Also called lupus or SLE, lupus is a chronic inflammatory disease of unknown etiology affecting skin, joints, kidneys, nervous system, serous membranes, and often other organs of the body. In this condition, a person's immune systemdefine attacks and injures the body's own organs and tissues.
Now, a new research by Canadian researchers has found that intake of combined oral contraceptives (COCs) containing estrogen and progestogen increases the risk of SLE, particularly among those who have just started using the drug.
The findings demonstrated a significant increased risk of newly diagnosed SLE associated with the first three months of use of older first- and second-generation contraceptives instead of third-generation ones.
Led by Dr. Samy Suissa of the Centre for Clinical Epidemiology at Jewish General Hospital of McGill University in Montreal, a team of researchers conducted a study of 786 women aged 18 to 45 who were diagnosed with SLE and 7,817 matched controls without the condition.
The results showed that the use of COCs was associated with a significant higher risk of newly diagnosed SLE.
"This risk is particularly elevated in women who recently started contraceptive use, suggesting an acute effect in a small subgroup of susceptible women," the study authors wrote. "Further studies on the acute effects of combined oral contraceptives will be needed to better identify the characteristics of women susceptible to developing systemic lupus erythematosus when exposed to combined oral contraceptives."
The investigators further note that a potential mechanism for the link between the use of oral contraception and lupus stems from the ability of estrogen to directly modulate the immune response, which could complete the action of some sex-linked genesdefine and contribute to the genetic predisposition of the disease.
Current users of first- and second-generation contraceptives that combined ethinyl estradiol with norethisterone, levonorgestrel, and norgestrel were at increased risk of developing lupus. Use of third-generation contraceptives that combined ethinyl estradiol with either gestodene, desogestrel, or norgestimate was not associated with increased risk of incident lupus, probably because these versions contain lower doses of estrogen.
"Our findings that longer-term use of contraceptives is associated with an increased risk of incident SLE (albeit of lower magnitude) and that current use of contraceptives with higher doses of ethinyl estradiol is associated with an increased risk of incident SLE, suggest a possible dose-response effect of estrogen on SLE onset, which could be an alternative or additional mechanism to favor occurrence of the disease," the authors said.
The findings were published in the April issue of Arthritis Care & Research.
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