Skip to main content

Advertisement

Log in

Major flares in women with SLE on combined oral contraception

  • Case Report
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript

Abstract

Two recent trials concluded that the use of oral contraceptives (OC) did not induce flares in lupus patients. We record our experience with OC in patients with stable lupus. Eight patients were enrolled in an open trial. Six received a combined contraceptive pill and two were allocated to the control arm. During a 12 month follow-up, 3 patients in the active arm experienced 4 major flares. One patient died as a result of uncontrolled disease complicated by sepsis. At this point, we abandoned the trial. The 2 patients in the control arm experienced no disease exacerbation during the 7 months of observation. We would urge that patients who are placed on OC be closely monitored.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Petri M, Kim MY, Kalunian KC et al (2005) Combined oral contraception in women with systemic lupus erythematosus. N Engl J Med 353:2550–2558

    Article  CAS  PubMed  Google Scholar 

  2. Sanchez-Guerrero J, Uribe AG, Jimenez-Santana L et al (2005) A trial of contraceptive methods in women with systemic lupus erythematosus. N Engl J Med 353:2539–2549

    Article  CAS  PubMed  Google Scholar 

  3. Bermas BL (2005) Oral contraceptives in systemic lupus erythematosus—a tough pill to swallow? N Engl J Med 353:2602–2604

    Article  PubMed  Google Scholar 

  4. Cooper GS, Parks CG, Treadwell EL et al (2002) Differences by race, sex and age in the clinical and immunologic features of recently diagnosed systemic lupus erythematosus patients in the southeastern United States. Lupus 11:161–167

    Article  CAS  PubMed  Google Scholar 

  5. Alarcon GS, McGwin G Jr, Petri M et al (2002) Baseline characteristics of a multiethnic lupus cohort: PROFILE. Lupus 11:95–101

    Article  CAS  PubMed  Google Scholar 

  6. Bombardier C, Gladman DD, Urowitz MB et al (1992) Derivation of the SLEDAI. A disease activity index for lupus patients. The Committee on Prognosis Studies in SLE. Arthritis Rheum 35:630–640

    Article  CAS  PubMed  Google Scholar 

  7. Austin HA 3rd, Klippel JH, Balow JE et al (1986) Therapy of lupus nephritis. Controlled trial of prednisone and cytotoxic drugs. N Engl J Med 314:614–619

    Article  PubMed  Google Scholar 

  8. Ehrenstein MR, Conroy SE, Heath J et al (1995) The occurrence, nature and distribution of flares in a cohort of patients with systemic lupus erythematosus: a rheumatological view. Br J Rheumatol 34:257–260

    Article  CAS  PubMed  Google Scholar 

  9. Petri M, Genovese M, Engle E et al (1991) Definition, incidence and clinical description of flare in systemic lupus erythematosus. A prospective cohort study. Arthritis Rheum 34:937–944

    Article  CAS  PubMed  Google Scholar 

  10. Rampone A, Rampone B, Tirabasso S et al (2001) Contraception with the latest estroprostagens in women suffering from systemic lupus erythematosus. Minerva Ginecol 53(1 Suppl 1):75–77

    CAS  PubMed  Google Scholar 

  11. Julkunen HA (1991) Oral contraception in systemic lupus erythematosus: side-effects and influence on the activity of SLE. Scand J Rheum 20:427–433

    Article  CAS  PubMed  Google Scholar 

  12. Jungers P, Dougados M, Pelissier C et al (1982) Influence of oral contraceptive therapy on the activity of systemic lupus erythematosus. Arthritis Rheum 25:618–623

    Article  CAS  PubMed  Google Scholar 

  13. Buyon JP, Petri MA, Kim MY et al (2005) The effect of combined estrogen and progesterone hormone replacement therapy on disease activity in systemic lupus erythematosus: a randomized trial. Ann Intern Med 142:953–962

    Article  CAS  PubMed  Google Scholar 

  14. Grimaldi CM, Hill L, Xu X et al (2005) Hormonal modulation of B cell development and repertoire selection. Mol Immunol 42:811–820

    Article  CAS  PubMed  Google Scholar 

  15. Cutolo M (2004) Estrogen metabolites: increasing evidence for their role in rheumatoid arthritis and systemic lupus erythematosus. J Rheumatol 31:419–421

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to D. A. Whitelaw.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Whitelaw, D.A., Jessop, S.J. Major flares in women with SLE on combined oral contraception. Clin Rheumatol 26, 2163–2165 (2007). https://doi.org/10.1007/s10067-007-0641-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-007-0641-y

Keywords

Navigation