Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Study Demonstrates Safety of Oral Contraceptives in Women with Lupus

23.12.2005


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.”

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.

Ray Fleming | EurekAlert!
Further information:
http://www.niams.nih.gov
http://www.nih.gov

More articles from Studies and Analyses:

nachricht Researchers simplify tiny structures' construction drip by drip
12.11.2018 | Princeton University, Engineering School

nachricht Mandibular movement monitoring may help improve oral sleep apnea devices
06.11.2018 | Elsevier

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: A Chip with Blood Vessels

Biochips have been developed at TU Wien (Vienna), on which tissue can be produced and examined. This allows supplying the tissue with different substances in a very controlled way.

Cultivating human cells in the Petri dish is not a big challenge today. Producing artificial tissue, however, permeated by fine blood vessels, is a much more...

Im Focus: A Leap Into Quantum Technology

Faster and secure data communication: This is the goal of a new joint project involving physicists from the University of Würzburg. The German Federal Ministry of Education and Research funds the project with 14.8 million euro.

In our digital world data security and secure communication are becoming more and more important. Quantum communication is a promising approach to achieve...

Im Focus: Research icebreaker Polarstern begins the Antarctic season

What does it look like below the ice shelf of the calved massive iceberg A68?

On Saturday, 10 November 2018, the research icebreaker Polarstern will leave its homeport of Bremerhaven, bound for Cape Town, South Africa.

Im Focus: Penn engineers develop ultrathin, ultralight 'nanocardboard'

When choosing materials to make something, trade-offs need to be made between a host of properties, such as thickness, stiffness and weight. Depending on the application in question, finding just the right balance is the difference between success and failure

Now, a team of Penn Engineers has demonstrated a new material they call "nanocardboard," an ultrathin equivalent of corrugated paper cardboard. A square...

Im Focus: Coping with errors in the quantum age

Physicists at ETH Zurich demonstrate how errors that occur during the manipulation of quantum system can be monitored and corrected on the fly

The field of quantum computation has seen tremendous progress in recent years. Bit by bit, quantum devices start to challenge conventional computers, at least...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

“3rd Conference on Laser Polishing – LaP 2018” Attracts International Experts and Users

09.11.2018 | Event News

On the brain’s ability to find the right direction

06.11.2018 | Event News

European Space Talks: Weltraumschrott – eine Gefahr für die Gesellschaft?

23.10.2018 | Event News

 
Latest News

Massive impact crater from a kilometer-wide iron meteorite discovered in Greenland

15.11.2018 | Earth Sciences

When electric fields make spins swirl

15.11.2018 | Physics and Astronomy

Discovery of a cool super-Earth

15.11.2018 | Physics and Astronomy

VideoLinks
Science & Research
Overview of more VideoLinks >>>