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Safety of hormonal replacement therapy and oral contraceptives in systemic lupus erythematosus : A systematic review and meta-analysis

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dc.creatorRojas-Villarraga, Adriana
dc.creatorTorres-Gonzalez, July-Vianneth
dc.creatorRuíz Sternberg, Ángela María
dc.creator.googleRojas-Villarraga, A.spa
dc.creator.googleTorres-Gonzalez, J.-V.spa
dc.creator.googleRuiz-Sternberg, Á.-M.spa
dc.date.accessioned2020-04-23T18:05:15Z
dc.date.available2020-04-23T18:05:15Z
dc.date.created2014
dc.date.issued2014
dc.description.abstractBackground: There is conflicting data regarding exogenous sex hormones [oral contraceptives (OC) and hormonal replacement therapy (HRT)] exposure and different outcomes on Systemic Lupus Erythematosus (SLE). The aim of this work is to determine, through a systematic review and meta-analysis the risks associated with estrogen use for women with SLE as well as the association of estrogen with developing SLE. Methods and Findings: MEDLINE, EMBASE, SciElo, BIREME and the Cochrane library (1982 to July 2012), were databases from which were selected and reviewed (PRISMA guidelines) randomized controlled trials, cross-sectional, case-control and prospective or retrospective nonrandomized, comparative studies without language restrictions. Those were evaluated by two investigators who extracted information on study characteristics, outcomes of interest, risk of bias and summarized strength of evidence. A total of 6,879 articles were identified; 20 full-text articles were included. Thirty-two meta-analyses were developed. A significant association between HRT exposure (Random model) and an increased risk of developing SLE was found (Rate Ratio: 1.96; 95%-CI: 1.51-2.56; P-value<0.001). One of eleven meta-analyses evaluating the risk for SLE associated with OC exposure had a marginally significant result. There were no associations between HRT or OC exposure and specific outcomes of SLE. It was not always possible to Meta-analyze all the available data. There was a wide heterogeneity of SLE outcome measurements and estrogen therapy administration. Conclusion: An association between HRT exposure and SLE causality was observed. No association was found when analyzing the risk for SLE among OC users, however since women with high disease activity/Thromboses or antiphospholipid-antibodies were excluded from most of the studies, caution should be exercised in interpreting the present results. To identify risk factors that predispose healthy individuals to the development of SLE who are planning to start HRT or OC is suggested. © 2014 Rojas-Villarraga et al.eng
dc.format.mimetypeapplication/pdf
dc.identifier.doihttps://doi.org/10.1371/journal.pone.0104303
dc.identifier.issn1932-6203
dc.identifier.urihttps://repository.urosario.edu.co/handle/10336/21750
dc.language.isoengspa
dc.relation.citationIssueNo. 8
dc.relation.citationTitlePLoS ONE
dc.relation.citationVolumeVol. 9
dc.relation.ispartofPLoS ONE, ISSN: 1932-6203 Vol. 9, No. 8 (2014)spa
dc.relation.urihttps://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0104303&type=printablespa
dc.rights.accesRightsinfo:eu-repo/semantics/openAccess
dc.rights.accesoAbierto (Texto Completo)spa
dc.source.instnameinstname:Universidad del Rosario
dc.source.reponamereponame:Repositorio Institucional EdocUR
dc.subject.ddcEnfermedadesspa
dc.subject.keywordPhospholipid antibodyeng
dc.subject.keywordOral contraceptive agenteng
dc.subject.keywordCase control studyeng
dc.subject.keywordComparative studyeng
dc.subject.keywordCross-sectional studyeng
dc.subject.keywordDisease activityeng
dc.subject.keywordDisease associationeng
dc.subject.keywordDisease predispositioneng
dc.subject.keywordDrug contraindicationeng
dc.subject.keywordDrug efficacyeng
dc.subject.keywordDrug exposureeng
dc.subject.keywordDrug safetyeng
dc.subject.keywordEffect sizeeng
dc.subject.keywordEstrogen therapyeng
dc.subject.keywordEvidence based medicineeng
dc.subject.keywordHormone substitutioneng
dc.subject.keywordHumanspa
dc.subject.keywordMenopausal syndromeeng
dc.subject.keywordMeta analysiseng
dc.subject.keywordOral contraceptive useeng
dc.subject.keywordOutcome assessmenteng
dc.subject.keywordProspective studyeng
dc.subject.keywordRandomized controlled trial (topic)eng
dc.subject.keywordRetrospective studyeng
dc.subject.keywordRevieweng
dc.subject.keywordRisk assessmenteng
dc.subject.keywordRisk benefit analysiseng
dc.subject.keywordRisk factoreng
dc.subject.keywordSensitivity analysiseng
dc.subject.keywordSystematic revieweng
dc.subject.keywordSystemic lupus erythematosuseng
dc.subject.keywordThrombosiseng
dc.subject.keywordAdulteng
dc.subject.keywordChemically inducedeng
dc.subject.keywordEstrogen therapyeng
dc.subject.keywordFemaleeng
dc.subject.keywordInfertility, Femaleeng
dc.subject.keywordLupus Erythematosus, Systemiceng
dc.subject.keywordMiddle agedeng
dc.subject.keywordPathologyeng
dc.subject.keywordRiskeng
dc.subject.keywordAdulteng
dc.subject.keywordCase-Control Studieseng
dc.subject.keywordContraceptives, Oraleng
dc.subject.keywordEstrogen Replacement Therapyeng
dc.subject.keywordEstrogensspa
dc.subject.keywordHumansspa
dc.subject.keywordInfertility, Femaleeng
dc.subject.keywordMiddle Agedeng
dc.subject.keywordOdds Ratioeng
dc.subject.keywordProspective Studieseng
dc.subject.keywordRetrospective Studieseng
dc.subject.keywordRiskeng
dc.titleSafety of hormonal replacement therapy and oral contraceptives in systemic lupus erythematosus : A systematic review and meta-analysisspa
dc.typerevieweng
dc.type.hasVersioninfo:eu-repo/semantics/publishedVersion
dc.type.spaRevisiónspa
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