Tags

Type your tag names separated by a space and hit enter

Systemic lupus erythematosus in a multiethnic US cohort (LUMINA L II): relationship between vascular events and the use of hormone replacement therapy in postmenopausal women.
J Clin Rheumatol 2007; 13(5):261-5JC

Abstract

OBJECTIVES

To examine the influence of hormone replacement therapy (HRT) in the occurrence of vascular arterial and venous thrombotic events in postmenopausal women with systemic lupus erythematosus (SLE).

PATIENTS AND METHODS

SLE women aged > or =16 years, disease duration < or =5 years from LUMINA, a multiethnic, longitudinal outcome study, were included. Menopause was defined at disease onset as the presence of amenorrhea >6 months and/or oophorectomy, and/or increased follicle stimulating hormone values, and/or HRT use regardless of the presence or absence of climacteric symptoms (hot flashes). Patients were divided into HRT ever users and nonusers. Patients with positive antiphospholipid antibodies (n = 9) or vascular arterial events (n = 1) occurring before HRT use were excluded. The occurrence of vascular arterial and venous thrombotic events was compared between HRT users and HRT nonusers and its role examined by logistic regression after adjusting for "confounding by indication" using propensity score or logistic regression analyses.

RESULTS

Seventy-two postmenopausal women, 32 (44%) HRT users and 40 (56%) HRT nonusers, were studied. HRT use was associated with fewer vascular arterial but not venous thrombotic events (P = 0.021) in the univariable analyses. However, after adjusting for the propensity score, HRT use was no longer significant (P = 0.064). Comparable results were obtained by logistic regression.

CONCLUSIONS

HRT use was not associated with the occurrence of vascular arterial events in the LUMINA patients. HRT use in women with SLE should be individualized, but our data suggest its use may be safe if antiphospholipid antibodies are not present or vascular arterial events have not previously occurred.

Authors+Show Affiliations

Division of Clinical Immunology and Rheumatology, Department of Medicine, Schools of Medicine and Public Health, The University of Alabama at Birmingham, 510 20th Street South, Birmingham, AL 35294, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17921793

Citation

Fernández, Mónica, et al. "Systemic Lupus Erythematosus in a Multiethnic US Cohort (LUMINA L II): Relationship Between Vascular Events and the Use of Hormone Replacement Therapy in Postmenopausal Women." Journal of Clinical Rheumatology : Practical Reports On Rheumatic & Musculoskeletal Diseases, vol. 13, no. 5, 2007, pp. 261-5.
Fernández M, Calvo-Alén J, Bertoli AM, et al. Systemic lupus erythematosus in a multiethnic US cohort (LUMINA L II): relationship between vascular events and the use of hormone replacement therapy in postmenopausal women. J Clin Rheumatol. 2007;13(5):261-5.
Fernández, M., Calvo-Alén, J., Bertoli, A. M., Bastian, H. M., Fessler, B. J., McGwin, G., ... Alarcón, G. S. (2007). Systemic lupus erythematosus in a multiethnic US cohort (LUMINA L II): relationship between vascular events and the use of hormone replacement therapy in postmenopausal women. Journal of Clinical Rheumatology : Practical Reports On Rheumatic & Musculoskeletal Diseases, 13(5), pp. 261-5.
Fernández M, et al. Systemic Lupus Erythematosus in a Multiethnic US Cohort (LUMINA L II): Relationship Between Vascular Events and the Use of Hormone Replacement Therapy in Postmenopausal Women. J Clin Rheumatol. 2007;13(5):261-5. PubMed PMID: 17921793.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Systemic lupus erythematosus in a multiethnic US cohort (LUMINA L II): relationship between vascular events and the use of hormone replacement therapy in postmenopausal women. AU - Fernández,Mónica, AU - Calvo-Alén,Jaime, AU - Bertoli,Ana M, AU - Bastian,Holly M, AU - Fessler,Barri J, AU - McGwin,Gerald,Jr AU - Reveille,John D, AU - Vilá,Luis M, AU - Alarcón,Graciela S, PY - 2007/10/9/pubmed PY - 2008/1/9/medline PY - 2007/10/9/entrez SP - 261 EP - 5 JF - Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases JO - J Clin Rheumatol VL - 13 IS - 5 N2 - OBJECTIVES: To examine the influence of hormone replacement therapy (HRT) in the occurrence of vascular arterial and venous thrombotic events in postmenopausal women with systemic lupus erythematosus (SLE). PATIENTS AND METHODS: SLE women aged > or =16 years, disease duration < or =5 years from LUMINA, a multiethnic, longitudinal outcome study, were included. Menopause was defined at disease onset as the presence of amenorrhea >6 months and/or oophorectomy, and/or increased follicle stimulating hormone values, and/or HRT use regardless of the presence or absence of climacteric symptoms (hot flashes). Patients were divided into HRT ever users and nonusers. Patients with positive antiphospholipid antibodies (n = 9) or vascular arterial events (n = 1) occurring before HRT use were excluded. The occurrence of vascular arterial and venous thrombotic events was compared between HRT users and HRT nonusers and its role examined by logistic regression after adjusting for "confounding by indication" using propensity score or logistic regression analyses. RESULTS: Seventy-two postmenopausal women, 32 (44%) HRT users and 40 (56%) HRT nonusers, were studied. HRT use was associated with fewer vascular arterial but not venous thrombotic events (P = 0.021) in the univariable analyses. However, after adjusting for the propensity score, HRT use was no longer significant (P = 0.064). Comparable results were obtained by logistic regression. CONCLUSIONS: HRT use was not associated with the occurrence of vascular arterial events in the LUMINA patients. HRT use in women with SLE should be individualized, but our data suggest its use may be safe if antiphospholipid antibodies are not present or vascular arterial events have not previously occurred. SN - 1076-1608 UR - https://www.unboundmedicine.com/medline/citation/17921793/Systemic_lupus_erythematosus_in_a_multiethnic_US_cohort__LUMINA_L_II_:_relationship_between_vascular_events_and_the_use_of_hormone_replacement_therapy_in_postmenopausal_women_ L2 - http://Insights.ovid.com/pubmed?pmid=17921793 DB - PRIME DP - Unbound Medicine ER -