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Hormone replacement therapy in systemic lupus erythematosus
S Kreidstein1, M B Urowitz, D D Gladman
1Centre for Prognosis Studies in the Rheumatic Diseases, The Toronto Hospital, Ontario, Canada.
Objective:
To test whether hormone replacement therapy (HRT) causes an increase in lupus flares.
Methods:
Sixteen postmenopausal patients with systemic lupus erythematosus (SLE) who had been taking HRT for at least 12 months were included in the study. Thirty-two controls were matched to patients for age at start of hormone therapy and calendar year of followup. The incidence of disease flare was defined as any increase in Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) over 12 months from baseline in these 2 groups; incidence of flare was compared by McNemar's test or Mantel-Haenszel test.
Results:
Control patients were older at diagnosis (38.8 vs 30.5 yrs) and at presentation to clinic (41 vs 30 yrs). HRT patients had longer disease duration (17.9 vs 5.6 yrs). SLEDAI at presentation was similar in both groups. There was no statistically significant difference in the rates of flares in both groups.
Conclusion:
The use of HRT in postmenopausal women with SLE does not appear to increase the rate of lupus flares over a one year followup.