A study published in the December 15, 2005 issue of the New England Journal of Medicine shows that women with inactive or stable lupus might be able to use oral contraceptives containing estrogen without triggering significant additional disease activity. “The findings are important because women represent 90 percent of the estimated 1.5 million cases of lupus in the United States,” said Sandra C. Raymond, President & CEO of the Lupus Foundation of America (LFA). “The results are welcome news as lupus develops most frequently during the childbearing years and many women with lupus can benefit from the use of oral contraceptives. “
Because lupus pregnancies are associated with higher risk, oral contraceptives offer the advantage of a planned pregnancy timed for periods of remission, improving the chances for a better outcome. Also, a reliable form of birth control is important for women with lupus who are being treated with immunosuppressive agents that may harm the fetus. Oral contraceptives also might improve bone health among women who are taking steroids for the treatment of lupus and could possibly preserve ovarian function among those patients who are taking medications that can contribute to infertility, although sufficient careful, controlled studies about these potential benefits are lacking.
The study conducted at 15 centers in the United States involved 183 women ages 18-39 with inactive or stable lupus. Women who had severe or unstable lupus, high blood pressure, a history of abnormal blood clotting, or moderate to high levels of antiphospholipid antibodies (considered a risk for blood clotting) were not eligible for the study. Half of the study participants received oral contraceptives (Ortho-Novum 7/7/7) while the other half received a placebo. Researchers measured the number of severe or mild/moderate flares over a one-year period.
Only seven of the 91 individuals who received oral contraceptives experienced a severe flare compared to seven of 92 individuals who received the placebo. The rate of mild to moderate flares also was not significantly different between the two groups. Sixty-three individuals who received oral contraceptives had mild to moderate flares compared to 55 individuals who received the placebo. In this study, the researchers found that oral contraceptives did not increase the risk of flares among women with lupus who have stable disease.
“This study provides important information to women with lupus and their physicians when making informed decisions about the appropriateness and safety of oral contraceptives,” said Raymond. “It is hoped that these kinds of studies will help to build a better quality of life for the 1.5 million Americans with the disease.”
