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Ovarian antibodies among SLE women with premature menopause after cyclophosphamide
Author(s) -
Tsaliki Martha,
Koelsch Kristi A.,
Chambers Ambre,
Talsania Mitali,
Scofield R. Hal,
Chakravarty Eliza F.
Publication year - 2021
Publication title -
international journal of rheumatic diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.795
H-Index - 41
eISSN - 1756-185X
pISSN - 1756-1841
DOI - 10.1111/1756-185x.14022
Subject(s) - premature ovarian failure , medicine , menopause , premature menopause , cyclophosphamide , systemic lupus erythematosus , anti thyroid autoantibodies , antibody , obstetrics , disease , gynecology , immunology , autoantibody , chemotherapy
Background Women with systemic lupus erythematosus (SLE) are at risk of premature ovarian failure when treated with cyclophosphamide. This risk is increased when autoimmune thyroid disease is present. We undertook this study to determine whether the presence of ovarian autoimmunity also increased the risk of early ovarian failure among women receiving cyclophosphamide. Methods We examined the records of women enrolled in the Lupus Family Registry and Repository, a cross‐sectional study of ~3300 SLE subjects, for treatment with cyclophosphamide as well as menopausal status. We defined premature menopause as permanent, spontaneous cessation of menstruation before age 45. We measured anti‐ovarian antibodies by enzyme‐linked immunosorbent assay using stored sera. Results There were 258 women treated with cyclophosphamide in whom presence of absence or premature menopause could by defined. A total of 169 (65.6%) had premature ovarian failure, while 89 (34.6%) did not. While anti‐ovarian antibodies were present in a small percentage of patients, there was no association of premature menopause to either level of these antibodies (16.2 ± 20.3 units vs 17.4 ± 21.7 units, P = NS by Fisher's exact test), or positivity on this testing (11 of 169 [6.5%] positive vs 8 of 89 [8.9%], χ 2 = 0.53, P = .46, 95% CI 0.95‐1.1). Neither renal disease nor hypothyroidism increased the risk of premature ovarian failure in these women receiving cyclophosphamide. Conclusion Anti‐ovarian antibodies among women with SLE are not associated with premature ovarian failure after treatment with cyclophosphamide.