EULAR: Drug Regimen May Help Preserve Fertility in Lupus

Shorter course of cyclophosphamide followed by mycophenolate mofetil also effectively controls disease

TUESDAY, June 17 (HealthDay News) -- A shorter course of cyclophosphamide followed by mycophenolate mofetil (MMF) controls disease and preserves ovarian function in women with systemic lupus erythematosus, according to study findings presented at the European League Against Rheumatism Congress 2008, held June 11-14 in San Francisco.

Katerina Laskari, M.D., of the National and Kapodistrian University of Athens in Greece, and colleagues retrospectively evaluated 61 premenopausal women with systemic lupus erythematosus treated for lupus nephritis (58 women), autoimmune hemolytic anemia (one woman) and central nervous system involvement (two women). Thirty-nine of the women received prolonged treatment with 1 g/m2 intravenous cyclophosphamide pulses, and the other 22 received five to seven monthly 1 g/m2 intravenous cyclophosphamide pulses followed by 2 g/day MMF.

The researchers found that disease activity was equally controlled with either regimen. The patients in the non-MMF group had a 12-fold increased risk of developing amenorrhea, or the absence of menstrual periods, compared with the MMF group. Only 14 percent of women in the non-MMF group resumed menstruation after treatment ended, versus 67 percent of the women in the MMF group. Restoration of menstruation was related to both the form of treatment and the age of the patient, the researchers found.

"We suggest that treatment with MMF following five to seven intravenous pulses of cyclophosphamide is an effective means to control disease activity and preserve ovarian function in premenopausal women with systemic lupus erythematosus," the authors write.

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