%0 Journal Article
%T Association between low-dose pulsed intravenous cyclophosphamide therapy and amenorrhea in patients with systemic lupus erythematosus: A case-control study
%A Sayumi Baba
%A Yasuhiro Katsumata
%A Yasushi Kawaguchi
%A Takahisa Gono
%A Tomoko Sugiura
%A Tokiko Kanno
%A Masako Hara
%A Hisashi Yamanaka
%J BMC Women's Health
%D 2011
%I BioMed Central
%R 10.1186/1472-6874-11-28
%X A case-control retrospective study of premenopausal women ¡Ü 45 years old who had been treated for SLE with low-dose IVCY (500 mg/body/pulse) plus high-dose glucocorticoids (0.8-1.0 mg/kg/day of prednisolone; IVCY group) or glucocorticoids alone (0.8-1.0 mg/kg/day of prednisolone; steroid group) in our hospital from 2000 through 2009 was conducted using a questionnaire survey and medical record review.Twenty-nine subjects in the IVCY group and 33 subjects in the steroid group returned the questionnaire. A multivariate analysis revealed that age at initiation of treatment ¡Ý 40 years old was significantly associated with amenorrhea [p = 0.009; odds ratio (OR) 10.2; 95% confidence interval (CI) 1.8-58.7]. IVCY treatment may display a trend for association with amenorrhea (p = 0.07; OR 2.9; 95% CI 0.9-9.4). Sustained amenorrhea developed in 4 subjects in the IVCY group and 1 subject in the steroid group; all of these patients were ¡Ý 40 years old. Menses resumed in all subjects < 40 years old, irrespective of treatment.Although low-dose IVCY may increase the risk for amenorrhea, our data suggest that patients < 40 years old have a minimum risk for sustained amenorrhea with low-dose IVCY treatment. A higher risk for sustained amenorrhea following treatment with IVCY is a consideration for patients ¡Ý 40 years old.Systemic lupus erythematosus (SLE) remains a therapeutic challenge. One of the most successful therapies for severe SLE has been administration of monthly intravenous cyclophosphamide (IVCY) for 6 months followed by quarterly maintenance infusions for 2 years (traditional/NIH IVCY regimen) [1-3]. However, the side effects of long-term exposure to cyclophosphamide include infection, bone marrow damage, malignancy, hemorrhagic cystitis, and ovarian dysfunction [2]. Ovarian dysfunction may result in physiological changes associated with menopause, including loss of bone mineral density, hypercholesterolemia, onset of vasomotor and genitourinary symptoms, psychological
%U http://www.biomedcentral.com/1472-6874/11/28