Predictors of sustained amenorrhea from pulsed intravenous cyclophosphamide in premenopausal women with systemic lupus erythematosus
dc.contributor.author | Ioannidis, J. P. | en |
dc.contributor.author | Katsifis, G. E. | en |
dc.contributor.author | Tzioufas, A. G. | en |
dc.contributor.author | Moutsopoulos, H. M. | en |
dc.date.accessioned | 2015-11-24T18:57:15Z | |
dc.date.available | 2015-11-24T18:57:15Z | |
dc.identifier.issn | 0315-162X | - |
dc.identifier.uri | https://olympias.lib.uoi.gr/jspui/handle/123456789/19146 | |
dc.rights | Default Licence | - |
dc.subject | Adult | en |
dc.subject | Age Factors | en |
dc.subject | Amenorrhea/chemically induced/*diagnosis/epidemiology | en |
dc.subject | Antirheumatic Agents/administration & dosage/*adverse effects | en |
dc.subject | Cohort Studies | en |
dc.subject | Cyclophosphamide/administration & dosage/*adverse effects | en |
dc.subject | Female | en |
dc.subject | Greece/epidemiology | en |
dc.subject | Humans | en |
dc.subject | Injections, Intravenous | en |
dc.subject | Lupus Erythematosus, Systemic/complications/*drug therapy/epidemiology | en |
dc.subject | Predictive Value of Tests | en |
dc.subject | *Premenopause | en |
dc.subject | Pulse Therapy, Drug | en |
dc.subject | Risk Factors | en |
dc.title | Predictors of sustained amenorrhea from pulsed intravenous cyclophosphamide in premenopausal women with systemic lupus erythematosus | en |
heal.abstract | OBJECTIVE: To identify predictors of intravenous cyclophosphamide (IC) induced sustained amenorrhea, especially in young premenopausal women with systemic lupus erythematosus (SLE). METHODS: The cumulative dose resulting in sustained amenorrhea in 50 and 90% of the treated women (D50 and D90) and predictors of sustained amenorrhea at various ages were determined with Kaplan-Meier plots and Cox regressions in a consecutively enrolled cohort of 67 premenopausal women with SLE who received a pulsed IC regimen (monthly doses of 0.75-1.00 g/m2) for nephritis (n = 59) or other indications (n = 8). RESULTS: Twenty-one of 67 women developed sustained amenorrhea of > 12 months' duration. Age was the strongest determinant of this adverse event. For women in the upper age tertile (>or= 32 years old), D50 was 8 g/m2 and D90 was 12 g/m2, and no strong protective or predisposing factors were identified. Conversely, only 5 of 44 women <or= 31 years old at initiation of IC developed sustained amenorrhea. In these young women the risk was modulated by the prior SLE disease duration (risk increased 1.28-fold per year; p = 0.002), the presence of anti-U1RNP antibodies (relative risk 9.5; p = 0.016), and the presence of anti-Ro antibodies (relative risk 13.5; p = 0.021). In multivariate modeling, anti-U1RNP and disease duration were still significant (p < 0.05). CONCLUSION: Sustained amenorrhea is difficult to avoid in women 32 years or older, even with very short IC courses, and alternative regimens should be considered. In younger women treated with a monthly IC regimen, sustained amenorrhea may occur predominantly in those with the recognized adverse predictors of this complication. | en |
heal.access | campus | - |
heal.fullTextAvailability | TRUE | - |
heal.identifier.secondary | http://www.ncbi.nlm.nih.gov/pubmed/12375322 | - |
heal.journalName | J Rheumatol | en |
heal.journalType | peer-reviewed | - |
heal.language | en | - |
heal.publicationDate | 2002 | - |
heal.recordProvider | Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής | el |
heal.type | journalArticle | - |
heal.type.el | Άρθρο Περιοδικού | el |
heal.type.en | Journal article | en |
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