title: Menopause hormonal therapy in women with systemic lupus erythematosus.
abstract: OBJECTIVE
  To evaluate the effects of menopause hormonal therapy on disease activity in women with systemic lupus erythematosus (SLE).
  
  
  METHODS
  We conducted a double-blind, randomized clinical trial involving 106 women with SLE who were in the menopausal transition or in early or late postmenopause. Patients received a continuous-sequential estrogen-progestogen regimen (n = 52) or placebo (n = 54). Disease activity was assessed at baseline and at 1, 2, 3, 6, 9, 12, 15, 18, 21, and 24 months, according to the SLE Disease Activity Index (SLEDAI). The primary outcome measure was global disease activity, estimated by measuring the area under the SLEDAI curve. Secondary outcome measures included maximum SLEDAI score, change in SLEDAI score, incidence of lupus flares, median time to flare, medication use, and adverse events. Results were studied using intent-to-treat analysis.
  
  
  RESULTS
  At baseline, demographic and disease characteristics were similar in both groups. Mean +/- SD SLEDAI scores were 3.5 +/- 3.3 and 3.1 +/- 3.4 in the menopause hormonal therapy and placebo groups, respectively (P = 0.57). Disease activity remained mild and stable in both groups throughout the trial. There were no significant differences between the groups in global or maximum disease activity, incidence or probability of flares, or medication use. Median time to flare was 3 months in both groups. Thromboses occurred in 3 patients who received menopause hormonal therapy and in 1 patient who received placebo. One patient in each group died during the trial due to sepsis.
  
  
  CONCLUSIONS
  Menopause hormonal therapy did not alter disease activity during 2 years of treatment. However, an apparently increased risk of thrombosis seems to be a real threat in women with SLE who receive menopausal hormone therapy.
authors.affiliation: Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, Mexico. jsanchez@innsz.mx
authors.forename: Jorge
authors.initials: J
authors.lastname: Sánchez-Guerrero
authors.forename: Marisol
authors.initials: M
authors.lastname: González-Pérez
authors.forename: Marta
authors.initials: M
authors.lastname: Durand-Carbajal
authors.forename: Pilar
authors.initials: P
authors.lastname: Lara-Reyes
authors.forename: Luisa
authors.initials: L
authors.lastname: Jiménez-Santana
authors.forename: Juanita
authors.initials: J
authors.lastname: Romero-Díaz
authors.forename: María-del-Carmen
authors.initials: MD
authors.lastname: Cravioto
mesh_terms: D000328:Adult; D000368:Aged; D004311:Double-Blind Method; D015914:Estrogen Replacement Therapy; D005500:Follow-Up Studies; D020249:Hormone Replacement Therapy; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000503:physiopathology*; D008593:Menopause; D008875:Middle Aged; D011372:Progestins / Q000627:therapeutic use*
chemical_list: D011372:Progestins