[Risk factors of ovarian failure in the patients with systemic lupus erythematosus receiving cyclophosphamide therapy].
OBJECTIVE
To determine the risk factors for ovarian failure after cyclophosphamide therapy in the patients with systemic lupus erythematosus (SLE).


METHODS
A case-control study was conducted among 138 female SLE patients, aged 16-45, and treated with cyclophosphamide, 46 of which with premature ovarian failure were included in the case group and 92 of which without menopause after completion of induction therapy with cyclophosphamide were included in the control group. A Logistic regression model was established and step-wise selection was used to analyze different factors, such as age of initiation of therapy, marital history, childbearing history, disease activity index, accumulative dosage of cyclophosphamide, accumulative dosage of azathiopurine, and usage of traditional Chinese medicines etc.


RESULTS
Univariate analysis showed that age of initiation of cyclophosphamide treatment (OR = 1.11, 95% CI = 1.06 - 1.17), SLE activity index (OR = 1.11, 95% CI = 1.06 - 1.17), duration of Trypterygium wilfordii treatment (OR = 1.26, 95% CI = 1.05 - 1.51), duration of cyclophosphamide treatment (OR = 0.16, 95% CI = 0.028 - 0.94), and marital situation were associated with ovarian failure; and multivariate analysis showed that age of initiation of cyclophosphamide treatment (OR = 1.24, 95% CI = 1.14 - 1.35), cumulative dosage of cyclophosphamide (OR = 1.13, 95%, CI = 1.05 - 1.23), and duration of treatment of Trypterygium wilfordii agents (OR = 1.36, 95% CI = 1.09 - 1.69)were significantly associated with premature ovarian failure. Only 4 cases in the case group began to receive cyclophosphamide treatment before the age of 20 and their accumulative cyclophosphamide dosage was 28.8 - 32.4 g. The median of cumulative dosage of cyclophosphamide was only 4.8 g for the 11 cases aged 40-45 in the case group.


CONCLUSIONS
The risk factors of premature ovarian failure during the induction therapy in SLE patients include age of initiation of cyclophosphamide treatment, cumulative dosage of cyclophosphamide and duration of treatment with leigongteng.
Yang
Xiu-yan
XY
Department of Rheumatology and Clinical Immunology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China.
Zhu
Xun
X
Liang
Liu-qin
LQ
Zhan
Zhong-ping
ZP
Ye
Yu-jin
YJ
D000293:Adolescent; D000328:Adult; D000568:Amenorrhea / Q000139:chemically induced*; D016022:Case-Control Studies; D003520:Cyclophosphamide / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D016015:Logistic Models; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy*; D008875:Middle Aged; D016649:Primary Ovarian Insufficiency / Q000139:chemically induced*; D012307:Risk Factors
D007166:Immunosuppressive Agents; D003520:Cyclophosphamide