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Menopausal Hormone Therapy May Be an Option in Some With Lupus

By David Douglas

April 14, 2015

NEW YORK (Reuters Health) – Hormone therapy in menopausal patients with systemic lupus erythematosus (SLE) appears to be generally well tolerated, according to a new review.

“Our review shows that women with SLE should not be automatically excluded from menopausal hormone therapy. Each patient should be evaluated on her risks and quality of life impact,” Dr. Wen Shen, of Johns Hopkins School of Medicine, Baltimore, Maryland, told Reuters Health by email.

Dr. Shen and colleagues examined the literature and identified two relevant randomized clinical trials and three observational studies involving 282 women using or having used hormone therapy, they report in a March 28 online paper in Maturitas.

One randomized controlled trial involving 173 menopausal women receiving hormone therapy versus 177 receiving placebo found that those on hormone therapy were at a higher risk for developing minor to moderate SLE flares. Severe flares were rare in both groups with no significant difference in their rates.

In the other four studies, researchers found no significant difference in SLE disease activity between users and nonusers of hormone therapy.

The possible risk of developing minor to moderate flares, the investigators wrote, “has to be weighed against the beneficial use of hormone therapy in reducing menopausal symptoms.”

The patients in these clinical trials were followed for a maximum of two years, they wrote. Hence, no available data exists about long-term effects.

Larger prospective studies are needed, they concluded, to determine which patients are considered good candidates to receive hormone therapy and identify factors that may increase flare risks.

Commenting on the findings by email, rheumatologist Dr. Rosalind Ramsey-Goldman, of Northwestern University Feinberg School of Medicine, Chicago, told Reuters Health, “It is important to individualize the risks and benefits of hormone therapy in postmenopausal women with SLE.”

“It is reassuring,” she concluded, “that in carefully selected patients hormone therapy can be an option for those who are considering it for short-term use.”


Maturitas 2015.  Article take from Medscape

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