XML Feed for RxPG News   Add RxPG News Headlines to My Yahoo!   Javascript Syndication for RxPG News

Research Health World General
 
  Home
 
 Latest Research
 Cancer
 Psychiatry
 Genetics
 Surgery
 Aging
 Ophthalmology
 Gynaecology
 Neurosciences
 Pharmacology
 Cardiology
 Obstetrics
 Infectious Diseases
 Respiratory Medicine
 Pathology
 Endocrinology
 Immunology
  Autoimmune Diseases
   Lupus
  Immunosupressants
  Monoclonal Antibodies
 Nephrology
 Gastroenterology
 Biotechnology
 Radiology
 Dermatology
 Microbiology
 Haematology
 Dental
 ENT
 Environment
 Embryology
 Orthopedics
 Metabolism
 Anaethesia
 Paediatrics
 Public Health
 Urology
 Musculoskeletal
 Clinical Trials
 Physiology
 Biochemistry
 Cytology
 Traumatology
 Rheumatology
 
 Medical News
 Health
 Opinion
 Healthcare
 Professionals
 Launch
 Awards & Prizes
 
 Careers
 Medical
 Nursing
 Dental
 
 Special Topics
 Euthanasia
 Ethics
 Evolution
 Odd Medical News
 Feature
 
 World News
 Tsunami
 Epidemics
 Climate
 Business
Search

Last Updated: Aug 19th, 2006 - 22:18:38

Lupus Channel
subscribe to Lupus newsletter

Latest Research : Immunology : Autoimmune Diseases : Lupus

   DISCUSS   |   EMAIL   |   PRINT
Oral Contraceptives in Women with Lupus might be Safe
Dec 25, 2005, 00:59, Reviewed by: Dr. Priya Saxena

“Estrogen, as used in this study, appears to be safe in the majority of women with stable disease. This research brings us another step forward in improving quality of life for people with rheumatic disease.”

 
In a major study funded by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), a part of the National Institutes of Health (NIH), women with either inactive or stable systemic lupus erythematosus (lupus) — a disease in which the body’s immune system mistakenly attacks and damages healthy tissues of the skin, joints and internal organs — were able to take oral contraceptives without increased risk of flares, or periods of increased disease activity, that characterize the disease.

Safe and effective contraception is an issue that many women of childbearing age face. But for women with lupus, doctors have often been hesitant to prescribe one of the most effective forms of contraception — oral contraceptives, or the “pill” — for fear that it might increase disease activity.

In the 15-center study of 183 women with inactive or stable lupus, those taking oral contraceptives (triphasic 35 µg.ethinylestradiol/0.5-1 mg norethindrone for twelve 28-day cycles) had no statistically significant difference in the occurrence of flares than those taking a placebo. Severe flares occurred in about 7 percent of the women, regardless of whether they received oral contraceptives or placebo. A severe flare was defined by several criteria, including the presence of new or worsening central nervous system involvement; inflammation of the blood vessels (vasculitis), kidneys (nephritis) and/or muscles (myositis); and/or blood problems, including low platelet count (thrombocytopenia) and destruction of the red blood cells (hemolytic anemia).

Mild-to-moderate flares and disease complications were similar between the two groups over the 12-month follow-up as well. Mild-to-moderate flares included fevers and inflammation of the skin, joints, the sac of fibrous tissue that surrounds the heart (pericarditis), and mucous membranes lining the nose and mouth.

Reluctance to prescribe oral contraceptives and other hormones for women with lupus arose in part from the fact that lupus is far more common in women (women with the disease outnumber men 10 to 1), and that it typically begins during the childbearing years (after the onset and before the cessation of menstruation) when female hormone levels are at their peak. In mouse models of lupus, giving estrogen makes lupus worse and, depending on the genetic background, influences the activity of white blood cells called B cells that are believed to play a key role in the disease process.

But for most women with moderate lupus that is inactive or stable, taking estrogen — whether as part of an oral contraceptive or hormone replacement therapy — appears to have no detrimental effect on disease activity, say co-authors Jill Buyon, M.D., of New York’s Hospital for Joint Diseases, and Michelle Petri, M.D., M.P.H., of the Johns Hopkins University, who jointly led the study. However, they note that oral contraceptives still are not advised for women who have a history of, or are at high risk for, blood clots, because estrogens have been associated with dangerous blood clots.

The recently published study on oral contraceptives is one of two separate randomized, placebo-controlled studies that comprise the Safety of Estrogens in Lupus Erythematosus, National Assessment (SELENA) Trial. The other study, which showed no increased risk of severe flares in postmenopausal women on hormone replacement therapy, was published earlier this year (Buyon JP, et. al. The effect of combined estrogen and progesterone hormone replacement therapy on disease activity in systemic lupus erythematosus: a randomized trial,” Ann Intern Med 2005; 142: 953-962).

“There are settings in which estrogens might provide benefit,” say the authors. Among women with lupus, they say, there is a high elective abortion rate — approaching 23 percent of pregnancies — which may reflect a failure of the birth control method used or the absence of an adequate birth control program.

“Estrogen, as used in this study, appears to be safe in the majority of women with stable disease,” says NIAMS Director Stephen I. Katz, M.D., Ph.D. “This research brings us another step forward in improving quality of life for people with rheumatic disease.”
 

- National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
 

www.niams.nih.gov

 
Subscribe to Lupus Newsletter
E-mail Address:

 

In addition to NIAMS, other funders of the study included NIH’s Office of Research on Women’s Health, National Center on Minority Health and Health Disparities, National Center for Research Resources and National Institute of Allergy and Infectious Diseases.

The mission of the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), a part of the Department of Health and Human Services’ National Institutes of Health, is to support research into the causes, treatment, and prevention of arthritis and musculoskeletal and skin diseases; the training of basic and clinical scientists to carry out this research; and the dissemination of information on research progress in these diseases. For additional information, call NIAMS’s Clearinghouse toll free at 1-877-22-NIAMS, or visit the NIAMS Web site at www.niams.nih.gov.

The National Institutes of Health (NIH) — The Nation's Medical Research Agency — includes 27 Institutes and Centers and is a component of the U. S. Department of Health and Human Services. It is the primary Federal agency for conducting and supporting basic, clinical, and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit http://www.nih.gov.


Related Lupus News

Pregnant women with lupus are at higher risk for complications
Oral Contraceptives in Women with Lupus might be Safe
Pro-inflammatory HDL (piHDL) is a potential biomarker for lupus atherosclerosis
Epratuzumab may Serve as a Potential Treatment Option for SLE
How lupus T cells lose IL-2


For any corrections of factual information, to contact the editors or to send any medical news or health news press releases, use feedback form

Top of Page

 

© Copyright 2004 onwards by RxPG Medical Solutions Private Limited
Contact Us