Combined oral contraceptive use and the risk of systemic lupus erythematosus

The implications of autoimmunity and pregnancy

“…Several case-control studies from the USA and Finland, failed to detect significant associations [95,99,100]. In contrast, a slight increase in risk was seen in the Nurses' Health Study cohorts (USA) [101], and UK case-control studies indicated an increased risk of SLE development with past and particularly current use of combined oral contraceptives and in some cases with postmenopausal hormone replacement therapy [96,102]. Consistent with the favorable effects of pregnancy on disease activity in MS, a prospective Swedish incidence cohort study showed that the onset of MS symptoms was significantly less likely to occur during gestation compared to the periods before and after pregnancy [103].…”

Hormone replacement and contraceptive therapy in autoimmune diseases

“…A large cohort study suggested that reproductive factors associated with increased risk for SLE were early age at menarche, use of oral contraceptives, early menopause, and post-menopausal hormone replacement therapy [6]. One nested case control study and another cohort study of nurses described an increased incidence of SLE after use of exogenous estrogens, in the form of oral contraceptives and hormone replacement therapy, respectively [7,8]. Some case reports have also described induction of SLE after oral contraceptive use [9,10].…”

Recommendations for obstetric management and principles of cooperation between rheumatologists and obstetricians in systemic connective tissue disease patients

“…W badaniach The Nurses' Health Study stwierdzono zwiększone ryzyko (odds ratio -OR 1,9) rozwinięcia się TRU w grupie kobiet uprzednio przyjmujących doustną antykoncepcję hormonalną [7]. W innym badaniu porównującym 786 chorych na TRU z 7814 zdrowymi kobietami stwierdzono zwięk-szone ryzyko tocznia u kobiet stosujących doustną hormonalną antykoncepcję (RR 1,19 -dla osób kiedykolwiek stosujących, RR 1,54 -dla obecnie stosujących i RR 2,52 -dla kobiet, które dopiero zaczęły ją stosować) [8]. W innym badaniu obejmującym prawie 200 kobiet z TRU nie Tabela I. Wybór metody ochrony przed niepożądaną ciążą w grupie 97 aktywnych seksualnie chorych na toczeń rumieniowaty układowy [3] Due to an elevated risk of thrombotic complications when using hormonal contraception, it is recommended that combined preparations comprising third generation progestogens and oestrogens, and also single-component medicines with high progestogen content, be avoided [4].…”

“…In the Nurses'Health Study, an elevated risk (odds ratio -OR 1.9) of SLE development was observed in a group of females with a history of oral hormonal contraception use [7]. In a comparative study of 786 SLE patients and 7814 healthy women, an increased risk of lupus was observed in women using oral hormonal birth control methods (RR 1.19 for females who used them at any time in the past, RR 1.54 for current users, and RR 2.52 for those who had just started) [8]. Another study included nearly 200 SLE female patients, but no risk increase associated with the use of hormonal contraception was found [9].…”