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September - October 2010 Utilization of hyperestrogenic therapies in systemic lupus erythematosus

Reumatología Clínica (English Edition)

ISSN: 2173-5743

Reumatología Clínica is the official publication of scientific Spanish Society of Rheumatology (SER) and the Mexican College of Rheumatology (CMR). Reumatología Clínica publishes original research papers, editorials, reviews, case reports and pictures. Published studies are primarily clinical and epidemiological research but also basic.

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Vol. 6. Issue 5.

Pages 264-267 (September - October 2010)

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Vol. 6. Issue 5.

Pages 264-267 (September - October 2010)

DOI: 10.1016/S2173-5743(10)70061-7

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Utilization of hyperestrogenic therapies in systemic lupus erythematosus

Utilización de terapias hiperestrogénicas en el lupus eritematoso sistémico

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Jaime Calvo-Alén

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jcalvo@hsll.scsalud.es

Corresponding author.

, Cristina Mata, Elena Aurrecoechea

Sección de Reumatología, Hospital General Sierrallana, IFIMAV, Universidad de Cantabria, Cantabria, Spain

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Abstract

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Abstract

The use of treatments that increase oestrogen levels has usually been deemed risky in lupus patients. Past studies about the utilisation of oral contraceptive drugs and hormone replacement therapy (HRT) have shown contradictory results. More recently, prospective studies about this issue suggest that either oral anticontraceptives or HRT can be used in patients with stable disease without special risk for increments in clinical activity. Neither has an association with the development of arterial or venous thrombosis been observed. However, in this respect, several methodological limitations preclude establishing definitive conclusions.

Regarding the use of assisted reproduction techniques in lupus patients, only retrospective data are available. Overall they indicate that the real risk of disease exacerbation is quite low, the flares being generally mild when these procedures are performed in patients with stable disease.

Keywords:

Systemic lupus erythematosus

Estrogen

Assisted fertilization

Resumen

La utilización de tratamientos que aumenten los niveles estrogénicos ha sido considerada clásicamente de riesgo en pacientes lúpicos. Estudios relativamente antiguos sobre la utilización de anticonceptivos orales y de tratamiento hormonal sustitutivo han proporcionado resultados contradictorios o inconsistentes. Más recientemente, estudios prospectivos sobre esta problemática sugieren que tanto los anticonceptivos como el tratamiento hormonal sustitutivo pueden ser utilizados en pacientes con enfermedad estable sin riesgo de un aumento en la actividad clínica de ésta. Tampoco se ha observado una asociación al desarrollo de complicaciones tromboembólicas arteriales y/o venosas. Aunque, a este respecto, determinaciones y limitaciones metodológicas imposibilitan el establecer valoraciones definitivas sobre esta problemática.

Con respecto a la utilización de técnicas de fertilización asistida en pacientes lúpicas, todos los datos de que se disponen son de tipo retrospectivo. Globalmente considerados, estos estudios indican que el riesgo real de reagudización de la enfermedad es relativamente bajo y que, en general, no son agudizaciones graves, siempre y cuando estas técnicas se realicen en pacientes con enfermedad estable.

Palabras clave:

Lupus eritematoso sistémico

Estrógenos

Fertilización asistida

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