[Systemic lupus erythematosus and contraception: A systematic literature review].
OBJECTIVE
The aim of our study was to evaluate the safety of contraceptive methods use among women with systemic lupus erythematosus (SLE).


METHODS
A systematic review of the literature was performed using the two databases MEDLINE and SCOPUS, in order to identify articles concerning the safety of contraceptive methods use among women with SLE, through May 2016. Information on study characteristics, objectives, population, contraception and outcomes were extracted.


RESULTS
A total of 907 articles were identified and 21 were selected for the systematic review. Two randomised controlled trials found no worsening of disease activity with the use of combined oral contraceptive in women with stable or inactive SLE. Disease activity was not exacerbated with the use of progestogens-only contraceptive. There was an increased risk of thrombosis with the use of combined contraceptive, particularly in women with positive antiphospholipid antibodies and this must lead to a restriction of use in these patients.


CONCLUSIONS
Use of oral combined hormonal contraceptives should be limited to patients with non-severe and stable disease, without thrombosis risk factors.
Service de médecine interne et immunologie clinique, hôpital Saint-André, CHU de Bordeaux, 1, rue Jean-Burguet, 33000 Bordeaux, France; UMR CNRS 5164, université de Bordeaux, 146, rue Léo-Saignat, 33076 Bordeaux, France.
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Gensous
Service de médecine interne et immunologie clinique, hôpital Saint-André, CHU de Bordeaux, 1, rue Jean-Burguet, 33000 Bordeaux, France.
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Doassans-Comby
UMR CNRS 5164, université de Bordeaux, 146, rue Léo-Saignat, 33076 Bordeaux, France; Service de médecine interne et maladies infectieuses, hôpital Haut-Lévêque, CHU de Bordeaux, avenue de Magellan, 33604 Pessac, France.
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Lazaro
Service de médecine interne et immunologie clinique, hôpital Saint-André, CHU de Bordeaux, 1, rue Jean-Burguet, 33000 Bordeaux, France; UMR CNRS 5164, université de Bordeaux, 146, rue Léo-Saignat, 33076 Bordeaux, France. Electronic address: pierre.duffau@chu-bordeaux.fr.
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Duffau
D003267:Contraception / Q000009:adverse effects / Q000706:statistics & numerical data*; D003277:Contraceptives, Oral, Combined / Q000009:adverse effects; D003278:Contraceptives, Oral, Hormonal / Q000009:adverse effects; D018450:Disease Progression; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000453:epidemiology* / Q000473:pathology; D012307:Risk Factors
D003277:Contraceptives, Oral, Combined; D003278:Contraceptives, Oral, Hormonal
Contraception; Lupus érythémateux systémique; Revue systématique de la littérature; Systematic literature review; Systemic lupus erythematosus