practices in women with systemic lupus erythematosus and/or antiphospholipid syndrome: What advice should we be giving?

Lakasing¹,

Khamashta²

2001

j fam plann reprod health care

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Section: Systemic Lupus Erythematosusmentioning

confidence: 99%

Contraceptive practices in women with systemic lupus erythematosus and/or antiphospholipid syndrome: What advice should we be giving?

Lakasing¹,

Khamashta²

2001

j fam plann reprod health care

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“…Several case reports described a temporal association between the start of oral contraceptives (OCs) containing estrogen and the onset of SLE, especially in predisposed individuals (5). Four casecontrol studies failed to find such a risk (6 -9).…”

Section: Introductionmentioning

confidence: 99%

Combined oral contraceptive use and the risk of systemic lupus erythematosus

Bernier

Mikaeloff

Hudson

et al. 2009

Arthritis & Rheumatism

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“…These risk factors include age at SLE diagnosis (10,14,15), disease duration (10,14), hypertension (15)(16)(17), dyslipidemia (10,15,17,18), hyperhomocysteinemia (18,19), oxidized low-density lipoprotein (LDL) (18), smoking (14,16), use of corticosteroids and their duration (10,15,18), aPL (14,18,20,21), and valvular abnormalities of the heart (22). Other factors that may be relevant to arterial or venous thromboembolism in SLE are genetic mutations (23), pregnancy, and the use of exogenous estrogens (24) for contraception, climacteric symptoms, and control of cyclic SLE activity. The use of hydroxychloroquine in SLE, on the other hand, may be protective (25).…”

mentioning

confidence: 99%

Incidence and risk factors of thromboembolism in systemic lupus erythematosus: A comparison of three ethnic groups

Mok

Tang

et al. 2005

Arthritis & Rheumatism

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220

173

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Objective. To compare the incidence and risk factors for thromboembolic events in systemic lupus erythematosus (SLE) patients of different ethnic backgrounds.Methods. SLE patients who were newly diagnosed or were referred within 6 months of diagnosis between 1996 and 2002 were prospectively followed up for the occurrence of thromboembolic events. Cumulative hazard and risk factors for thromboembolism were evaluated and compared among patients of different ethnic origins.Results. We studied 625 patients who fulfilled the American College of Rheumatology criteria for SLE (89% women): 258 Chinese, 140 African Americans, and 227 Caucasians. The mean ؎ SD age at SLE diagnosis was 35.7 ؎ 14 years. After a followup of 3,094 patientyears, 48 arterial events and 40 venous events occurred in 83 patients. The overall incidence of arterial and venous thromboembolism was 16/1,000 patient-years and 13/1,000 patient-years, respectively. The cumulative hazard of arterial events at 60 months after the diagnosis of SLE was 8.5%, 8.1%, and 5.1% for the Chinese, African Americans, and Caucasians, respectively. The corresponding cumulative risk of venous events was 3.7%, 6.6%, and 10.3%, respectively (P ‫؍‬ 0.008 for Chinese versus Caucasians, by log rank test). Smoking, obesity, antiphospholipid antibodies, and use of antimalarial agents and exogenous estrogens were less frequent in the Chinese patients. In Cox regression models, low levels of high-density lipoprotein (HDL) cholesterol, Chinese ethnicity, oral ulcers, and serositis predicted arterial events, whereas male sex, low levels of HDL cholesterol, antiphospholipid antibodies, non-Chinese ethnicity, obesity, renal disease, and hemolytic anemia predicted venous events.Conclusion. There are ethnic differences in the incidence of arterial and venous thromboembolism in patients with SLE that cannot be fully explained by the clinical factors studied. Further evaluation of other genetic and immunologic factors is warranted.Premature atherosclerosis is a major cause of mortality and late morbidity in patients with systemic lupus erythematosus (SLE) (1-3). In several cohort studies, it was found that atherosclerotic cardiovascular and cerebrovascular diseases are more common causes of late deaths than active SLE itself (1,(4)(5)(6). More recent studies have demonstrated that subclinical coronary heart disease and carotid plaque were present in a significantly higher proportion of SLE patients than in age-and sex-matched control subjects with similar risk factors (7,8). The etiology of accelerated atherosclerosis in SLE is multifactorial and cannot be fully explained by traditional risk factors (9).Compared with individuals without SLE, the risk of myocardial infarction in SLE patients is 2-50 times higher, and the risk of stroke is 2-10 times higher (2,9,10). The prevalence of symptomatic coronary heart disease in SLE patients has been reported to be 6-20%, The Hopkins Lupus Cohort is supported by NIH grants R01-AR-43727 and M01-RR-00052 (to the outpatient Clinical Research Center).

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Oral contraceptives and systemic lupus erythematosus

Cited by 108 publications

References 68 publications

Contraceptive practices in women with systemic lupus erythematosus and/or antiphospholipid syndrome: What advice should we be giving?

Contraceptive practices in women with systemic lupus erythematosus and/or antiphospholipid syndrome: What advice should we be giving?

Combined oral contraceptive use and the risk of systemic lupus erythematosus

Incidence and risk factors of thromboembolism in systemic lupus erythematosus: A comparison of three ethnic groups

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