Premature ovarian insufficiency in patients with systemic lupus erythematosus on cyclophosphamide: a systematic review and meta-analysis - Report - MDSpire

Premature ovarian insufficiency in patients with systemic lupus erythematosus on cyclophosphamide: a systematic review and meta-analysis

  • By

  • Manuel Ramón García-Sáenz

  • Claudia Ramírez-Rentería

  • Etual Espinosa-Cárdenas

  • Ernesto Sosa-Eroza

  • José Luis Eduardo Doval-Caballero

  • Paulo César Gete Palacios

  • Fabiola Pazos-Pérez

  • Mario César Ocampo-Torres

  • Rocío Catana-Hernández

  • Miguel Ángel Vázquez-Zaragoza

  • Adolfo Camargo-Coronel

  • Juan Rodrigo Gómez-Bernal

  • Aldo Ferreira-Hermosillo

  • May 28, 2026

  • 0 min

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Clinical Report: Premature Ovarian Insufficiency in Women with SLE Treated with CYC

Overview

This systematic review and meta-analysis estimates the prevalence of premature ovarian insufficiency (POI) in women with systemic lupus erythematosus (SLE) treated with cyclophosphamide (CYC) at approximately 15%.

Background

Premature ovarian insufficiency (POI) is a significant long-term consequence of cyclophosphamide therapy in women with systemic lupus erythematosus (SLE).

Data Highlights

MeasureValue
Pooled Prevalence of POI15% (95% CI 7-26%)
Heterogeneity (I²)85%
Prevalence Post-20059%
Prevalence Pre-200529%
Age at Exposure Predictor (β)0.21 (95% CI: 0.04-0.38)

Key Findings

  • Pooled prevalence of POI in SLE treated with CYC is approximately 15%.
  • Substantial heterogeneity in prevalence rates was observed (I² = 85%).
  • Prevalence of POI decreased in studies published after 2005 (9%) compared to those before (29%).
  • Age at exposure to CYC is a significant predictor of POI prevalence.
  • Cumulative CYC dose was not independently associated with POI prevalence.
  • No evidence of publication bias was found in the analysis.

Clinical Implications

Healthcare providers should be aware of the substantial risk of POI in women with SLE undergoing CYC treatment. Standardized diagnostic criteria and fertility counseling are essential for managing the reproductive health of these patients.

Conclusion

The findings indicate a significant burden of POI among women with SLE treated with CYC, emphasizing the need for careful monitoring and individualized treatment strategies.

Related Resources & Content

  1. Frontiers in Immunology, 2026 -- Prevalence of female sexual dysfunction among women with systemic lupus erythematosus: a systematic review and meta-analysis
  2. The Journal of Clinical Endocrinology & Metabolism, 2025 -- The Prevalence of Autoimmune Disorders is Elevated in Women Diagnosed with Primary Ovarian Insufficiency
  3. The ASCO Post, 2026 -- Meta-Analysis Explores Impact of Ovarian Function Suppression on Breast Cancer Recurrence and Survival
  4. KDIGO, 2024 -- 2024 Lupus Nephritis Guideline
  5. The ASCO Post — Pembrolizumab Plus Bevacizumab and Oral Metronomic Cyclophosphamide for Recurrent Ovarian Cancer KEY POINTS
  6. 2024 American College of Rheumatology (ACR) Guideline for the Screening, Treatment, and Management of Lupus Nephritis
  7. EULAR recommendations for the management of systemic lupus erythematosus: 2023 update
  8. Evidence-based guideline: premature ovarian insufficiency
  9. https://kdigo.org/wp-content/uploads/2024/01/KDIGO_2024_Lupus_Nephritis_Guideline.pdf
  10. 2025 American College of Rheumatology (ACR) Guideline for the Treatment of Systemic Lupus Erythematosus - PubMed
  11. Premature Ovarian Insufficiency
  12. Premature Ovarian Insufficiency
  13. Immunosuppressive therapy in lupus nephritis: the Euro-Lupus Nephritis Trial, a randomized trial of low-dose versus high-dose intravenous cyclophosphamide - PubMed
  14. Risk for sustained amenorrhea in patients with systemic lupus erythematosus receiving intermittent pulse cyclophosphamide therapy - PubMed
  15. Frontiers | Premature Ovarian Insufficiency in patients with Systemic Lupus Erythematosus on cyclophosphamide: A Systematic review & meta-analysis

Original Source(s)

Premature ovarian insufficiency in patients with systemic lupus erythematosus on cyclophosphamide: a systematic review and meta-analysis

  • by Manuel Ramón García-Sáenz, Claudia Ramírez-Rentería, Etual Espinosa-Cárdenas, Ernesto Sosa-Eroza, José Luis Eduardo Doval-Caballero, Paulo César Gete Palacios, Fabiola Pazos-Pérez, Mario César Ocampo-Torres, Rocío Catana-Hernández, Miguel Ángel Vázquez-Zaragoza, Adolfo Camargo-Coronel, Juan Rodrigo Gómez-Bernal, Aldo Ferreira-Hermosillo

  • May 28, 2026

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