Risk factors for ovarian failure in SLE observed.

Higher disease activity, treatment with cyclophosphamide, older age, and a certain ethnic background were each linked with a significantly increased risk for developing premature gonadal failure in a study of 316 women with systemic lupus erythematosus.

Disease activity and Texan-Hispanic ethnicity had not previously been reported to boost the risk for premature gonadal failure (PGF) in younger women with systemic lupus erythematosus (SLE), reported Dr. Luis A. Gonzalez of the division of immunology and rheumatology at the University of Alabama, Birmingham, and his associates (Ann. Rheum. Dis. 2008 Feb. 13 [doi: 10.1136/ard.2007.083576]). The findings also confirmed the previously reported findings that cyclophosphamide treatment and older age were linked with PGF in women with SLE.

Alternatives to cyclophosphamide treatment are needed for treating young women with SLE, said Dr. Gonzalez and his associates.

They used data collected in the Lupus in Minorities: Nature vs. Nurture (LUMINA) study, a longitudinal outcomes study that included SLE patients aged 16 or older who were diagnosed with SLE for 5 years or less. From this group, they focused on women younger than 40 years of age who were not postmenopausal when they entered the study.

This yielded a study group of 316 women, with an average age of about 29 years. Their average duration of SLE at enrollment was 1 year.

The group included women from four racial and ethnic groups: Texan-Hispanics, Puerto Rican-Hispanics, African Americans, and whites.

During follow-up, 37 women (12%) developed PGF. The total group of 316 women included 76 who were treated with cyclophosphamide, of whom 33% developed PGF.

A multivariable analysis identified four factors that were each linked with a statistically significant, increased risk of developing PGF during follow-up: older age, Texan-Hispanic ethnicity, treatment with cyclophosphamide, and greater SLE severity that was quantified with the revised systemic lupus activity measure.

Women categorized as Texan-Hispanic were about four-to fivefold more likely to develop PGF, compared with white women. Women with more severe SLE were about 20% more likely to develop PGF, compared with women with less severe disease.

BY MITCHEL L. ZOLER

Philadelphia Bureau