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

J Sánchez-Guerrero, Jorge Sánchez‐Guerrero, Armando Villegas, A Villegas, A Mendoza-Fuentes, Angélica Mendoza-Fuentes, J Romero-Díaz, Juanita Romero‐Díaz, G Moreno-Coutiño, Gabriela Moreno‐Coutiño, Marı́a del Carmen Cravioto, M C Cravioto
The American journal of medicine · 2001 · vol. 111(6) , pp. 464–468 · doi:10.1016/s0002-9343(01)00885-3 · PMID:11690572 · W2059647493
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This study found that disease activity in women with systemic lupus erythematosus remains mild and similar between premenopausal and postmenopausal periods, with only a modest decrease in maximum disease activity observed after natural menopause.

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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.

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MeSH descriptors

Lupus Erythematosus, Systemic Postmenopause Premenopause Anti-Inflammatory Agents Anti-Inflammatory Agents Antirheumatic Agents Antirheumatic Agents Chloroquine Chloroquine Cohort Studies Disease Progression Emergency Service, Hospital Female Hospitalization Humans Immunosuppressive Agents Immunosuppressive Agents Lupus Erythematosus, Systemic Medical Records Middle Aged

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