Premature ovarian insufficiency in patients with systemic lupus erythematosus on cyclophosphamide: a systematic review and meta-analysis - Scorecard - MDSpire
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Premature ovarian insufficiency in patients with systemic lupus erythematosus on cyclophosphamide: a systematic review and meta-analysis
Clinical Scorecard: Premature Ovarian Insufficiency Among Women with Systemic Lupus Erythematosus Treated with Cyclophosphamide: A Systematic Review and Meta-Analysis
At a Glance
Category
Detail
Condition
Key Mechanisms
Cyclophosphamide (CYC) therapy in systemic lupus erythematosus (SLE) as reported in the study.
Target Population
Care Setting
Key Highlights
Pooled prevalence of POI in SLE treated with CYC is 15% (95% CI 7-26%)
Substantial heterogeneity in prevalence estimates across studies (I2 = 85%)
Reduced prevalence of POI in studies published after 2005 (9%) compared to pre-2005 (29%)
Age at exposure is a significant predictor of POI prevalence
Guideline-Based Recommendations
Diagnosis
Standardized diagnostic criteria for POI are needed as per the study findings.
Consider both clinical surrogates and endocrinologic criteria for diagnosis.
Management
Gonadotropin-releasing hormone analogues (GnRHa) may be used as ovarian-protective co-therapy during CYC treatment as indicated in the study.
Monitoring & Follow-up
Monitor for signs of estrogen deficiency and associated health risks as discussed in the study.
Risks
Increased risks of cardiovascular disease, osteoporosis, and impaired quality of life due to estrogen deficiency as noted in the study.
Patient & Prescribing Data
Women of reproductive age diagnosed with SLE
CYC is indicated for severe, organ-threatening manifestations of SLE
Clinical Best Practices
Implement fertility counseling for women undergoing CYC treatment as suggested in the study.
Adopt lower-dose CYC regimens where appropriate as indicated in the study.
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
