Use of a gonadotropin-releasing hormone analog for protection against premature ovarian failure during cyclophosphamide therapy in women with severe lupus

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dc.contributor.author Somers, Emily C. en_US
dc.contributor.author Marder, Wendy en_US
dc.contributor.author Christman, Gregory M. en_US
dc.contributor.author Ognenovski, Vladimir en_US
dc.contributor.author McCune, William Joseph en_US
dc.date.accessioned 2006-09-20T15:01:07Z
dc.date.available 2006-09-20T15:01:07Z
dc.date.issued 2005-09 en_US
dc.identifier.citation Somers, Emily C.; Marder, Wendy; Christman, Gregory M.; Ognenovski, Vladimir; McCune, W. Joseph (2005)."Use of a gonadotropin-releasing hormone analog for protection against premature ovarian failure during cyclophosphamide therapy in women with severe lupus." Arthritis & Rheumatism 52(9): 2761-2767. <http://hdl.handle.net/2027.42/48676> en_US
dc.identifier.issn 0004-3591 en_US
dc.identifier.issn 1529-0131 en_US
dc.identifier.uri http://hdl.handle.net/2027.42/48676
dc.identifier.uri http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=retrieve&db=pubmed&list_uids=16142702&dopt=citation en_US
dc.description.abstract Objective Cyclophosphamide (CYC) therapy for systemic lupus erythematosus (SLE), a disease predominantly affecting women of childbearing age, causes an unacceptably high incidence of irreversible premature ovarian failure (POF). This study was performed to evaluate the effectiveness of depot leuprolide acetate, a synthetic gonadotropin-releasing hormone analog (GnRH-a), for protection against POF during CYC therapy. Methods Young women with severe SLE treated in a standardized protocol of monthly intravenous bolus CYC were offered treatment with GnRH-a (depot leuprolide acetate; a 3.75-mg monthly injection during the standard CYC regimen). Patients treated with GnRH-a were compared with controls individually matched by age (±5 years) and by cumulative CYC dose (±5 gm). Reproductive status was determined after a minimum followup of 3 years after CYC therapy. The primary outcome was time to POF. Paired summary statistical analyses, Kaplan-Meier survival estimates, and Cox regression analyses were performed to assess differences in outcome between groups. Results POF developed in 1 of 20 women treated with GnRH-a (5%) compared with 6 of 20 controls (30%) matched by age and cumulative CYC dose (matched odds ratio 0.09, P < 0.05). Kaplan-Meier estimates demonstrated improved cumulative ovarian protection over time in the GnRH-a–treated group ( P = 0.04). Conclusion Treatment with GnRH-a during CYC therapy was associated with a significant reduction of POF in young women with severe SLE. en_US
dc.format.extent 78457 bytes
dc.format.extent 3118 bytes
dc.format.mimetype application/pdf
dc.format.mimetype text/plain
dc.language.iso en_US
dc.publisher Wiley Subscription Services, Inc., A Wiley Company en_US
dc.subject.other Life and Medical Sciences en_US
dc.title Use of a gonadotropin-releasing hormone analog for protection against premature ovarian failure during cyclophosphamide therapy in women with severe lupus en_US
dc.type Article en_US
dc.rights.robots IndexNoFollow en_US
dc.subject.hlbsecondlevel Geriatrics en_US
dc.subject.hlbtoplevel Health Sciences en_US
dc.description.peerreviewed Peer Reviewed en_US
dc.contributor.affiliationum University of Michigan Health System, Ann Arbor and London School of Hygiene and Tropical Medicine, London, UK en_US
dc.contributor.affiliationum University of Michigan Health System, Ann Arbor en_US
dc.contributor.affiliationum University of Michigan Health System, Ann Arbor en_US
dc.contributor.affiliationum University of Michigan Health System, Ann Arbor en_US
dc.contributor.affiliationum University of Michigan Health System, Ann Arbor ; 3918 Taubman Center, 1500 East Medical Center Drive, Ann Arbor, MI 48109-0358 en_US
dc.identifier.pmid 16142702 en_US
dc.description.bitstreamurl http://deepblue.lib.umich.edu/bitstream/2027.42/48676/1/21263_ftp.pdf en_US
dc.identifier.doi http://dx.doi.org/10.1002/art.21263 en_US
dc.identifier.source Arthritis & Rheumatism en_US
dc.owningcollname Interdisciplinary and Peer-Reviewed
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